the iliotibial band (IT band) is something that people
rarely think of unless they are involved in sports of some sort.
Because it is not a muscle, it doesn't occur to people that it would
need to be stretched. The IT band provides attachment for the
gluteus maximus and tensor fascia lata for hip abduction and provides
stability to the knee. In the closed kinetic chain the action on the IT
band controls the movement of the leg toward midline
(adduction) and lateral tilting of the pelvis. This stability is needed
in running and walking. || |
Band Contents What
the IT band?
the IT band move?
is snapping hip?
is trochanteric bursitis?
is iliotibial band syndrome?
and Muscular Imbalances
How is IT band
syndrome and trochanteric bursitis treated.
How can I
prevent IT band problems?
Iliotibial band stretches
the Iliotibial Band?
The IT band is a thick band of fascia that lies over the
outside of the thigh. The deep fascia of the thigh is known as the
fascia lata. It is strong and dense and invests the muscles of the
thigh like a stocking. it is thickened along a band from the iliac
crest to the tibia and it is this part that is referred to as the
iliotibial band. The muscles tensor fascia lata and gluteus maximus
insert into the IT band and the IT band is continuous
with the lateral intermuscular septum deep to it.
does the iliotibial band move?
The iliotibial band moves forward and backward relative to the axis of
rotation of the knee and is thus prone to friction over the lateral
epicondyle on the outer aspect of the knee. There is a bursa that lies
between the ITB and the epicondyle which often becomes inflamed in
these friction syndromes.
The iliotibial band also moves over the greater trochanter of the femur
as one walks or runs. That is what you feel is the "hip bone" on the
side of your pelvis. It is here that it is also prone to friction. The
large trochanteric bursa is a cushion that lies between the iliotibial
band and the greater trochanter. This becomes inflamed when the
iliotibial band is tight. This is sometimes referred to as "snapping
hip syndrome" or "iliotibial band syndrome".
Pain and tenderness are apparent over the hip or the outside of the
knee or both. A snapping may be felt during walking or stair climbing.
in the IT band is usually the cause, but in some
athletes it may be due to tightness in the hip muscles, pulling the IT
band tight. Excessive use of the hip abductors and external
rotators can result in muscle imbalances causing ITB tightness.
Lengthening the ITB and correcting poor movement patterns and muscle
imbalances is the best method of treating ITB tightness issues.
* deep friction massage
* ice to address any inflammation
To prevent these issues it is important to incorporate a stretching
routine into your training program that addresses hip musculature and
A bursa is a sack of fluid found between moving parts of the body.
is a large bursa over the lateral aspect of your hip that is normally
asymptomatic and functions to allow the iliotibial band to glide
smoothly over the greater trochanter. Through acute trauma, cumulative
trauma, or repeated irritation from friction, the bursa can become
inflamed. Often stretching is included in treatment to address the
causes of trochanteric bursitis If you suspect you are suffering from
pain related to trochanteric bursitis it is important to see your
physical therapist for a full evaluation.
Simply stretching may not be enough and the sooner you address
problems, often the easier they are to fix.
Possible causes of trochanteric bursitis are as follows:
trauma due to a
fall, sleeping on a hard surface, surgery, or hit playing sports
- Repeated excess
friction of the ITB against the greater trochanter due to:
No apparent reason
- Muscle imbalances
- Gait problems
- Leg length
is iliotibial band
syndrome?IT band syndrome is one of the most common problems
runners. Repetitive knee flexion will create excessive friction of the
iliotibial band on the femur which can be exacerbated by running on the
same side of the road or always running the same direction around the
Other biomechanical problems can lead to IT band issues such as
- Over pronation of the
walking or running. This overpronation causes excessive rotation of the
tibia, which in turn causes excessive rotation of the femur.
- Leg length
discrepancy. A leg length
discrepancy causes a tilting of the pelvis forcing the IT band
to stretch over the prominences of the higher hip.
muscles will pull the ITB tight.
of iliotibial band syndrome and trochanteric bursitis.
Problems to be addressed with this disorder are as follows:
To get to the bottom of the source of your iliotibial band syndrome it
is prudent to be evaluated by a physical therapist. From my experience
trochanteric bursitis responds well to physical therapy when
biomechanical causes are addressed. Simply treating the
symptoms is often not enough
Ice, antiinflammatories, and ultrasound may be used by your physical
therapist. Relative rest is also advised until inflammation is under
control. Persistent inflammation results in the deposition of scar
tissue, worsening the friction and tightness.
ITB stretches at home and those assisted by your physical therapist.
the list on this page.
Overuse of some muscles, and tightening of others can result from
specific sports training or just a sedentary lifestyle and must be
addressed to prevent recurrences.
- Gait disorders
corrected through the
use of orthotics, or if there is any other underlying joint
dysfunction, this will be addressed through manual treatment by your
- Poor movement patterns
can cause excessive
pelvic motion resulting in stress on the ITB. Gait training and
feedback can assist you in correcting this if this is an issue.
can I prevent iliotibial band problems?
Here are some tips to prevent iliotibial band syndrome:
- If you are a runner
make sure you are fitted with the appropriate shoes or wear your
othotics if those have been prescribed.
your shoes in
a timely fashion. The standard is every 300-500 miles, but depending on
your wear pattern that may be different for you.
running too many
hills or stairs.
- If running on the
street, switch sides of the street regularly.
running on a track,
change directions regularly.
- Thoroughly stretch
- Avoid crossing your
legs while sitting.
- use your foam roller
on a regular basis.
- When running, don't
increase your mileage too quickly.
- Above all, if
don't run through it. Have it evaluated by a physical therapist.
Using an Exercise Ball
Using an exercise ball you can stretch the IT band as follows:
Hold this for the appropriate
- To stretch your right
iliotibial band lean your right hip against an exercise ball.
- Cross the left leg in
front of the right.
- Allow the right leg to
move out away from the exercise ball while keeping your chest up.
- Lean further into the
ball as you left your chest up and pull your head to the
out as you gently rock the pelvis back and forth and sink into the
To stretch the right IT band in standing, stand with your right side
facing a wall
or leaning on the back of a chair.
Hold this position for the appropriate
your right foot
behind your left foot and point the toes of your
right foot out about 45 degrees.
- Put your left
your left hip and while keeping your right leg
straight, push your hip in toward the wall.
common mistake made
when performing this stretch is to bend forward
at the hips or to rotate the body.
- Make sure you
upright and keep your torso perpendicular to the
|Another method of stretching the ITB
is to stand facing a chair or counter top. |
your right foot behind you and to the left of your left
foot as far as you can while remaining tall.
bending forward, lower yourself until you feel
tension in the outside of your right thigh.
and exhale, holding this stretch for the appropriate
- To stretch the
right it band lie on your left side
with your left hip and knee flexed to 90 degrees.
your right hand on your right hip to stabilize your
- Bend your right knee to 90 degrees as
your right hip stays
- Allow gravity to pull your right knee
toward the floor.
- Be sure to keep your pelvis
stable with your right hand.
- Relax and hold this
for the appropriate time.
Hold this position for the appropriate time, relax and breath.
do this stretch you must be able to comfortably sit on the floor and
already have good hip mobility. Sit with your legs crossed, right leg
on top .
- Slide the top leg
across so that your knees are touching or try and get them as close as
- Bring your feet
forward in front of your knees. (If you feel any strain in your knees
or pain in your groin then stop the stretch and straighten your knees.
You may have an underlying hip or knee problem and should seek the
advice of a physical therapist.)
- Keep your back
straight and bend your trunk toward the right foot.
a Foam Roll |
Using the foam roller helps to release adhesions, relax the muscles,
stimulate the circulation and gently stretch the ITB and surrounding
- Lie on the
right side with the foam roller beneath the
thigh toward the top of your thigh.
- Place your
left foot in front of you for balance and
support. Roll yourself slowly along the foam roller toward the knee but
don't go beyond the knee.
- Be sure to move slowly
and breath throughout.
- Do not apply so much
pressure that it is painful, and if
you get to a tense area you can hold it for 20 to 30 seconds extra at
the Stick |
Using the stick to loosen up the fascia on the lateral aspect of the
thigh is most easily done by a partner.
on your left side with left hip and knee slightly bent.
hold of your right ankle behind you with your right
- Allow gravity to pull your knee down toward
- Have your partner use the stick up and
down on your vastus
lateralis and iliotibial band for 20 to 30 strokes as tolerated.