Benchmark Runners

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Prevention and Treatment of the Iliotibial Band

Thanks for listening to my brief talk on lliotbial Band Friction Syndrome last Saturday. As your training distances increase, your risk of developing Iliotibial Band Syndrome increases. Iliotibial Band Syndrome (or IT Band Syndrome) is a condition that is commonly seen in runners. The chief symptom is pain on the lateral aspect of the knee joint (see anatomy below) and the onset is usually after the athlete increases their distance, starts hills, runs on a surface with significant camber (slanted) or a change in shoe wear.

Runners with excessive knee hyperextension, knee varus (bow-legged) or valgus (knocked-knees) are predisposed to IT Band Syndrome. This condition is also present in runners with hard heel strike patterns.

Recommendations:

Follow the prescribed training program from your coaches. Increasing distance or speed too quickly can lead to this problem.
Stretching: make sure you are warmed up before stretching. When you start to experience IT band problems, take extra time to stretch after a run. See below for descriptions of the stretches we discussed last Saturday.
Strengthening: weak gluteals can promote compensatory patterns that cause IT band problems.
Technique: try to avoid a long stride when you run, a standard cadence (the RPM for your legs) is 90 foot strike on one side per minute. This should shorten and soften your stride. Run “lightly”. Think quick, light steps to decrease the ground reaction forces to your lower extremities. Some runners benefit from video gait analysis to improve their running technique. Find a coach or PT that is trained in running analysis.

If you have symptoms that sound like an IT Band problem, I recommend backing off of your training by 25% and avoiding hills and any surface with camber (tilting of the pavement so one foot is higher than the other). Increase your stretching to 3x/day.

If the symptoms are severe, I recommend icing 15-20 minutes. Resting for 1-2 weeks and stretching. If you are getting close to your event, therapy can be helpful in speeding up the healing process utilizing manual techniques (see /treatment/services/astym/) and modalities, providing possible shoe modifications and customizing your stretching and strengthening program.

Please feel free to contact me if you have any questions.

Keep On Running!

Rob Barnes, PT, DPT, Board Certified Orthopaedic Clinical Specialist, TAI Boise Physical Therapy

Piriformis Stretch	Tensor Stretch	Hip Flexor Stretch	Quadriceps Stretch	Hamstring Stretch
Cross legs, right on top. Gently pull other knee toward chest until stretch is felt in buttock/hip of top leg. Rock hip bones forward. Put foot against wall for increased stretch. Hold 30 seconds.	Cross left leg over the other, then lean to same side until stretch is felt on other hip. Tuck hips under. Slightly bend back(right) leg until stretch is felt. Hold 30 seconds.	Kneeling on right knee, slowly push pelvis down while slightly arching back until stretch is felt on front of hip.	Pull right heel toward buttock until stretch is felt in front of thigh.	Supporting right thigh behind knee, slowly straighten knee until stretch is felt in back of thigh.