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What is the best way to treat IT band friction syndrome?

What is the best way to treat IT band friction syndrome?

ITB Friction Syndrome is primarily caused by the repeated friction between the iliotibial band (ITB), a thick band of connective tissue that runs along the outside of the thigh, and the lateral epicondyle of the femur (the bony protrusion on the outside of the knee). This friction can occur during activities that involve repetitive bending and extending of the knee, such as running or cycling. Other contributing factors may include muscle imbalances, weakness in the glutes and hip muscles, improper biomechanics, and overuse of the ITB due to excessive training or sudden increases in activity levels. These factors can lead to inflammation and irritation of the ITB, resulting in pain on the outside of the knee.

Although ITB pain can be debilitating, I’ve written this blog to give you some insight and a few simple steps to follow to help you address this issue effectively.

Many of you may have tried foam rolling the outside of your thigh to manage the symptoms and reduce tension. While foam rolling can be helpful, it won’t address the root cause of the problem, which can have multiple factors involved. Nonetheless, incorporating an intense period of release work can be beneficial. Focus on slow movements up and down the outside of the thigh, and try dragging the leg side to side over the roller. Spend 2-5 minutes daily on this until the pain subsides or becomes more manageable.

Improving strength is crucial in addressing ITB pain to ensure efficient lower limb mechanics and reduce overloading of the ITB. Strengthening the posterior chain, particularly the glutes and hamstrings, will almost always have a significant impact. If you haven’t done regular strength training, start with movements like Bridges, Hip Thrusts, Squats, Split Squat/Lunges, Step-ups, and Hinges/RDLs. Side planks can also help strengthen the hip abductors.

I’m always surprised how many runners neglect their strength training, especially when injuries start hindering their running ability. Just dedicating two sessions a week, 30-40 minutes each, to strength training can bring amazing benefits in managing injuries and improving overall performance.

Iliotibial Band Syndrome Exercises

  1. Glute Bridge

  1. Hip Thrust

  1. Step Up

  1. Split Squat

  1. Romanian Deadlift (RDL)

  2. Side Plank

Perform these movements 2-3 times per week, on non-consecutive days, doing 3-4 sets of 10-15 reps. Gradually add weight, about 2.5-5kg each week, if your form is solid.

You don’t have to stop running or participating in your sport entirely, but managing the load on your knee is crucial for recovery. Deloading the tissue allows it to heal and become less sensitive to stress. A good rule of thumb is to move as much as you can without aggravating the pain. For example, if you usually run 15km on Sundays and the pain starts at 10km, drop back to 8km for now. Also, if you wake up the next day with significant pain, it’s a sign that you need to reduce the loading from the previous day’s activities.

This basic program should help most people, but keep in mind that at Kinematics, we take a holistic approach and assess the body as a functioning unit. Deficiencies in stability or range of motion at the pelvis, hip, ankle, and foot could also contribute to the issue and might require specific management. If the strength program and release work mentioned above don’t completely resolve your symptoms, feel free to visit one of our therapists for further guidance to get you back on track.

By Mark Charalambous

Senior Physiotherapist