In this article we will discuss how to treat it band syndrome with physical therapy. If you need treatment because you feel pain in IT band syndrome, we make an online appointment to diagnose and treat you with physical therapy, and always adapting to your schedule.
What is iliotibial band syndrome?
The iliotibial band syndrome or commonly called runner’s syndrome is an injury in which the iliotibial band muscle is inflamed due to repetitive rubbing against the knee bones, causing a shooting pain or burning sensation on the outer side of the knee for example while we run. It is a very frequent injury in runners, whether they are new due to inadequate physical shape and footwear, or advanced runners due to the over-training to which they are exposed.
What to do in case of inflammation of the iliotibial band muscle?
To calm down the inflammation a little, applying cold with ice can help you, always through a towel and not exceeding 10 minutes. A good idea is to freeze a small bottle of water and use it to massage the painful area, thus combining the effect of the massage with the effect of the cold.
In addition, relative rest should be kept until the assessment and diagnosis of a physiotherapist, thus avoiding sports or domestic activities that cause pain.
This inflammation of the tendon can be caused by
Prior to this rubbing (which always exists during movement to a greater or lesser extent) there is inflammation of the tendon and the sheath that covers it (protective function). This increases the pressure on the condyle of the femur, establishing a state of congestion in the affected area.
Anatomical factors :
- Excessive pronation of the foot.
- Internal rotation of the tibia with respect to the femur.
- Genu varus / knee valgus / recorvatum.
- MMII length asymmetry / postero / anterior musculature asymmetry.
- Muscle flexibility / hypertonia / hypotonia.
- Excessive epicondyle prominence (prominent part of the femur).
- Worn footwear, with inappropriate insoles for our footprint, foot morphology are some of the elements to take into account.
- Running in the same direction in track and road training.
- Training on slopes (up or down).
Old injuries/traumas :
- Fiber breaks in the hamstring and femoral muscles.
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Symptoms of it band syndrome
1- Pain on the outside of the knee
The pain appears on the outside of the knee and sometimes a burning sensation may appear
Pain is exacerbated on palpation on the outside of the knee just above the joint line
3- Pain worsens with activity
Pain worsens with activity, pain gradually increasing with activity as a dull ache. Initially, the pain may appear shortly after starting the activity, but each time it will appear earlier to the point of being able to hurt when climbing stairs or walking.
How can treat it band syndrome with physical therapy?
Physiotherapy treatment will focus on the recovery of damaged tissue and progressively readapt the patient to the activities he performs. It is essential to carry out an exercise program that can help the patient to prevent future relapses. These exercises are related to improvements in lower extremity motor control, increased strength and resistance of weakened muscles that may be related to the problem, to improvements in the runner’s biomechanics with specific running technique exercises for each one.
It band syndrome physical therapy
Physiotherapy treatment consists of restoring the tone of the affected muscles through techniques such as massage or other myofascial techniques, as well as strengthening and preparing the muscles in the area. A good diagnosis and subsequent treatment will have a good prognosis in almost all cases, in most cases not exceeding three weeks of rehabilitation.
It is important to rest in the acute phase of the injury to reduce pain and prevent the band from continuing to swell due to activity.
Application of cold and heat
The application of cold in the area of pain (outer part of the knee) is indicated in the acute phase to control inflammation and reduce pain. Once the pain is controlled and the acute phase has passed, heat can be applied to the muscles involved (tensor fascia lata) to relax them.
Self-massages are indicated to relax the muscles involved using a ball or a foam roller. It is very important that the treatment is combined with different types of exercises. In addition massage of it band syndrome under physical therapy supervisor.
First of all, it is important to perform a stretch of the tensor fascia lata to normalize the tension: you must leave the injured leg behind the healthy one, with the knee straight, and push your pelvis to that same side until you feel tension in the area from the hip Hold the position for 20 seconds, slowly return to the starting position, and repeat again.
To continue, it is important that you strengthen the muscles that help stabilize the hip during the race.
Physical therapy exercises
An example of exercises that you can perform daily would be the following:
1. Pigeon pose
The ‘dove’ comes from yoga and effectively opens the hips.
- To get into the pigeon, stretch your left leg out behind you and bend your right leg in front of your body.
- The hands are on the ground.
- Try to push your left hip forward and down so you get a stretch there.
- Hold for 30-60sec, then switch sides!
2. Steffi Special
I gave the exercise this name because I haven’t found it anywhere yet. It came about because I wanted to increase the pull over the hips.
- This is done by tilting and turning slightly.
- Feet hip-width apart.
- Your legs straight.
- Pull your hands toward the floor.
- Then bend the left knee (-> oblique position) and bring the hands to the left foot (-> rotation).
- You should now feel a strong pull on your right hip.
- Hold for 30-60 seconds, then change sides!
- Lie on your side and bend your knees 45 degrees .
- A fitness band can be placed just above the knees to intensify the exercise.
- The upper leg lies exactly on top of the lower one, the feet are together and in line with the axis of the body.Place your lower arm under your head for more stability.
- Raise your top knee as high as you can without moving the rest of your body.
- Feet stay together!
- Lower the knee again
- Repeat the exercise 5-10 times
- Then switch sides!
The aim of the exercise is to strengthen the gluteal muscles.
4. Leg back raises on the floor
- Lie on your side
- The legs are slightly bent and exactly on top of each other.
- Support your upper arm in front of your body to stabilize yourself.
- Raise the top leg.
- Then pull your leg back a little without rotating your hips.
- The upper body remains still and straight!
- Then push the leg forward again and lower it.
- Repeat the exercise 10-15 times, then change sides!
5. Lateral rolling on the fascia roller
- IT strap massage is very painful for many of us.
- To regulate the pressure on the band, you can support yourself with your upper leg in front of your body.
- Then, lying sideways on the foam roller, roll from your thighs almost to your knees.
- Advanced users put both legs on top of each other. Roll 6-8 times, then pause.
- Repeat if necessary.
- Always roll the unaffected leg as well!
6. The bridge:
- Lying on your back.
- Your knees bent and the soles of your feet resting at the width of your hips.
- Raise the pelvis by pulling the pubis towards the navel until it rests on the shoulders and feet.
- Repeat 10 times
7. Separation of the affected leg:
- Standing with the legs stretched out, we resist the separation with an elastic band.
- If you do not have an elastic band, it can also be done lying on your side on the healthy side with your legs straight.
- Then raising and lowering the affected leg.
- Repeat 10 times with each leg.
If you notice pain in the area of ilitibial band, don’t wait for it to be unbearable and the injury takes you weeks away from practicing your sport.
What type of physical therapist do I need for it?
As previously mentioned, the iliotibial band syndrome is an injury that, if treated wth physical therapy in its initial phases, usually responds very well, but if time is allowed to pass, the clinical picture worsens and it is difficult to treat with conservative treatment.
Therefore, if we suspect that we may have this injury, it is advisable to consult with expert physiotherapists who will evaluate the case and carry out the corresponding treatment.
This treatment, although it is usually specific in each case, in the first phase, it focuses on relieving pain and reducing inflammation . In the second phase, look for the cause of the injury, be it a biomechanical alteration, high-load training, etc.
Finally, the strengthening and functional re-education exercises are carried out so that the muscles act correctly during the race. In addition, the physiotherapists will provide you with the guidelines to follow and the lifestyle habits to change to avoid future recurrences.
- Techniques to relieve and control pain
- Anti-inflammatory techniques
- Techniques to relax the muscles
- Fascial release techniques
- Intratissue Percutaneous Electrolysis (EPI)
- Proprioceptive reeducation exercises
- Deep transverse massage
- Strengthening exercises
It band syndrome physical therapy: what is recommended to be avoided
If there is a suspicion that we may have this injury, it is recommended to avoid movements that involve knee flexion extensions such as running, riding a bicycle, or repeatedly bending and getting up.
Activities that aggravate the pain:
It is important to avoid movements that cause pain, as these movements can help increase the inflammation of the bracelet.
This injury usually appears due to an overload of training, so it is necessary if you start noticing the above symptoms to regulate your training load.
Can it band syndrome be prevented with physical therapy?
If you are going to start a new sport or a new activity, the most important thing is to prepare your body for it. The progression in training and physical conditioning are the two basic pillars to avoid injuries. If you notice pain in the area, don’t wait for it to be unbearable and the injury takes you weeks away from practicing your sport.
If you need treatment or diagnosis because you feel pain and you think it may be an IT band syndrome, remember that we come to your home to diagnose and treat you, and always adapting to your schedule.