by Alina Kennedy, special to SportsMD.com
Iliotibial Band Syndrome (ITB Syndrome, IT Band Syndrome or ITBS) affects hundreds of thousands of runners each year. However, despite being one of the most common injuries in runners, it is still often misunderstood and poorly treated.
What is the IT Band?
The IT Band is a thick connective tissue, similar to a tendon or ligament, that runs along the side of the leg. It starts at the hip and runs all the way down to the knee. It plays a very important role in structurally supporting the leg during movement, stopping the knee from buckling in or rotating out. It also serves as an anchor for several major muscles like the glutes and quads.
What is IT Band Syndrome?
IT Band Syndrome is an injury that results from overuse and causes pain on the outside of the knee. This pain comes from irritated tissues underneath the IT Band – not the IT Band itself. It is important to be aware that the IT Band itself is not damaged. In fact, the IT Band might have little to do with the injury, despite the name.
The actual irritated structures are cysts and fatty tissues that lie directly under the IT Band, next to the knee. These structures get inflamed and painful when there is too much repetitive strain over the knee.
IT Band Syndrome usually only affects one leg – the weaker leg – because joint stress is always greater where there is less muscle support. So the best way to treat (and prevent) IT Band Syndrome is to strengthen the supporting muscles around the IT Band (particularly the glutes, hamstring and quads), and improve single leg balance and control.
The Exercises to Treat and Prevent IT Band Syndrome
Exercise 1: Hip Thrusts
(source: https://sprintrehab.com)
How to do it: Loop a resistance band above your knees and rest your head and shoulders on the edge of a bench (or couch). Your knees should be slightly wider than your hips pulling the resistance band apart. Your feet should be facing forward. Drop your hips down then squeeze your buttocks and lift your hips to create a straight line from knees to shoulders. Make sure you don’t over-arch your back. Your glutes should activate as your hips lift up.
Reps & Sets: 15 reps x 3 sets
Why is it great for IT Band Syndrome: Hip thrusts are a great exercise to engage your glutes, plus the band around your knees helps maintain proper alignment and increase resistance on the muscles.
Exercise 2: Star Balance
(source: https://sprintrehab.com)
How to do it: Balance on one leg and with the other leg tap the ground in 5 points around you – straight forward, diagonally forward, out to the side, diagonally back and straight back. Your balancing leg will be doing small squats with each tap. Your knee should stay steady and facing forward, in line with your foot. Your core should be engaged, trunk should be rigid and your pelvis should be level.
Reps & Sets: 5 reps on each leg x 3 sets
Why is it great for IT Band Syndrome: IT Band Syndrome is often a symptom of poor single leg control. This exercise is perfect for working on your balance in a motion that closely resembles running.
Exercise 3: Single Leg Wall Squats
(source: https://sprintrehab.com)
How to do it: Stand beside a wall with one knee bent and pressing into the wall. Perform a squat movement. Watch that your spine stays neutral and you are looking forward. While you squat, push your knee into the wall with as much force as possible and keep your other knee facing forward (don’t let it collapse inwards). As you squat, your weight should be on the heel of your standing leg (not your toes). You should feel your glutes fatiguing, especially in your standing leg.
Reps & Sets: 12 reps each leg x 3 sets
Why is it great for IT Band Syndrome: This exercise really targets and strengthens your glute muscles and helps you focus on your single leg control.
Exercise 4: Wall Lunges
(source: https://sprintrehab.com)
How to do it: Stand in a split stance with your back foot pressing into the wall. Drop down into a lunge while pushing your foot into the wall as hard as possible. Keep your torso upright and your spine neutral. Make sure that your knee faces forward (never collapsing inward).
Reps & Sets: 12 reps each leg x 3 sets
Why is it great for IT Band Syndrome: Any kind of lunging exercise is great for IT Band syndrome because it helps build stability and improve the control of your leg movements. I particularly like the addition of the wall press because it increases glute engagements and adds extra resistance to the lunge, which increases strengthening of the glutes.
Exercise 5: Running Man
(source: https://sprintrehab.com)
How to do it: Balance on one leg, extend your other leg back as far as you can and tap your foot on the floor. Move your leg forward and up, bending your knee. Squeeze your glutes on your balancing leg as you move your leg forward. Focus on maintaining control and balance during the power movement.
Reps & Sets: 12 reps each leg x 3 sets
Why is it great for IT Band Syndrome: As the name suggests, this exercise is perfect for runners. It also great for IT Band because it’s a more difficult version of the Star Balance exercise and it’s a great way to improve your single leg balance and stability.
Alina Kennedy is a Physiotherapist, Strength & Conditioning Specialist and avid runner with over 10 years clinical experience. She is also the founder of Sprintrehab.com, a website providing Physio rehab and strength training exercise programs for runners.
Alina graduated from the University of South Australia. After moving from her home town of Adelaide, Alina spent 4 years living in Sydney working in several sports Physiotherapy clinics. She’s now based in New York City and works exclusively with runners on all things rehab and performance.
