Iliotibial Band Injury Treatment
Running is a great way to help you stay healthy, lose weight or reach your fitness goals! That is why InStride, Downtown Toronto Podiatrist and Physiotherapist, want to help educate you on running injuries. It can be frustrating when injuries set you back.
Your iliotibial (IT) band runs from your hip to your knee. This is fascia that connects from your hip to the outside of your knee. The muscle that attaches to it is the tensor fascia latae (TFL), which works with your glute muscles to provide hip stability and internal rotation of the thigh.
Symptoms
IT Band Syndrome happens when the IT band rubs against your leg bone, creating friction. This friction creates pain and inflammation. The sensation is a sharp or shearing pain on the outside of the knee.
Tests
This can be tested by the Ober’s test.
The patient is lies on their side with the injured extremity facing upwards. The knee is flexed at 90 degrees and the hip in abduction and extension, the thigh is maintained in line with the trunk. The patient is invited to adduct the thigh as far as possible. The test is positive if the patient cannot adduct farther than the examination table. A positive Ober test indicates a short / tense ilio-tibial band or tensor fasciae latae, which is frequently related to the friction syndrome.
Nobel Compression Test is also used to help diagnose this injury.
This test starts in supine posture and a knee flexion of 90 degrees. As the patient extends the knee the assessor applies pressure to the lateral femoral epicondyle. If this induces pain over the lateral femoral epicondyle near 30-40 degrees of flexion, the test is considered positive. A goniometer is used to ensure the correct angle of the knee joint
Causes
This syndrome arises when the glute medius and hip adbuction muscles are weak. The TFL overcompensates and takes over the roles of these muscles. Since the Ilitobial band is connected to the TFL, the tightness of the TFL causes tightness of the IT Band.
Running is a high impact activity, demanding a lot of energy absorption on the hips. The constant impact on the hips can weaken if not strengthened, resulting in an overuse injury. Our Chiropodist, Laura Desjardins, is an elite runner, foot specialist and kinesiologist. She has experience in running specific injuries relating to the foot and leg in her Downtown Toronto Podiatry Foot and Physiotherapy clinic.
Treatment
Initially reducing any provocative movements, such as running, and opting for cross training. The main goal in the initial stages is to help reduce inflammation, pain, reduce muscle tightness and carefully integrate strength training.
Soft tissue therapy of the TFL and muscles around the IT Band include massage, cupping, foam roller and myofascial release. With this injury, the muscles are so tight from compensation, that doing strength can sometime make the IT Band tighter. Starting with lower load strengthening such as band work, can help in the rehabilitation process.
Exercises
Side Lying Hip Abduction
Side Lying Hip Abduction is a great way to isolate the glute medius. This muscle is typically weak in runners and can contribute to many injuries of the lower extremity. The important thing about this exercise is to not bring the hip into flexion, keep the ankle in line or slightly posterior to the shoulder and slightly turn in the foot. Turning in the foot helps to get internal glute strength, which is important in the gait phases of walking and running. This can be made more difficult with a resistance band around your hips or shins.
Click on video below.
Hip Bridge with Resistance Band
Doing a glute bridge with abduction against a band helps reduce anterior pelvic tilt. That is where the back arches. Reducing that movement helps to practice proper hip control and helps to improve glute Maximus strength.
Video is in link below.
Lateral Band Walk
This is a more difficult/ functional exercise. Increased hip abduction strength helps control lower extremity alignment, which is also important for reducing foot injuries too! When performing this exercise, the foot should be slightly turned inwards. The stepping foot leads and is also pushed off from. Poor execution of this exercise is when the trailing leg pushing off. Try to keep tension on the band at all times.
Click on link below for exercise.
Side Planks and Hip Hikes
Side plank start by performing 3-5 repetitions for 10 seconds each, gradually adding more repetitions. Since ITBS can often be associated with hip abductor weakness, strengthening and stabilizing of the hip will be help. Hip hikes help to prevent the hip from dropping when walking and running.
It is evident that overuse injuries can happen in a sport like running and even walking. It is important to maintain a strengthening regimen so the body can tolerate the demands the activity places on it. At InStride, we believe prevention is the best medicine. If you have any foot pain conditions we would be happy to help treat you in our Downtown Toronto Podiatry Foot and Physiotherapy Clinic.
