Iliotibial Band Syndrome

What is iliotibial band syndrome?

Iliotibial band syndrome is inflammation and pain on the outer side of the knee. The iliotibial band is a layer of connective tissue on the outside of the thigh. It connects a muscle near the outer side of your hip to the outer side of your upper shin bone (tibia) in your lower leg.

Causes of  iliotibial band syndrome?

Iliotibial band syndrome happens when the iliotibial band gets irritated from rubbing over the bump of the thigh bone near the knee. This most often happens when you are running.

This problem may happen because you:

• Have a tight iliotibial band
• Have tight muscles in your hip, pelvis, or leg
• Have legs that are not the same length
• Run on sloped surfaces
• Run in shoes with a lot of wear on the outside of the heel

Symptoms of iliotibial band syndrome?

This problem causes pain on the outer side of the knee.

Diagnosis of iliotibial band syndrome?

Your healthcare provider will ask about your symptoms, review your medical history, and examine your knee.

Treatment of  iliotibial band syndrome

To reduce swelling and pain in the first day or two, your provider will probably tell you to:

• Put an ice pack, gel pack, or package of frozen vegetables, wrapped in a cloth, on the injured area every 3 to 4 hours for up to 20 minutes at a time.
• You could also do ice massage. To do this, first freeze water in a Styrofoam cup, then peel the top of the cup away to expose the ice. Hold the bottom of the cup and rub the ice over the painful area for 5 to 10 minutes. Do this several times a day while you have pain.
• Take an anti-inflammatory medicine, such as ibuprofen, or other medicine as directed by your provider. Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, do not take for more than 10 days.
• Your provider may give you an injection of a steroid medicine.

How long it takes you to recover depends on many factors, such as your age, health, and history of previous injuries. A mild injury may get better in a few weeks, but a severe injury may take several months to heal. You need to stop doing the activities that cause pain until the iliotibial band has healed. If you keep doing activities that cause pain, your symptoms will come back and it will take longer to recover.

How can I take care of myself?

• Follow your treatment plan.
• Follow your provider’s instructions for doing exercises to help you recover.
• While your knee heals, you will need to change your sport or activity to activities that don’t make your problem worse. For example, ride a bicycle instead of run.
• Contact your healthcare provider if you have new or worsening symptoms.

When can I return to my normal activities?

Everyone recovers from an injury at a different rate. Return to your activities depends on how soon your knee recovers, not by how many days or weeks it has been since your injury has occurred. In general, the longer you have symptoms before you start treatment, the longer it will take to get better. The goal is to return to your normal activities as soon as is safely possible. If you return too soon you may worsen your injury.

You may safely go back to your normal activities when:

• Your injured knee can be fully straightened and bent without pain.
• Your knee and leg are again as strong as your uninjured knee and leg.
• You can walk or jog straight ahead without limping.

How can I help prevent iliotibial band syndrome?

The best way to prevent this problem is to warm up properly and do stretching exercises before sports or other physical activity.

Physiotherepy of  iliotibial band syndrome

Iliotibial Band Syndrome Exercises

You may do all of these exercises right away.

Iliotibial band stretch, standing:

Cross your uninjured leg in front of the other leg and bend down and reach toward the inside of your back foot. Do not bend your knees. Hold this position for 15 to 30 seconds. Return to the starting position. Repeat 3 times.

Iliotibial band stretch, side-leaning:

Stand sideways near a wall with your injured side closest to the wall. Place a hand on the wall for support. Cross the leg farther from the wall over the other leg. Keep the foot closest to the wall flat on the floor. Lean your hips into the wall. Hold the stretch for 15 to 30 seconds. Repeat 3 times

Standing calf stretch:

Stand facing a wall with your hands on the wall at about eye level. Keep your injured leg back with your heel on the floor. Keep the other leg forward with the knee bent. Turn your back foot slightly inward (as if you were pigeon-toed). Slowly lean into the wall until you feel a stretch in the back of your calf. Hold the stretch for 15 to 30 seconds. Return to the starting position. Repeat 3 times. Do this exercise several times each day.

Hamstring stretch on wall:

Lie on your back with your buttocks close to a doorway. Stretch your uninjured leg straight out in front of you on the floor through the doorway. Raise your injured leg and rest it against the wall next to the door frame. Keep your leg as straight as possible. You should feel a stretch in the back of your thigh. Hold this position for 15 to 30 seconds. Repeat 3 times.

Quadriceps stretch:

Stand an arm’s length away from the wall with your injured side farthest from the wall. Facing straight ahead, brace yourself by keeping one hand against the wall. With your other hand, grasp the ankle on your injured side and pull your heel toward your buttocks. Don’t arch or twist your back. Keep your knees together. Hold this stretch for 15 to 30 seconds.

Side-lying leg lift:

Lie on your uninjured side. Tighten the front thigh muscles on your injured leg and lift that leg 8 to 10 inches away from the other leg. Keep the leg straight and lower it slowly. Do 2 sets of 15.

Knee stabilization:

Wrap a piece of elastic tubing around the ankle of your uninjured leg. Tie a knot in the other end of the tubing and close it in a door at about ankle height.

Stand facing the door on the leg without tubing and bend your knee slightly, keeping your thigh muscles tight. Stay in this position while you move the leg with the tubing straight back behind you. Do 2 sets of 15.

Turn 90 degrees so the leg without tubing is closest to the door. Move the leg with tubing away from your body. Do 2 sets of 15.
Turn 90 degrees again so your back is to the door. Move the leg with tubing straight out in front of you. Do 2 sets of 15.
Turn your body 90 degrees again so the leg with tubing is closest to the door. Move the leg with tubing across your body. Do 2 sets of 15.

Hold onto a chair if you need help balancing. This exercise can be made more challenging by standing on a firm pillow or foam mat while you move the leg with tubing.

Iliotibial band stretch, side-bending:

Cross one leg in front of the other leg and lean in the opposite direction from the front leg. Reach the arm on the side of the back leg over your head while you do this. Hold this position for 15 to 30 seconds. Return to the starting position. Repeat 3 times and then switch legs and repeat the exercise.

Clam exercise:

Lie on your uninjured side with your hips and knees bent and feet together. Slowly raise your top leg toward the ceiling while keeping your heels touching each other. Hold for 2 seconds and lower slowly. Do 2 sets of 15 repetitions.