Ask a Physical Therapist

SteveNahsFINAL

What can a runner do to prevent or heal IT band syndrome?

“Illiotibial Band Syndrome (ITBS) most commonly occurs on the outside of the knee or just above it.  ITBS accounts for 8-10% of all running injuries and can affect  both recreational and elite runners.  IT band syndrome typically occurs after a set distance into the run – you’ll feel okay for a mile or two, but then the outside of your knee will begin to ache, progressing from a dull stiffness to a sharp or burning pain. 

Factors such as old running shoes, running on cambered roads, and tight turns on indoor tracks have all been thought of as risk factors for ITBS, but there is a lack of scientific evidence to back them up.  Recent studies have linked hip abduction and external rotation weakness with ITBS. 

While the painful area is the outside of the knee, the real problem lies further up the leg.  The best current research-approved protocol for ITBS (Fredericson Protocol) is a simple program that consists of two stretches and two strengthening exercises.  Stretches are preformed three times a day holding the stretch for 15 seconds on each side.  Strengthening exercises start with one set of 15 repetitions every day, increasing by 5 reps. Daily, building up to three sets of 30 over time.  The entire program lasts six weeks.

Stretches:

Lying rope hip stretch
Lying_rope_hip_stretch

Standing hip cross-over stretch
standing_hip_crossover_stretch

Strengthening:

Side-lying hip abduction
Lying_hip_abduction

Standing hip hike
standing_hip_hike

Your ability to return to running will be determined by your progress in hip strengthening.  In the beginning, you may need a few days to a few weeks off for the initial inflammation to calm down.  Once this irritation is gone, you may find your IT band still gets irritated after a few miles of running if you haven’t worked on your hip strength.  It may take 4-6 weeks of daily hip strength exercises to completely recover, and you may be able to continue running during this time.  You may need to keep you runs short enough as to not irritate your IT band,” Steve Nahs, PT, DPT Advanced Physical Therapy Center – Grand Blanc.    

References:

1) Gaudette, J., IT Band Syndrome Injury in Runners: Stretches, Preventive Exercises, and Research-Backed Treatments. Runners Connect 2012.

2) Fredericson, M.; Cookingham, C. L.; Chaudhari, A. M.; Dowdell, B. C.; Oestreicher, N.; Sahrmann, S. A., Hip Abductor Weakness in Distance Runners with Iliotibial Band Syndrome. Clinical Journal of Sports Medicine 2000, (10), 169-175.

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