ITB Stretches - 7 Best Iliotibial Band Stretching Exercises | Pain Care

ITB Stretches – 7 Best Iliotibial Band Stretching Exercises

The iliotibial band is also called iliotibial tract, maissiat’s band, or IT band (ITB). It is a long fibrous sheath that extends from the fascia lata, the deep fascia enclosing the thigh muscles.

The IT band from its name “ilio-tibial” originates from the anterolateral iliac tubercle of the iliac crest and inserts into the Gerdy’s tubercle at the lateral condyle of the tibia.

The gluteus maximus muscle and the tensor fascia lata are two muscles that insert upon the tract.

The IT band, together with the muscles associated with it, helps to extend, abduct and laterally rotate the hip joint. Additionally, it stabilizes the knee when it is extended and partially flexed.

Therefore, the IT band serves to provide active support to the knee against gravity when a person flexes the knee and leans forward.

The band is, therefore, essential in major hip and knee movements such as running, squatting, bicycling and walking.

These major functions of the IT band necessitate frequent stretches to keep it strong and flexible enough to perform these active movements.

Inadequate or absence of IT stretches would predispose to a constellation of symptoms which characterize the Iliotibial band syndrome.

Iliotibial Tract Syndrome

Also called Iliotibial band friction syndrome, IT band syndrome is an injury to the IT band resulting from overuse and inflexibility of the tract.

IT syndrome usually occurs while running, cycling, or hiking which are the activities in which the band is repetitively compressed on the lateral aspect of the knee. Iliotibial band syndrome is the commonest cause of lateral knee pain in runners and cyclists.

Other risk factors for IT syndrome include lack of proper warm up before exercises, a sudden increase in the intensity of exercises or movements involving the hip and knee, bow-leggedness, and discrepancies in length of both legs.

Symptoms of IT syndrome include pain in and swelling of the lateral aspect or outside area of the knee occurring during exercises and movements such as running downhill, and difficulty making such movements.

Iliotibial Band Stretches (ITB Stretches)

If the IT band shortens or tightens from inflexibility, it may affect the movement of the knee and hip joints causing pain. In this situation, activities such as running, walking, and cycling become severely painful.

Additionally, tightening of the IT band may also irritate a bursa called the trochanteric bursa between the band and the bone beneath it, making it inflamed and causing pain, swelling, and tenderness around the outside aspect of the hip joint. This condition is called trochanteric bursitis.

These are the reasons performing routine iliotibial stretch exercises is essential.

The IT stretch exercises are divided into three categories based for descriptive purposes: The standing ITB stretch, the lying down stretches, and the assisted stretches.

The following are the methods of IT stretches.

Standing ITB stretch

This method includes the basic ITB stretch and the wall ITB stretch

  1. Basic Iliotibial band stretch

Basic Standing ITB Stretches

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This method is performed in the following steps:

  • Stand upright and place your right leg crossed behind your left
  • Lean forwards gently to your left side till you feel the band at the outside aspect of your right leg stretch.
  • Place your hands on your head while leaning forwards. Doing this increases the intensity of the stretch.
  • Hold this position for about 30 seconds
  • Repeat the steps three times for one session
  • Repeat the steps for the other leg
  • Perform one or two sessions for each leg twice daily or before and after you commence your exercise routine.

 

  1. Wall Iliotibial Stretch

 

Wall ITB Stretches

You may perform this method of ITB stretch in the following steps;

  • Stand upright and cross your right leg behind your left. Although similar to the basic ITB stretch, but the right leg is placed further behind the left.
  • Lean to your left side gently and simultaneously glide your hips gently to the right till you feel a stretch of the IT band.
  • Place your hands on your head or lean on a wall. Doing this increases the stretch of the IT band.
  • Maintain this position for 30 seconds
  • Repeat this process three times in one session
  • Repeat this process for the other leg
  • Perform two sessions daily for each leg or before and after your routine exercise.

People have admitted that the wall ITB stretch gave them more balance and control than the basic method.

ITB Stretched Lying Down

Examples of stretches under this category include the side lying ITB stretch, belt IT band stretch, the gluteal stretch, and the tensor fascia lata stretch.

  1. Side Lying IT band stretch

Side Lying IT band stretch

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This method is performed in the following steps;

  • Lie on the edge of a bed or table with the left side of your body
  • Keep the leg at the bottom (left) bent
  • Move the leg on top (right) backwards such that it hangs over the edge of the bed.
  • Gently allow the right leg drop further down to further stretch the IT band
  • Hold this position for about 30 seconds
  • Repeat the process three times in a session
  • Repeat the process for the other foot.
  • Perform one or two sessions for each foot daily or before and after your routine exercises.

 

  1. Belt IT band Stretch

ILIOTIBIAL BAND STRETCH WITH BELT

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This method is performed in the following steps;

  • Lie on your back and loop a belt around your right foot
  • Raise the right leg straight up over your body till your feel a stretch where the IT band is.
  • Turn your foot inwards to increase the stretch of the IT band.
  • Avoid letting your hips be raised up or twisted to one side. Keep your hips down.
  • Hold this position for 30 seconds
  • Repeat the process three times in a session.
  • Repeat the process for the other foot.
  • Perform one or two sessions for each foot daily

 

  1. Tensor Fascia Lata Stretch

Stretching the tensor fascia lata muscle strengthens it and prevents it from being injured from overuse.

The tensor fascia lata muscle is found on the outside aspect of the hip where, together with the gluteus medius and gluteus minimus muscles, it helps to abduct and rotate the thigh inwardly.

How is the tensor fascia late related to the iliotibial band? The muscle inserts into the band making the band seem like a tendon extending from the muscle and inserting into the knee.

Technically, the tensor fascia lata stretch is not a lying-down IT band stretch exercise, but it is performed almost similar to the lying down IT band stretch techniques.

This muscle is stretched in the following steps;

  • Sit on the floor with one leg outstretched while the other one is bent.
  • The bent leg is the one to be stretched
  • Place the foot of the bent leg on the outside of the other knee
  • Apply pressure on the bent knee as if trying to force it across the other one till a stretch on the outside of the thigh of the bent leg is felt.
  • Maintain this position for 30 seconds, then relax
  • Repeat the process three times per session
  • Repeat the process for the other leg
  • Perform this twice daily for each leg.

 

  1. Gluteal stretch

This stretch exercise aims at strengthening the gluteal muscles, especially the gluteus maximus.

Gluteal Exercises to Stretch Muscles

It is done in the following steps;

  • Lie on your back with one leg flat on the floor and the other leg raised and bent such that the knee almost touches your chest
  • Pull the bent leg across your body until you feel a strong stretch in your buttocks and outside area of your hip.
  • Hold this position for 30 seconds
  • Repeat the process three times in a session
  • Repeat the process for the other leg
  • Perform one to two sessions per leg daily

Assisted Iliotibial Band Stretches

If performing the standing and lying down methods of stretching the IT band is difficult, having a partner assist you might be a better option for you.

Assisted iliotibial band stretch is performed in the following steps;

  • Lie on your back with both legs out straight
  • Your assistant would raise your right leg up and place across your body until you feel a stretch in the right IT band on the outside of your right thigh.
  • Your assistant may also turn your right foot inwards. Doing this increases the stretch of the band.
  • Your assistant would hold this position for 30 seconds
  • Repeat the process three times in a session.
  • Repeat the process for the other leg
  • Perform the stretch in these steps twice daily for each leg

How to Prevent Iliotibial Band Syndrome

As noted earlier, iliotibial band syndrome describes an injury to the iliotibial band resulting from overuse and poor flexibility.

It often occurs in runners, cyclists, and athletes who do repetitive squatting movements.

Inadequate stretching of the iliotibial band may also cause acute injury which would result in the iliotibial band syndrome.

In addition to the stretch exercises described above, the following tips are vital in preventing iliotibial band syndrome.

  • Do adequate warm-ups before running. This may involve as simple as walking a quartet to half a mile before commencing your exercise.
  • Ensure your sporting shoes are not worn out along the outer lining of the soles. If such is the case, your shoes require immediate replacement.
  • Run on roads that are flat. This may require you to run in the middle of the roads, where the surfaces are usually smooth and flat.

For safety reasons, ensure the road you run on are those with little or no traffic and clear visibility.

Running on rough surfaces may cause the hip and knee joints to make abnormal compensatory movements which may strain the IT band.

Additionally, unlevelled surfaces may create an abnormal transient tilt to the pelvis, increasing strain on the band and the risk of IT band syndrome.

  • Avoid running on concrete surfaces, this may also strain the IT band.
  • When you are running on a track, ensure you change directions alternatively. Running on one direction or on the same side of the road for too long may tilt the pelvis, straining the IT band.
  • If you feel pain on the outside aspect of your knee, take a few days off running or reduce the distance you have to cover to lower the inflammation of the band.
  • Bicyclists should avoid pedalling with their toes turned inwards. This pedalling technique causes an abnormal stretching of the iliotibial band, increasing the risk of IT band syndrome.
  • Ensure the pedals and clips of your bicycle are set properly to avoid bending pf the pelvis to one side or abnormal stretching or straining of the IT band on one side.

Although iliotibial band syndrome may be considered a benign musculoskeletal injury, it may takes weeks to months for the individual to resume sporting activities pain-free.

While Iliotibial pain syndrome often responds to conservative management including rest, ice application on, elevation, compression of the band, and use of mild analgesics such as ibuprofen and naproxen, severe cases may require more advanced treatment options such as ultrasound techniques and orthopaedic surgery.

In addition to the non-surgical conservative treatment options mentioned above, physical therapy and injection of corticosteroids into the site of inflammation also play key roles in relieving iliotibial band syndrome.

The iliotibial band or IT band is a tough fibrous tissue which is an extension of the thigh fascia, the fascia lata.

The iliotibial band, as its name implies extends from the iliac crest of the hip bone to the tibia or the shin bone.

The IT band associated with the strong thigh muscles, the gluteus maximus muscle and the tensor fascia lata helps in abduction, extension, and outward rotation of the hip.

It also helps stabilize the knee when it is stretched out or bent partially. This band, therefore, is essential for running, walking, and squatting.

Stretching this band strengthens it and makes it more flexible, preventing an injury called the iliotibial band syndrome.

If the band is properly stretched and warmed up, it would enable an individual to carry out those crucial knee and hip movements with ease and without pain.

Essentially, the stronger and more flexible the IT band is, the lower the risk of IT band syndrome.

Dr. Sachin
 

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