ITBS – Iliotibial Band Syndrome

A common complaint for runners, cyclists and weight lifters is Iliotibial band (ITB) syndrome. ITB syndrome is one of the leading causes of lateral (outside) knee pain in runners. It occurs when the iliotibial band, the fascia (tissue) that runs down the outside of the thigh from the hip to the top of the shin, becomes tight or inflamed.

Cause of ITBS

It is really important to get to the root cause of ITBS. Normally there is an underlying weakness in the gluteal muscles which then causes the TFL and ITB to tighten so if you just stretch out the ITB/TFL without strengthening the right muscles it will keep coming back. Also, a sudden increase in mileage can be another thing which causes ITBS so be careful to slowly increase your mileage, don’t suddenly ramp it up.

How can physiotherapy/sports massage help with ITBS?

The best treatment for ITB syndrome is massage combined with certain stretches and exercises some of which are listed below.

Please be aware of your body and take advice from your GP before exercising or send an email to physio-logical for advice and guidance.

Get help

Early/Irritable Stage

Rest – it is really important to listen to your body. If it is painful to walk then it is best to rest from running, it may be that you cross train instead. Make sure you find an activity which is pain free both during and after.

Ice – apply for 10-15 minutes over the painful area to help ease the pain and inflammation (make sure you protect your skin with a damp towel).

Massage/Foam roller – massage non painful areas of ITB, focus on TFL up the top (muscle which tightens which then pulls on the ITB).

 

Stretches – ITB/TFL

Cross one leg in front of the other one and bend that knee. Keep the back leg straight. Drop your hip of the back leg to the side. To increase the stretch lift the arm of the straight leg up and over. You should feel the stretch in the outer thigh/hip of the straight leg. Hold for 30 seconds repeat, 3 times, 2 times a day

 

Early Strengthening Exercises

These are if your knee is very painful and you are struggling to walk. It is really important to start with low level exercises to activate the muscles before you try and do high level exercises. These are not functional for running but after a few days of switching the muscles back on you can progress to the more functional exercises.

All these exercises should be repeated 2 x a day but repetitions should be guided by comfort, please do not push into pain otherwise it will switch the muscles off you are trying to switch back on.

Static Quads

Sitting straight-backed, or lying down. Tighten your thigh muscle and hold for 10 seconds.

 

Inner Range Quads

Lying flat or sitting up. With the knee supported on a towel in a bent position. Pull toes up towards you, squeeze thigh and straighten the knee. Hold out straight for 10 seconds

 

Get help

 

Later Strengthening Exercises

As soon as comfortable then progress onto the next exercises, even if you can only manage 3-4 reps pain free, repeat 2 x a day.

Side Leg Raises

Lying on your side with your back against a wall Squeeze your buttocks Lift your top leg up, by sliding your heel up the wall This should be slow and controlled, so lift your leg up for a count of 3 seconds and down for 3 seconds The aim is to repeat but is should be comfortable to do

 

Mini Squats 

In standing, with feet hip width apart. Slowly bend at your hips until your knees are at about 45 degrees. Tighten leg muscles as you push up.

 

Single leg Dip

Stand on the flat ground Lift you right foot off the floor, bend your left knee, sinking down through your hips, and keeping your knee in line with second toe The key is to keep good control, it should be comfortable, do as many as you can.

 

It you are suffering from ITBS or any other running injuries then we can help you get to the root cause and ease your symptoms using hands on treatments to release the tight muscles. We also work together with you giving you the right rehabilitation exercises to do and progress through to get you back to achieving your running goals.

To book an appointment call us on 07835 712306, book online or email enquiries@physio-logical.net.

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