ILIOTIBIAL BAND SYNDROME

Iliotibial band syndrome is swelling, irritation, and pain on the outer side of the knee. The iliotibial band is a layer of tissue on the outside of the thigh. It connects a muscle in your hip to the shinbone in your lower leg.

WHAT IS THE CAUSE?

The iliotibial band can get irritated from rubbing over the end of the thighbone near the knee. This happens most often from running or cycling.

This problem may happen because you:

Have a tight iliotibial band
Have tight muscles in your hip 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
WHAT ARE THE SYMPTOMS?

The main symptom is pain on the outer side of the knee.

HOW IS IT DIAGNOSED?

Your healthcare provider will examine you and ask about your symptoms, activities, and medical history.

HOW IS IT TREATED?

The pain from iliotibial band syndrome usually goes away in a few weeks with self-care. Your healthcare provider may recommend stretching and exercises to help you recover. You may be instructed to do self massage with a foam roller. Your provider may refer you to physical therapy. In some cases, your provider may give you a shot of steroid medicine.

If rest, physical therapy, and self-care don’t relieve your symptoms after 6 months, your healthcare provider may suggest surgery.

HOW CAN I TAKE CARE OF MYSELF?

You may need to change or stop doing the activities that cause pain until the iliotibial band has healed.

To help relieve pain:

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.
Do ice massage. To do this, 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, you should not take this medicine for more than 10 days.
Special shoes or shoe inserts may help. Talk to your healthcare provider about this.

Follow your healthcare provider's instructions. Ask your provider:

How long it will take to recover
What activities you should avoid and when you can return to your normal activities
How to take care of yourself at home
What symptoms or problems you should watch for and what to do if you have them
Make sure you know when you should come back for a checkup.

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 activities.

EXERCISES

Beginwith strectches then move to strengthening

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.
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.
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 at 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 (20 to 25 centimeters) 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 (your injured leg) and bend your knee slightly, keeping your thigh muscles tight. Stay in this position while you move the leg with the tubing (the uninjured leg) 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.

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.
Prone hip extension: Lie on your stomach with your legs straight out behind you. Fold your arms under your head and rest your head on your arms. Draw your belly button in towards your spine and tighten your abdominal muscles. Tighten the buttocks and thigh muscles of the leg on your injured side and lift the leg off the floor about 8 inches. Keep your leg straight. Hold for 5 seconds. Then lower your leg and relax. Do 2 sets of 15.

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