Iliotibial Band Syndrome
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1 Iliotibial Band Syndrome Definition and Home Stretches Edited by Dr. Ryan Lambert-Bellacov
2 Iliotibial Band: Definition The iliotibial band (ITB) is a dense fibrous band running from the lateral pelvis to the lateral tibial condyle (Gerdy s Tubercle). The ITB receives contributions from the gluteus maximus and the tensor fascia lata muscles. The action of the ITB and its associated muscles is to flex, abduct, and medially rotate the hip. In addition, the ITB contributes to lateral knee stabilization. During knee extension the ITB moves anterior, while knee flexion moves the ITB posterior.
3 ITB Syndrome: Definition ITB Syndrome is an overuse condition of the distal ITB near the lateral femoral condyle and at Gerdy s tubercle. Irritation and inflammation occurs due to the band rubbing over the lateral femoral condyle. The bursa underlying the ITB is also prone to swelling due to friction.
4 ITB Syndrome: Etiology ITB syndrome is most common in athletes ie. long distance runners, cyclists, and gymnasts. Males and females are equally affected, with those between the ages of being most prevalent. The most vulnerable range of knee flexion for this condition is at degrees; this is where the ITB crosses the lateral femoral condyle. Most commonly unilateral, yet activities that stress both lower extremities simultaneously such as horseback riding or skiing may predispose one to bilateral ITB syndrome.
5 Potential Causes Leg length asymmetry Over/under pronation Genu varum/valgum Anatomically thicker and/or wider ITB Weak or imbalanced gluteal, hamstring and quadriceps muscles. Tight ITB Poor shock absorption Running on hills and hard surfaces Over training Knee instability Improperly adjusted bicycle seat or pedals reavoices.com /betterpath/i mages/supers tock_1431r- 214silhouetteof-a-manrunningposters.jpg
6 Clinical Signs and Symptoms Lateral knee pain that has increased over the past days or weeks. Increased pain with downhill running. Pain occurring during knee extension, just prior to heel strike. Snapping or squeaking in knee during running and walking. May be associated with Patellofemoral Pain Syndrome.
7 Home exercises: Rationale and Goals Stretching the tight ITB will lengthen the muscles and fascia surrounding it, thus decreasing irritation over areas of friction; It will also release myofascial adhesions. Proper stretching can lead to more appropriate biomechanics. Home stretching is an integral portion of ITB syndrome treatment as it helps to maintain long term muscle balance. Having the patient be active in their treatment will result in a better prognosis.
8 Stretch #1 Place affected side down onto 6 inch firm foam roller. Use arms and top leg to support weight. Roll from hip to just above knee and back. Time: min/leg Times per day: Times per week:
9 Stretch #2 Cross affected leg behind other leg. Place opposite hand on hip to stabilize and lean away from affected leg. Reach arm overhead. Hold: seconds Sets: Times per day: Times per week: * Use wall or table for balance if needed
10 Stretch #3 Step 1 Bend and cross affected leg over other leg. Hold affected knee with opposite hand or elbow. Twist upper body toward affected leg. Step 2 Hold: seconds Sets: Times per day: Times per week:
11 Stretch #4 While seated, cross affected ankle onto opposite knee. Lean forward. Feel stretch in buttock. Hold: seconds Sets: Times per day: Times per week:
12 Gluteal Strengthening Exercise Lay on unaffected side. Raise top leg 45 degrees with toes pointing toward the ceiling then lower. Keep leg straight and in line with body. Repetitions: per leg Sets: Times per day: Times per week:
13 References Carnes, M. & Vizniak, N. (2009). Quick Reference Evidence-Based Conditions Manual: 3 rd Edition. Professional Health Systems Inc., Canada, pg Kendall, F. P. et al. (2005). Muscles: Testing and Function with Posture and Pain: Fifth Edition. Lippincott Williams and Wilkins, Baltimore, MD, pg Liebenson, C. (2007). Rehabilitation of the Spine: A Practitioner s Manual (2 nd Edition). Lippincott Williams and Wilkins, Baltimore, MD Prentice, W. E. (2006). Arnheim s Principles of Athletic Training: A Competency- Based Approach (12 th Edition). McGraw-Hill, New York, NY, pg Souza, T. A. (2009). Differential Diagnosis and Management For The Chiropractor: 4 th Edition. Jones and Bartlett Publishers, Canada, pg Emedicine.com: Iliotibital Band Syndrome (
The Iliotibial band syndrome (ITB) is commonly called "runner's knee" and is an inflammatory process in the iliotibial area which is the last section
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