Iliotibial Band Syndrome (IT Band Syndrome) Exercises - Knee pain condition

In the previous blog post we discussed what Iliotibial Band (IT Band) Syndrome is and some of the soft tissue problems associated with this condition.  In this current post, we'll discuss exercises that can help address muscular imbalances and relieve knee pain.


Massaging and Stretching


Massage prior to stretching to allow for greater range of motion


Massaging and stretching targets soft tissue flexibility and joint mobility.  Tools such as a foam roller, massage stick, massage ball, or massage gun are helpful to loosen “muscle knots," which are stiff and sensitive areas in a muscle that can appear as a bump or a thickened band.  We often recommend clients to massage prior to stretching as it allows for further stretch in the soft tissue and greater joint range in movement.


Massage for ~1-2 min and stretch 30 secs x 3 (Figure 1 & 2) for the following muscle groups:

  • Tensor Fasciae Latae (TFL)
  • Gluteus maximus
  • Quadriceps
  • Hip adductors
Figure 1. Areas to massage

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Figure 2. Areas to stretch

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Strengthening


The IT Band can tighten up as a compensatory mechanism


The IT Band is connected to the gluteus maximus and TFL and can tighten up as a compensatory mechanism to provide hip and knee stability if these muscles are weak.  Over time and with repetitive activity (eg.) running), knee pain occurs where the IT Band connects to the knee joint.  To directly address the cause, the gluteus maximus and TFL need to be strengthened.


1) Side plank from the knees (TFL, gluteus medius and gluteus minimus)

  • Lie on your side while resting on your forearm (keep shoulder blades squeezed together)
  • Bend the knees to 90 degrees and straighten the hips by squeezing your glutes
  • Push the outer edge of your knee against the ground to lift your hip off the ground
  • Hold for 10 seconds X 10 reps


2) Clamshell (gluteus maximus, piriformis)


Lie on your side with your hips and knees bent

  • Keep the ankles in contact with one another, then rotate your knee upwards and slowly release
  • 3 X15 reps
Figure 3. Clamshell

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Other biomechanical impairments can occur in association with IT Band Syndrome


Other biomechanical impairments can occur in association with IT Band syndrome; often a stiff ankle joint or altered lumbar spine and pelvic position can be observed.  If your IT Band pain does not resolve with strengthening of your gluteus muscles and TFL, then try strengthening the following areas.


1) Ankle inward tilt (tibialis posterior, inner calf)

  • Loop a resistance band around your forefoot with the other end anchored down
  • Draw a semi-circle with your foot pulling and then releasing the band
  • 3 X 5 reps
Figure 4. Ankle Inversion

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2) Bear crawl holds (abdominals, quads)

  • Start in a table top position on your hands and knees
  • Draw in your abdominal muscles so that your low back area flattens
  • Lift your knees off the ground
  • Hold for 10 seconds X10 reps
Figure 5. Bear Crawl Hold

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Coordination and Balance


Coordination and balance are important for day-to-day activities as well as sports


Reacting to rotational forces and controlling shift in body weight is essential for day-to-day activities such as walking up and down the stairs, and is especially important for sports such as running or playing soccer.  It requires coordinated activation and inhibition of opposing muscle groups to keep your body balanced against gravity or other external forces. With IT Band syndrome, there can be altered knee, hip and sometimes ankle joint positioning so improving joint stability will be beneficial, especially in seeing long term benefits.

1) Pallof press

  • Hold onto a resistance band anchored 90 degrees to where you are facing
  • Stand on one leg (slight bend in the knee and hip)
  • Push and pull the resistance band away and towards your chest
  • Turn around (resistance band will be anchored in the opposite direction) and perform the same exercise on the other side
  • Keep your hip, knee and ankle joint lined on top of one another (kneecap pointed straight ahead)
  • 2 X 15 reps on each side
Figure 6. Pallof Press

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2) Clockwork

  • Stand on one leg with hip and knee bent
  • With the opposite leg, stretch and reach as far as controllable to touch digits 1 through 12 (like in an analog clock) with your toes
  • Don’t transfer the weight
  • 3 sets (one set is equal to touching digits 1 to 12)
Figure 7. Clockwork

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These are some simple exercises which may help a person with a typical presentation of IT Band syndrome.  Depending on a person’s individual body structure, their impairments and the requirements of their painful activity, the exercises above may not be suitable enough. If you’ve been having persistent knee pain, Come in to see one of our experienced physiotherapists for an assessment and customized exercise treatment plan at our Vancouver location. We look forward to meeting you!



With care,

Therapy X Collective

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