Stretching 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.
the IT band?
How does the IT band move?
What is snapping hip?
What is trochanteric bursitis?
What is iliotibial band syndrome?
ITB Syndrome and Muscular Imbalances
How is IT band syndrome and trochanteric bursitis treated.
How can I prevent IT band problems?
Iliotibial band stretches
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.
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.
Tightness 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 ITB.
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:
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
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
Here are some tips to prevent iliotibial band syndrome:
Using an Exercise Ball
Using an exercise ball you can stretch the IT band as follows:
Hold this for the appropriate
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 time.
Another method of stretching the ITB
is to stand facing a chair or counter top.
Hold this position for the appropriate time, relax and breath.
a Foam Roll
Using the foam roller helps to release adhesions, relax the muscles, stimulate the circulation and gently stretch the ITB and surrounding musculature.
Using the stick to loosen up the fascia on the lateral aspect of the thigh is most easily done by a partner.
If you suffer from iliotibial band syndrome it may be because of
underlying weaknesses in your core and/or hip musculature. Stretches
are necessary, but you should also be evaluated by a physical therapist
to determine if there is an underlying imbalance.
A study published in the Clinical Journal of Sports Medicine looked at 24 randomly selected long distance runners with IT band syndrome compared to 30 asymptomatic long distance runners.(1) It was found that those with ITBS had statistically significantly weaker hip abductor strength on the affected side when compared to the unaffected side and those of the uninjured runners. They also found that after a 6 week program of strengthening 22 of the 24 athletes were painfree and there was no report of recurrences 6 months later.
A prospective study of the biomechanical forces on the IT band in individuals with iliotibial band syndrome found that those suffering from the disorder exhibited abnormal hip and knee motion.(2) Excessive hip adduction and knee internal rotation during running and bicycling causes compression of the IT band against the lateral femoral condyle of the knee. This group of researchers also recommend treatment that includes controlling these movements through stretching, strengthening, and reeducation.
Fredericson MD, CL Cookingham
MS, PT, AM Chaudhari MS, BC Dowdell MD, N Oestreicher BS, SA Sahrmann
PhD, PT. Hip Abductor Weakness in Distance Runners with Iliotibial Band
Syndrome. Clinical Journal of Sport Medicine: July 2000 - Volume 10 -
Issue 3 - pp 169-175
2. B Noehrena, I Davisa, J Hamill. Prospective study of the biomechanical factors associated with iliotibial band syndrome. Clinical Biomechanics Volume 22, Issue 9, November 2007, Pages 951-956 .