Tag Archives: Iliotibial Band Syndrome

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How to Perform a Key Lower Leg Stability Exercise

Weakness in the deep external rotation muscles and poor lower extremity single leg balance are commonly associated with many lower extremity overuse injuries. A simple and effective exercise to improve strength, balance, and general stability of the deep hip external rotator muscles is the clock exercise (also called the star drill).

The important points to remember in this exercise are to keep the stance knee unlocked (the leg you are standing on) with the patella (knee cap) slightly externally rotated (usually pointing towards the 3rd or 4th toe). The rotation must come from the hip, NOT the ankle. The stability of the hip and activation of the deep hip external rotators needs to be the primary focus.

Slowly touch the ground very gently with the opposite leg. The amount of pressure touching the ground should be so slight that if there were a package of crackers taped to the bottom of the foot the crackers would not break. Performing the drill on a balance pad will significantly increase the difficulty level of the exercise.

In the following video, I demonstrate how to use a balance pad to perform the clock exercise, a key lower leg stability exercise for treating knee pain, hip pain, and foot and ankle related issues as well as balance.

CLICK HERE TO WATCH NOW

For additional videos on my recommended exercises to increase hip strength and stability, be sure to check out:

For prevention strategies and to learn more about on how to self-treat the most common lower extremity overuse injuries, be sure to check out the Resilient Runner Program, which is designed to help YOU meet YOUR training goals by insuring you have the tools to avoid injury, recover quickly, and train at a peak level.

Have you performed the clock exercise before? If so, what was your experience like? Please leave your comments below.

If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com. In case you haven’t already, be sure to subscribe to my e-mail list and YouTube channel as well as join our community on Facebook by liking The Physical Therapy Advisor!

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How to Perform a Key Hip Stability Exercise

Hip pain, knee pain, and even foot pain (such as plantar fasciitis or posterior tibialis syndrome) can have an associated hip external rotation weakness. An important yet often overlooked component to proper lower extremity stability is how the deep hip external rotator muscles need to work along with other hip external rotators and hip abductors, such as the gluteus medius, to insure proper lower extremity positioning when the leg is in full weight bearing. Particularly, in a single leg stance position during walking, running, skipping or landing from a jump as the leg accepts full weight bearing while the opposite leg is in swing phase.

The deep hip rotators, also known as the short external hip rotators, are a group of muscles consisting of the superior and inferior gemelli, obturator internus, quadratus femoris, and the piriformis. This group of muscles is extremely important for stability of the body, pelvis, and leg as the leg/foot initiates full ground contact.

Weakness in these muscles is often associated with many of the more common lower extremity overuse injuries:

  • Foot injuries: Plantar Fasciitis, Achilles Tendinitis, Posterior Tibialis Syndrome
  • Knee injuries: Patella Femoral Pain Syndrome (PFPS), Iliotibial Band Syndrome (ITBS)
  • Hip related issues: Piriformis Syndrome, Hip Bursitis,  Hip Impingement

A simple and effective exercise to improve strength of these muscles is the standing hip 3-way exercise. The important points to remember in this exercise are to keep the stance knee unlocked and in a “soft” stance with the patella (knee cap) slightly externally (laterally) rotated (usually pointing toward the 3rd or 4th toe). The rotation must come from the hip, NOT the ankle. The stability of the hip and activation of the deep hip external rotators should be the primary focus.

In the following video, I demonstrate how to use an exercise band to perform the standing hip 3-way exercise, a key hip stability exercise for treating hip pain, knee pain, and foot and ankle related injuries.

CLICK HERE TO WATCH NOW

For additional videos on my recommended exercises to increase hip strength and stability, be sure to check out:

For prevention strategies and to learn more about on how to self-treat the most common lower extremity overuse injuries, be sure to check out the Resilient Runner Program, which is designed to help YOU meet YOUR training goals by insuring you have the tools to avoid injury, recover quickly, and train at a peak level.

Do you suffer from hip, knee or foot pain? If so, hip external rotation weakness may be part of the reason for the ongoing pain as you overload and overuse other structures trying to gain extra lower leg support. Additional discussion can help others to manage this condition more effectively. Please leave your comments below.

If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com. In case you haven’t already, be sure to subscribe to my e-mail list and YouTube channel as well as join our community on Facebook by liking The Physical Therapy Advisor!

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The Clamshell: A “go to” Exercise for Treating Foot, Hip, and Knee Pain

Do you suffer from foot, hip or knee pain? If so, hip external rotation weakness and poor single leg balance may be part of the reason for the ongoing pain as you overload and overuse other muscle groups in order to gain extra lower leg support. Weakness in the deep external rotation muscles is commonly associated with many lower extremity overuse injuries.

Injuries commonly associated with hip weakness include:

  • Foot/ankle injuries such as plantar fasciitis, Achilles tendinitis or posterior tibialis syndrome.
  • Hip related issues including piriformis syndrome, hip bursitis, and hip impingement.
  • Knee injuries such as Patellar Femoral Pain Syndrome (PFPS) and Iliotibial Band Syndrome (ITBS).

The deep hip external rotator muscles need to work along with the hip abductors (such as the gluteus medius) to insure proper lower extremity positioning when the leg is in full weight bearing. (Particularly, in a single leg stance.) One leg bears the full weight while the opposite leg is in the swing phase while walking, running or skipping.

The deep hip rotators (also known as the short external hip rotators) are a group of muscles including:  the superior and inferior gemelli muscles; obturator internus; quadratus femoris; and the piriformis. This group of muscles is extremely important for stability of the body, pelvis, and leg as the leg/foot initiates full ground contact.

The clamshell exercise is a commonly prescribed exercise designed to target the hip abductors and hip external rotators. However, this exercise is often performed incorrectly or ineffectively. 

In the following video, I demonstrate my preferred method of performing the clamshell exercise in order to insure optimal effectiveness.

In order to engage the deep hip rotators, you should feel the muscles working deep into the buttocks and directly behind the greater trochanter (the hard bone that pokes up at the top of the hip).

This exercise should be performed very slowly. I advise a count of 5 seconds up, a 5 second hold, and then a 5 second slow return to the starting position for at least 10 repetitions.

If you aren’t feeling the deep hip rotators activate, then you may need to reposition your legs. Usually, repositioning the knees and moving them up toward your head into a more fetal position will do the trick.

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If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com. In case you haven’t already, be sure to subscribe to my e-mail list and YouTube channel as well as join our community on Facebook by liking The Physical Therapy Advisor!

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How to Use the Clamshell Hip Exercise to Treat Knee Pain

Knee pain is the most common running related injury.  There are many different causes of knee pain including: Patellar Femoral Pain Syndrome (PFPS); Iliotibial Band pain (IT Band); Patellar Tendinitis; and meniscus injuries.

The root cause of many of the most common knee related issues is hip weakness.  The hip abductors and hip external (lateral) rotators are very important for knee control and stability.  When weakness is present in these groups of muscles, pain is often felt down the kinetic chain (particularly, in the knee).

One of the best ways to treat many common running aches and pains is to focus on strengthening these muscles which include the gluteus medius, the tensor fascia latae, and the other deep hip rotators.

In this video, I demonstrate how to perform the clamshell exercise.  It’s an excellent non-weight bearing exercise to work on hip rotator strength which will directly affect knee stability.  In the video, I use a red exercise band.  As you progress, you could transition to a thicker band to increase the resistance and difficulty of the exercise.

Looking for more comprehensive information on how to self-treat and prevent the most common running related injuries?  I have teamed up with Angie Spencer (RN and Certified Running Coach) and Trevor Spencer (co-host of the Marathon Training Academy Podcast) to give you the tools to become a Resilient Runner.

In the Resilient Runner program, we explain injury prevention strategies to keep you running.  We provide detailed videos and rehabilitation guides on how to effectively SELF-TREAT each problem area of the body including:

  • Lower Back Pain and Piriformis
  • Hip: Hip Bursitis and Hip Flexor Pain
  • Upper Leg: Iliotibial Band and Hamstring Injury
  • Knee Pain: Patellar Femoral Pain Syndrome (Runner’s Knee); Patellar Tendinitis; and Meniscus Injury
  • Lower Leg and Foot: Achilles Tendinitis; Plantar Fasciitis; Posterior Tibial Tendon Dysfunction; Shin Splints; and Stress Fractures

The Resilient Runner program is designed to help YOU meet YOUR training goals by insuring you have the tools to avoid injury, recover quickly, and train at a peak level.

It’s a virtual library of self-treatment protocols including downloadable podcasts, videos, and .pdf files of rehabilitation guides.  It also includes a 320 page eBook, The Resilient Runner, Prevention and Self-Treatment Guide to Common Running Related Injuries.

 

Not all of us are born bullet proof, but we can all learn how to be more resilient!

I WANT TO BE RESILIENT!

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How to Self-Treat IT Band Pain with a Mini Plunger

Pain in the lateral (outside) leg or knee is commonly associated with a condition known as Iliotibial Band Syndrome (ITBS).  (Iliotibial Band Syndrome is also known as IT Band Syndrome, ITB Syndrome, or IT Band Friction Syndrome.)  Pain can range from the lateral side of the leg up toward the hip area to just below the lateral side of the knee joint (where the head of the fibula bone begins).  The pain can be very debilitating to the point that running or hiking activities have to be stopped.  Even walking can be difficult.

Although ITBS can be very painful, it can be easily self-treated if you handle your pain and symptoms quickly.  For many years, I have taught people how to use a mini plunger as a method to provide a suction force for self-treatment.  In this video, I demonstrate how to utilize a mini plunger as a “cupping” technique to self-treat IT Band Syndrome.

Cupping is a method or technique to massage and mobilize tissues such as muscles, skin, fascia, and tendons.  The exact treatment effect is unclear, but presently the research indicates that it helps to reset neural pain receptors and stretch receptors.  Thus, reducing pain and allowing for improved movement.

Cupping has been around as a treatment technique for thousands of years.  The research on cupping is interesting and for the most part, concludes that cupping is helpful in pain management.  There are some indications that the “suction” may lead to improved blood flow to an injured area which could speed up healing times.  Other health claims of the benefits of cupping haven’t been adequately proven in current research.

Traditionally, cupping has been performed with glass cups by using a flammable paper to quickly “burn” the oxygen in the cup which causes a suction force.  There are now many types of plastic or silicon cups that can easily be purchased online.  CupEDGE Massage Tools are what I use and recommend.  Fancy cups are not necessary.  The cups can be more convenient, but even a small sink plunger will do.

Have you tried cupping to treat ITBS?  If so, what was your experience like?  Additional discussion can help others to manage this condition more effectively.  Please leave your comments below.

For more information on how to self-treat ITBS, please refer to the following:

Looking for that exercise or book I mentioned in a post?  Forgot the name of a product or supplement that you’re interested in?  It’s all listed in the Resource Guide.  Check it out today!

If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com.  Be sure to join our growing community on Facebook by liking The Physical Therapy Advisor!

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A Barbell Knee Stability Exercise for Runners

Patellar Femoral Pain Syndrome (PFPS) is the physical therapy term for runner’s knee, a common condition experienced by runners.  It accounts for roughly 25% of all reported cases of knee pain.  PFPS is a term used to describe pain in many areas of the knee including:  pain near the insertion point of the patellar tendon, just below the patella or knee cap; pain just above the knee cap where the quadriceps muscle is blending in and forming the quadriceps/patellar tendon; and/or pain underneath the patella.

Although there are many types of knee pain, many of the potential causative factors for PFPS are similar to other conditions such as IT Band Syndrome (ITBS) and Patellar Tendinitis.  Treatments for knee pain can vary wildly from person to person.  It can be quite painful and significantly affect a person’s ability to run or move properly.  In the case of PFPS, the cause of the pain is often associated with a patellar or knee cap that is tracking in the femoral groove improperly.

Common Causes and Risk Factors for Knee Pain and specifically, Patellar Femoral Pain Syndrome (PFPS) include:

  • Poor quadriceps strength (particularly the inner/medial quadriceps).
  • Poor hip abductor and/or hip external rotator strength.
  • Improper foot biomechanics during the single leg stance phase of the gait cycle or the mid foot strike during running.

One of the primary treatments for nearly all types of knee pain (including PFPS, Patellar Tendinitis, ITBS, and meniscus injury) is to improve your quadriceps and hip strength.  Quadriceps strength is an important component to your long term management and recovery.  As part of the quadriceps strengthening protocol, I have found it useful to skew toward the inner quad, known as the vastus medialis oblique (VMO).  Although you cannot specifically isolate the VMO, I still recommend implementing exercises that are likely to activate the muscle more when performed correctly.

The other critical factor is weak hip abduction and hip external (lateral) rotation muscles, which significantly contribute to PFPS.  The purpose of the lateral and external rotators of the hip is to prevent internal rotation (rolling in) of the hip and knee.  They also provide the stability for the pelvis and lower leg when in single leg stance.  The hip muscles are critical in controlling knee stability and ultimately, patellar (knee cap) tracking.  Adequate strength of the rotators and abductors of the hip is critical.

In this video, I demonstrate how to perform an advanced exercise known as the clock or star drill.  It’s an excellent exercise to work on knee stability and balance while specifically focusing on quadriceps and hip strength.  Although I demonstrate the exercise with a barbell in the video, I recommend that you initially be perform it without weight (as demonstrated below).  As you progress, then you could add weight.

ClockExercise

Have you performed the clock or star drill before?  If so, what was your experience like?  Please leave your comments below.

For more information on how to self-treat differing types of knee pain, please refer to the following:

Looking for that exercise or book I mentioned in a post?  Forgot the name of a product or supplement that you’re interested in?  It’s all listed in the Resource Guide.  Check it out today!

If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com.  Be sure to join our growing community on Facebook by liking The Physical Therapy Advisor!

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How to Self-Treat IT Band Syndrome with a Mobility Band

Pain in the lateral (outside) leg or knee is commonly associated with a condition known as Iliotibial Band Syndrome (ITBS). (Iliotibial Band Syndrome is also known as IT Band Syndrome, ITB Syndrome, or IT Band Friction Syndrome.) Pain can range from the lateral side of the leg up toward the hip area to just below the lateral side of the knee joint (where the head of the fibula bone begins).

The IT Band is a very thick fibrous band of tissue that spans from the hip’s origin point at a muscle known as the Tensor fasciae latae (TFL). The TFL transitions into the IT band and progresses down the lateral thigh and ends at the head of the fibula.  The IT Band’s primary function is to provide additional lateral support for the knee joint (particularly when standing or landing on one leg).

IT Band Syndrome is often associated with an over use injury. Runners will often develop ITBS after running on uneven terrain or downhill.  Gait or running abnormalities can increase your risk of developing ITBS.  Although it can be very painful, it can be easily self-treated if you handle your pain and symptoms quickly.

A simple and effective method to self-treat ITBS is through the use of a mobility/compression band (such as an EDGE Mobility Band). In this video, I demonstrate how to use a mobility/compression band to mobilize the iliotibial band (also known as the IT Band) as a self-treatment method for ITBS.

Have you tried using a mobility band before to treat ITBS? If so, what was your experience like?  Additional discussion can help others to manage this condition more effectively.  Please leave your comments below.

For more information on how to self-treat ITBS, please refer to the following:

Looking for that exercise or book I mentioned in a post?  Forgot the name of a product or supplement that you’re interested in?  It’s all listed in the Resource Guide. Check it out today!

If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com. Be sure to join our growing community on Facebook by liking The Physical Therapy Advisor!

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Q & A: Running Injuries, Part 2

MTA_RunningInjuries_Part2

http://marathontrainingacademy.com/running-injuries2

Marathon Training Academy

February 14, 2016

Do you have a nagging stubborn injury? Recovery and injury prevention are critical and should be performed regularly so you don’t miss valuable training time.  In Part 2 of this podcast interview with Marathon Training Academy, I discuss injury prevention and treatment for the most common running injuries.  For detailed written answers and web links for more in-depth prevention and self-treatment strategies, please refer to Q & A Running Injuries Show Notes.

Fit man gripping his injured calf muscle on a sunny dayRunning injuries that crop up during marathon training are a real bummer! Here’s part two of our Q and A with physical therapy doctor Ben Shatto.

In this episode, you will hear about injury recurrence, plantar fasciitis, knee pain, ITBS, and more. My favorite quote from this episode is, “Injury is never normal.” Listen to the podcast

Disclaimer: This blog post and podcast are not meant to replace the advice of your doctor/health care provider, or speak to the condition of one particular person but rather give general advice.

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Q & A: How to Increase Hip Strength and Improve Mobility

Q.  Hi. I have been noticing that even with my current strength training I’m pretty weak in my hip area.  I’d like to work on strengthening this area, so I don’t have problems when I’m older.  Can you recommend a few exercises that I can add to my routine?  Thanks, I love your posts and utilize the information as often as I can.  -Amy

A.  Thanks, Amy, for this fantastic question! It’s wonderful that you are aware of this particular weakness and you’re being proactive now versus experiencing potential issues later. Maintaining adequate hip and pelvic strength is important for many reasons. The hip muscles control or influence most of the lower leg mechanics, including the hip, knee, and foot.  They also play a role in lumbar stability and mobility.  Both hip strength and mobility is vital to insure proper lower extremity movement.

Weakness and/or poor mobility in the hips can lead to potential problems including:

  • Hip pain
  • Knee pain
  • Lumbar pain
  • Abnormal gait patterns
  • Increased fall risk
  • Early development of osteoarthritis in the hips and knees
  • Iliotibial band syndrome
  • Hip bursitis
  • Shin splints
  • Plantar fasciitis

Many other conditions and pain can also be attributed to poor hip strength and mobility.  This is by no means an all-inclusive list.  I have written specific blog posts regarding many of these conditions.  In each case, one of my recommended tips is to improve both hip strength and mobility.  Many of the hip muscles are located deep in the pelvis and buttock area.  They are not necessary large, but they are critical.  These hip muscles can also be responsible for pain, particularly when spasming.  Piriformis Syndrome occurs when the piriformis muscle (a deep hip rotator muscle) spasms.  The spasm can cause buttock pain.  Due to its proximity to the sciatic nerve, it can also cause radiating pain down into the leg known as sciatica.

How to Increase Hip Strength and Improve Mobility:

  • Squat. The squat activates nearly all of the muscles in the lower leg. It is particularly effective at activating the muscles in the legs referred to as the posterior chain, which includes the hamstrings, the glutes (or buttock muscles), and the hip adductors (or the groin muscles). It also activates muscles in the hips, the calves, the stabilizing muscles in the ankles, the quadriceps, as well as the core (the abdominals and lumbar extensor muscles). These muscles are critical for all functional mobility related movements, including walking; getting up from a chair or a toilet; or picking up someone or something. For more information on squatting, please refer to 7 Reasons Why the Squat is Fundamental to Life.
  • Target the hip muscles. Many of the muscles of the hip require specific exercises to insure that the correct muscle is activated. Please refer to Hip Strengthening Exercises for detailed descriptions and photos of my recommended exercises.

MonsterWalkWithExerciseBand

  • Improve your mobility. Tightness and restrictions in the hip and pelvic musculature are often associated with pain in the legs and low back. Please refer to Hip Stretches and Mobilizations for detailed descriptions and photos of specific stretches for the hip and pelvis and how to self-mobilize by using a foam roller and lacrosse ball. Tightness and restrictions increase your risk of injury due to improper mobility. For example, tightness in the hip internal rotator muscles causes the hip and lower leg to roll in, which is associated with Patellar Femoral Pain Syndrome (also known as runner’s knee). For more information on this condition, please refer to How to Self-Treat Patellar Femoral Pain Syndrome.
  • Self-mobilize. Using a foam roller is an excellent method to decrease pain and improve mobility throughout the hip and pelvis. For more information on how to use a foam roller, please refer to Foam Rolling for Rehabilitation.
  • Walk more frequently. Walking is a critical component to healthy aging. Walking on various surfaces and terrain is an excellent way to improve your health, fitness, and hip strength. To discover other benefits walking, please refer to Why You Should Walk, Not Run.

Maintaining adequate hip and pelvis mobility and strength is an important strategy in avoiding many lower extremity orthopaedic conditions.  Being aware of a particular area of weakness and being proactive now could save you from experiencing pain in the future. Thanks, Amy, for your question!

Which strategy will you use to increase your hip strength and improve mobility?  It could be as simple as using the foam roller or walking.  Most importantly, just get started!  Please leave your comments below.

Looking for that exercise or book I mentioned in a post?  Forgot the name of a product or supplement that you’re interested in?  It’s all listed in the Resource Guide.  Check it out today!

If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com. Be sure to join our growing community on Facebook by liking The Physical Therapy Advisor!

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How to Self-Treat IT Band Syndrome

Pain in the lateral (outside) leg or knee is commonly associated with a condition known as Iliotibial Band Syndrome (ITBS).  (Iliotibial Band Syndrome is also known as IT Band Syndrome, ITB Syndrome, or IT Band Friction Syndrome.)  Pain can range from the lateral side of the leg up toward the hip area to just below the lateral side of the knee joint (where the head of the fibula bone begins).  The pain can be very debilitating to the point that running or hiking activities have to be stopped.  Even walking becomes difficult.  I will address the many potential causative factors for IT Band Syndrome and offer advice on how to self-treat this condition.

TherabandRoller

The IT Band is a very thick fibrous band of tissue that spans from the hip’s origin point at a muscle known as the Tensor fasciae latae (TFL).  The TFL transitions into the IT band and progresses down the lateral thigh and ends at the head of the fibula.  The IT Band’s primary function is to provide additional lateral support for the knee joint (particularly when standing or landing on one leg).  IT Band Syndrome is often associated with an over use injury.  It can be very painful, but it can be easily self-treated if you handle your pain and symptoms quickly.

How to Self-Treat IT Band Syndrome: 

  • Improve your mobility. Mobility issues and myofascial restrictions are highly correlated with ITBS. Tightness in the IT Band or in the deep hip internal or external rotators is a contributing factor to ITBS. The tighter the IT Band, the more likely it will rub on the femoral condyle and develop into pain. Bowlegged describes a medical condition known as a varus deformity, an inward rotation of the tibia resulting in a leg that looks like it is bowed out. It can develop due to chronic friction of the IT Band along the femoral condyle. ITBS may also occur after a total knee replacement (TKA). I recommend using a foam roller to address tightness in the quadriceps or IT Band. To learn how to use a foam roller, please refer to Foam Rolling for Rehabilitation. I also recommend a Thera-Band Standard Roller Massager, which is very firm and allows for a deep amount of pressure. You may also utilize a tennis or lacrosse ball to mobilize the Tensor fasciae latae (TFL) appropriately. The foam roller and roller massager don’t work as well because the greater trochanter of the hip (the boney part of the hip that sticks out) tends to be in the way. Stretching the IT band or the TFL is very difficult, so I tend to utilize other mobilization techniques. However, I recommend a few pelvic and hip stretches. Please refer to IT Band Syndrome Rehabilitation Exercises for my top stretches, foam rolling, and self-mobilization techniques to address IT Band related issues.
  • Strengthen your hip muscles. Weakness in the hip external rotators and the hip abductors, like the Gluteus medius and the Tensor fasciae latae (TFL), can lead to IT Band Syndrome. Strengthening of these muscle groups can help avoid future ITB issues as well as reduce your risk of developing Patellar Femoral Pain Syndrome (PFPS). Please refer to Hamstring, Hip Flexor, and Piriformis Stretches for LBP for additional hip and lower leg stretching exercises.
  • Over use injury due to downhill running? IT Band Syndrome is often associated with an over use injury. For runners, a common cause of ITBS is running downhill. Few runners actually train appropriately for a race with downhill running. Afterward, they end up with a case of ITBS. I have been guilty of improper training in the past. If you have ever run in the Robie Creek Half Marathon, then you understand the importance of downhill training. To avoid ITBS, adequately train for the downhill portion of the race. Also, vary your running routine and surfaces while training. Although ITBS is often associated with over use, always address other contributing factors as well.
  • Check your shoes. Your shoes may be worn out and may be the cause of the pain. If you wear a shoe that helps to limit overpronation, remember that the inner cushion and structure of the shoe can wear out before its outer appearance. If this occurs, the shoe can no longer adequately control inappropriate foot and heel movements such as overpronation. This could result in IT Band Syndrome or other hip, knee, or ankle related issues. Shoes typically only last 350-500 miles. If you are nearing those miles, then it may be time to change. If you’re unsure if your shoes are performing correctly, visit your local running shoe store. The trained staff can inspect your shoes for wear and tear. They may ask you to walk or run in order to watch your gait to fit you in the appropriate shoe. Another option to help control overpronation is an over-the-counter orthotic such as Superfeet Blue Premium Insoles. The blue tends to fit most feet, but a variety of options are available for customization. In my experience, these insoles can last 1,000 to 1,500 miles easily. If the over-the-counter options aren’t helping you, please see a physical therapist or podiatrist for custom orthotics.
  • Did you progress too quickly into a minimalistic shoe? If you are used to a standard built up shoe, progressing into a minimalistic shoe may be more difficult and take more time. Unless you are a child or teenager, expect a safe transition to take at least three months. Don’t transition during a period of intense sports. I highly recommend waiting until the off season as progressing slowly is always a better choice.
  • Have your gait analyzed while running. Gait or running abnormalities can increase your risk of developing IT Band Syndrome. Over striding tends to occur while running downhill. Scissoring occurs when your leg crosses over the midline with each step. Both over striding and scissoring are easily recognized by a professional. Check with your local running store or a physical therapy clinic for a monthly gait analysis clinic. If you’re unable to obtain a gait analysis, ask your spouse or a friend to video record you (from behind) while you’re running. Then watch the recording to see if you notice either over striding or scissoring.
  • Don’t forget to ice. IT Band Syndrome is typically is due to a specific event. Afterward, there is usually an active inflammatory process occurring. I typically apply ice to the lateral part of the knee, but place it on your most painful location. The rule for icing is to apply ice no more than twenty minutes per hour. Don’t place the ice directly against the skin, especially if you are using a gel pack style. Individuals with poor circulation or impaired sensation should take particular care when icing. A bag of frozen peas can be a cheap alternative or you could use one of my favorite gel pack style cold packs.
  • Start a supplement. ITB Syndrome is typically associated with a specific event and an active inflammatory process typically occurs. I am a supporter of natural supplements and remedies. Many supplements include herbs which are designed to help reduce inflammation. Phenocane Natural Pain Management combines the following: Curcumin, an herb that reduces pain and inflammation; boswellia, a natural COX2 inhibitor that also reduces pain and inflammation; DLPA, an amino acid that helps to increase and uphold serotonin levels in the brain; and nattokinase, an enzyme that assists with blood clotting and reduces pain and inflammation. If you are taking blood thinner medication, please consult with your physician prior to taking Phenocane Natural Pain Management.

If you’re not experiencing relief after a week or two of aggressively managing the symptoms, contact your local physical therapist for an assessment and help in managing IT Band Syndrome.  The American Physical Therapy Association offers a wonderful resource to help find a physical therapist in your area.

Has a specific treatment for IT Band Syndrome helped you? Which treatments haven’t worked for you?   Additional discussion can help others to manage this condition more effectively.  Please leave your comments below.

Looking for that exercise or book I mentioned in a post?  Forgot the name of a product or supplement that you’re interested in?  It’s all listed in the new Resource Guide.  Check it out today!

If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com. Be sure to join our growing community on Facebook by liking The Physical Therapy Advisor!