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Apex Orthopedic Rehabilitation
IT band syndrome strengthening exercises (FIX IT FOR GOOD)
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Alright, today we're going to talk about IT band syndrome or iliotibial band syndrome. A lot of us have been stretching this structure, trying to get it longer, tugging on it, foam rolling, massaging, all these interventions to kind of help us treat this syndrome. At the end of this video, we're going to talk about our top strengthening exercises, which is going to really make the difference in long term in how you handle and you conquer this very common problem.
So who develops this problem? A lot of times we talk about it as it's not a trauma, it's like a repetitive overuse type injury, okay? Something you develop over repetitive movements, cyclists, runners, hikers, some of our ultra endurance athletes that are doing a lot of repeated movements at the knee that eventually over time creates some wearing and irritation for the IT band that goes down to the side of the knee here. So it gets that repetitive motion.
It can occur in people that are doing a lot of, like say, labor, where they're doing a lot of climbing ladders, you know, our carpenters, people that are doing a lot of that repeated motion, especially people that are holding, like, you know, working with labor and they're holding a lot of weights and equipment and such like that. Those people can be more predisposed. We always think about our recreational athletes, but you can see this in some other more intense labor environments as well. What often triggers with our athletes or maybe our labor athletes I'll call them is just an increase in the volume of work.
People that are doing longer shifts or increasing the amount of running they're doing, the intensity. They're increasing the intensity and they just don't have the strength or range of motion to catch up to that increased intensity, whether it be doing sprint workouts or speed workouts. They're increasing their frequency. They're starting to do a marathon and now they're running, instead of twice a week, they're running four times a week. Their body just hasn't quite, you know, they're not quite tolerating that. So that's where you'll see some of these conditions kind of pop up or in that population for those reasons.
So the anatomy of the iliotibial band, you have to know a little bit about where it starts. So some of the muscles that are basically, they provide the foundation around this hip area. You have the tensiofascia latae. You have the gluteus medius and also portions of the gluteus maximus. So the thing about all these muscles are kind of the foundation point and then they attach to the tendon, which is the iliotibial band, and the iliotibial band comes down the side, kind of like the side of your thigh here, kind of like in this region right here.
Extend down and they actually, at the very bottom, it splits to portions of the tibia and the kneecap, almost like a split like this, but runs up the side and then the attachment point is here. Okay, it's kind of, it's a tendon. So as these muscles contract and tighten, it affects the rotation and movements and stability of the outside of the knee. So anything we can affect here by getting these muscles stronger will affect the functioning of the iliotibial band later down here at its attachments.
So how do I know if I have an iliotibial band syndrome? One of the telltale signs is when your leg is moving, whether through the motion, flexing or extending, around 30 degrees of a bend here is where you'll get that clicking, stabbing, stinging symptoms on the very, very outside, typically right around this aspect of the collateral, the collateral femoral condyle. And in theory, the band kind of slips past there and creates this friction, okay, over the side and can irritate a lot of the structures in the area. But that repetitive movement, like we talked about with some of our cyclists or runners, can contribute to that.
So the idea is that with inadequate strength or stabilization up here, it affects the way that band moves and creates this kind of imbalance in a way that can affect the way the knee moves and creating that repetitive motion adds up over time and creating some problems. Sometimes it does appear to be the lateral or the IT band syndrome, but sometimes IT band syndrome is confused with other things. Have we ever heard or talked about refer pain? That means pain that's, you know, you're feeling pain in one location, in actuality, it's originating from another location. So we have our hip joint right here, which can refer pain down into the leg.
We can have a lateral meniscal tear or lateral or arthritis in the knee that can give you pain kind of in a general anatomical location because the band is crossing our joint line there. So sometimes there's some joint problems that can give you problems there as well. Occasionally, you'll get asked by people that have sciatica or lumbar radiculopathy or that might be coming from peer performance or disc herniation will give pain radiating down the side. So if you're doing and you're doing this self-treatment, you're trying to, you know, address the IT band, you're just not having success, you might be dealing with something else that's going on there and you may just need a little help with the right diagnosis.
So keep that in mind if you're kind of doing the exercise that we're telling you about and it's getting worse or it's just not getting better. That might be going on. The snapping and the aching and that very focal spot is classic, but it can be coming from other structures. So keep that in mind. So there are other things you can do. You can definitely do some stretching, massage, foam rolling for this area right here, the glutes and some of the musculature that attach to the band. Directly affecting the IT band is tremendously dense, thick band. It's really you cannot stretch this band manually. So keep that in mind.
But can you affect the soft tissue here, the musculature here by loosening up, doing some lacrosse ball work, foam rolling it, stretching it, that's fine. But realize that may give you a little symptom relief, but the real solution is to strengthen these structures and get them as resilient as they can and that's what's going to really make the long-term changes in how you function and how you participate. Do realize there's other things you have to consider that will complement what we're doing. One is just modifying our triggers. You know, are we running too long? Are we going too intense in our running workouts? Cycling, something at work we can modify.
Also looking at our footwear, are there something that we recently changed, a type of shoe we're using, maybe it's not the right shoe that could also impact any kind of repetitive activity. The type of surface we're running on, are we running on more of a beveled surface, a track, some of those little slight modifications that might be contributing to it is something to think about. But we have to kind of look at, as a whole person, we're going to focus on the strengthening part. So one of the exercises, I consider one of the prime exercises that you can do is this very simple side-lying straight leg raise, emphasizing some of the gluteal musculature on our hip here.
So what we want to do is we want to lie on our side. The lower leg you can bend, the key is that you want to have your trunk and your hip kind of in alignment here. So you're going to bring your leg like so, toe pointing down, you want to pretend like you're drawing your heel straight up, keeping this knee nice and straight. And as soon as you feel like you're starting to hike your hip, you want the motion to stop. So we're going to come down, kiss the floor, and back up.
If you're doing it correctly, you're going to feel like this area right here is going to start really have a good burn right here, you're going to feel like this muscle's working a great deal. The key is not to drag it in front or roll your hips back. You want your hip bones to be perpendicular. So you're looking at my trunk here, straight ahead, and you want your hip back slightly, drawing down and back up. You don't need a lot of weight to make this challenging. It's a long lever arm, it puts a lot of stress on this muscle group, but it's critical.
It's probably one of the muscle groups you see a lot of weakness in a variety of people. So you really want to see some improvement here. You don't need a lot, you can use ankle weights to make it a little harder. Let's do more of a higher repetition, you know, 10 to 15 repetitions, two or three sets. Okay, oh yep, and then back down. Okay. So the next one we're going to do is a unilateral bridge.
Some people can't do it right away, you have to do a bilateral bridge, and all that means is hands like so, or hands at your side, you want to initiate the movement by tightening toes up, pull, and make sure you're feeling through the glutes and the lower back. Little pause, and then back down. If this is pretty easy after 10 to 15 repetitions, then I would do a unilateral bridge, which is a lot more difficult. So I'm going to show you from a side view, we're working the right side. What we don't want is our pelvis as we lift up, we want to keep this pretty much level.
We want our waistline level, two bones in the front should be facing, should be level, and then back down. Okay, so all the way up, and then back down. You want to get good height, you want your thigh to be in line with your trunk as you lift up, we don't want to see a sag, a drop like that, because that will affect the rotators of the hip. That means that the right hip isn't weak if you see that little drag, a drop. Or if you can't, bend the knee a little bit if it's too much, if you're still seeing a drop, go back to the one we're doing bilateral like this. So that's a unilateral pelvic bridge.
Go to the regular double bridge if you have to until you get a little bit more strength and you get a little more confidence with it. Two or three sets, 10 to 15 repetitions. So the next one we're going to do is a unilateral bridge. Some people can't do it right away, you have to do a bilateral bridge, and all that means is hands like so, or hands at your side, you want to initiate the movement by tightening toes up, pull, and make sure you feel it through the glutes and the lower back. Little pause, and then back down.
If this is pretty easy after 10 to 15 repetitions, then I would do a unilateral bridge, which is a lot more difficult. So I'm going to show you from a side view, we're working the right side. What we don't want is our pelvis as we lift up, we want to keep this pretty much level. We want our waistline level, two bones in the front should be facing, should be level, and then back down. So all the way up, and then back down. You want to get good height, you want your thigh to be in line with your trunk as you lift up.
We don't want to see a sag, a drop like that, because that will affect the rotators of the hip. The right hip isn't weak if you see that little drag and drop. Or if you can't, bend the knee a little bit if it's too much, if you're still seeing a drop, go back to the one we're doing bilateral like this. So that's a unilateral pelvic bridge. Go to the regular double bridge if you have to until you get a little bit more strength and you get a little more confidence with it. I would say two or three sets, 10 to 15 repetitions.
The next one we're going to do is just, they'll refer to it as a clam exercise. You can lie on your side. There's different versions. You can do one in seated or lying on your side. I do like the one on your side because I kind of like to isolate out one side at a time. You could do that in sitting, but I'm going to show you the version I like. Okay, so you're going to wrap this around your knees. Okay. You're going to lie on your side like this. And you want to initiate the motion from here. So you're going to come up, pause, and then back down.
Really make sure you're not rolling backwards at all. Same idea. Just with the lift we did to the side, we're going to keep this one, probably want to tense this up a little bit more. Hands like so. I always have places people place their hands here. Rotate up, a little pause, and then back down. So rotate up, pause, and back down. You can also vary your position and you can bring a little bit more into hip flexion like this. Up like so, and then back down. And also bring it a little lower so you're hitting different aspects of the muscle belly in different positions. So you're going to bring your legs up and back down.
And you may find one position is a little harder than the other. So I would think of it as in three positions. One that's in line with your trunk. You're doing kind of a rotation one with this one. A little higher, and then at waist level. So that's your clam exercise. You can get a band like this at a local provider, one of the companies that uses TheraBand. But this is a great simple exercise. Same idea. So that's 10 to 15 repetitions. You can even institute a couple holds where you're doing a nice isometric hold at the end where you're holding it for a period. And then slowly allowing it to come back down.
Alright, listen, I hope this helps you out. It'll take a little time before you reap the benefits. But keep it up. I would say at two to four weeks you should see a change in how you're feeling. Just kind of getting that muscle to activate and follow. And hopefully you start being able to tolerate running, moving, and just feeling a little bit better. Alright, tell us how you do. Wish you luck. Subscribe and like this video if you got something from it. .
S K R Y B O T
Skrybot. 2023, Video transcriptions from YouTube
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