How to Treat ITB Syndrome

hi guys in this video I explain what type of treatments actually work for iliotibial band syndrome and I also give you tips on how you can adjust your running style that you can still stay active and do some running while you recover let me know if you've got any questions that brings me to treatment so how do you go about treating IVs again it's quite interesting because I actually did my Master's dissertation in 2011 about ITB syndrome and what I wanted to see it was a literature review I wanted to see if they can tell us or they've done enough research to see exactly what biomechanical issues goes on with runners that they actually develop ITB syndrome and the funny bit was that the research couldn't agree so some studies showed that your glute muscles that the people's the runners had weakly muscles other studies show that they didn't really have that then there were studies to show that oh no no they were really really tight others didn't show it there were some of the studies that showed that females especially their legs turned in more or adducted more but then there were several other studies that showed no actually that wasn't the case for their injured runners and I think the key to it all is that there's not one cause for it as I've pointed out previously several different things can make that ITB become taut so it's quite key that you identify what factors combined to give you ITB syndrome on that note the nice thing about this condition is that it may be one of the only things that more males get than females I didn't know that that existed so it's more often young men in their 20s that get this condition rather than the classic female where we seem to get everything else let me just see as the questions are coming in hi Odysseus I hope I'm saying your name right so Scylla says I've heard people say stretch other ITB but as you've said it can it can't be stretched so what did I mean I'm gonna tell you in a minute okay so let's start by that thing Oh actually no let's start with this say for instance you've done a long run or you've done a race today and it's sometimes you can feel the pain immediately sometimes it's the next morning that it says hi I don't like you the big thing is that at that point it's inflamed and soul and you really need to look after it so that's not the time to go and foam roll or heavily stretch over the painful area or do another run for the first three to five days after you've injured your ITB you really need to apply all the things of ice rest it you can even use anti-inflammatories if your doctor says it's ok anything like that to calm the inflammatory reaction down once that is calmed down you can look at the bigger cause and address that but please please please don't go stretch things that's painful and inflamed okay you will make it feel worse so stretching is definitely one of the things that helps because there's a large proportion of the patients I see in practice who are just overly tight a classic example he was actually quite an extreme example I guess was a guy who he just does weightlifting and a girl university student a girl challenged him to a 10k race so of course he said yes and the week before he thought it would be a good idea to test if he can actually run 10k because they hadn't done it three years and it was the worst flared up ITB I've seen in my life and when I tested him they was just he didn't have one muscle that wasn't tight and basically it came down to that he had read that you shouldn't stretch because it weakens your muscles which of course isn't true so he's been doing loads of weight training and stuff and no stretching no flexibility and because of that that poor IT band just rubbed on the bone now I hope if you guys are in this group you've learned by now that stretching isn't bad it's all about when you stretch and how long you stretch for and just to stretch at the right times so sellers when we talk about stretching the IT band I would want you to think about rather stretching all the muscles that attaches to the IT band so that would be definitely your glute max it would also be your glute meet as well as your TfL so glute max stretches I'm not going to run through them now I've done them previously I could I'll pop a link into this to a place where you can look at them but typical glute max stretches the figure for one that you lie down and you grab that pull up to your chest things for the TfL let me just put this on a bigger view is everything where you kind of cross your legs and you shift away that's not stretching the IT band is stretching the top but there TfL you can also stretch anything where you kind of sits and you pull your leg across I'm really struggling with this deciding which view we're using today but don't forget the lateral quad or the vastus lateralis that is a key one and a really difficult one actually to stretch so what I tend to do if you're really really tight in your quads you may have to start off with the easy ones of just catching the leg but you actually do have to let me just get this that we've got over wide of you you will have to angle it so if I could show you this so if I wanted to do that I would first stretch out just the regular quad stretch and then you can try pulling it over to the other side but actually the one that I find the most useful is if you on the floor and I just want to get something for my knee it's handy if you in your bedroom so this type of thing where you really able to lean into it and then what you can do is you can side flex away you could even grab hold of your foot and then I want to show you what I'm doing with my torso I'm grabbing hold of that so I'm getting the quad stretch and then I'm leaning to the opposite side so you're starting to really get a stretch into that bit there are loads of other fancy ones of a good one is one where you lie on your side and you're essentially doing that stretch where you catch it but you can then use your other leg to push your leg down so there are loads of different options and you guys can maybe share some in the comments in the group for the other people as well in a in a minute so yes I would say you're not stretching the IT band you're stretching the glutes that attach into it you're stretching the TfL that attaches into it and the lateral quads then that leads nicely into actually self massage as well using a foam roller or a massage ball those are exactly the same muscles you want to target so you want to be targeting especially with a massage ball I have done a video about this so I'll put the link on there as well you want to target all of the glute area with a massage ball you can either lean into a wall with a ball or on the floor and again you want to not only target the front of the quads but you want to lean side on and really get this bit I know it feels as if you of course you are massaging over the IT band as well but the lateral quad lives under that and that is the bit that's often really full of trigger points and I find in practice I can find some really you large trigger points in there that if I do dry needling on that people get nearly instant relief that's definitely something that you should consider if you're really struggling with tight tight quads you feel you're not making a difference go see somebody who can do soft tissue massage for you or who uses dry needling because it can be really effective for this condition okay so those are the stretching and the massage bits then let's move on to strength now although the research seems to be a little bit divided on whether people have muscle imbalances or not there's definitely a subgroup of athletes that I see that does come in with weak gluts and grid meet again they tend to actually be the female athletes rather than males the males tend to be more the overtraining and the tighter ones so remember the easiest test for that is if you're on one leg and you do a single leg squat you want to be making sure that everything moves in line so you can check out my youtube videos because there's definitely a video on this as well that when you do a single leg squat you want to see that you move your knee moves in line with the middle of your foot and middle of the hip and if you're seeing something like that happening then you know that your stability in your hip isn't good so to show you on this leg where it should be is in a nice straight line my hips are staying level if I did it and I saw this happen or that happen then I know this glute and glute Meade is not strong enough and then I would have to strengthen that up your choice of strengthening exercise for that it's quite important because if you're going to try and use exercises that uses knee flexion so anything like a single leg squat or squats per se you may actually fire it up because that's the same movement that's moving the IT band that's at the moment a little bit inflamed a little bit thickened and not happy with life over the bone so you've got to choose exercises to strengthen the glutes that doesn't actually hurt ideas that come to mind things that's worked for people in the past is doing like double leg glute bridges starting with those and if you want to work them a bit harder have your feet up on a bench you guys may remember that it's one of my favorite exercise I've shown it in quite a few videos I'll see if I can find some links to put in here for you as well two articles so yes the double leg glute bridge would be amazing one move it onto a single leg bridge as you get stronger and then of course you can try things like side leg lifts and clams as well just check sometimes if the IT band is really annoyed it doesn't like the pulling on that bit with this condition it's one of the conditions where I don't actually want you to feel any pain while you're exercising because what I find in practice is you just flare it up then so it's okay if you kind of think it's there I don't want you to think no more than hour one out of ten discomfort okay so yes strengthening wise I would definitely strengthen the glute max as well as the glute Meade but I would choose positions that doesn't hurt the knee so anything that doesn't actually involve the knee flexing and extending so if you think of the running action we don't want to recreate that in the beginning stages as soon as the knee has calmed down enough then yes of course you've got to go on to doing more functional type things like single leg squats and stuff then the other important thing is relative rest and that goes hand-in-hand with a running style for me so I'm going to kind of dip into the two and go between the two so what is relative rest means it means that you're exercising at an intensity or a volume that allows the injury to recover but you actually maintain your fitness now depending on your specific case of iliotibial band syndrome you may be able to run still sometimes you're able to do things like cycling sometimes you can you can't do any of that and you've got a resort to swimming even with with something between your legs that you don't actually use your feet so you've got to decide according to your own situation what you can actually do but the main thing is that you're not allowed to exercise into pain with us you've got to find the baseline that you can do without her hurting now a little tricks for running what I found is or and what the research actually agrees with is that if you can try and keep your your stride shorter and imagine running light that you can't hear your your feet touching the floor so in essence what that does is it makes you give lighter steps and you spend less time on the floor so you have less impact forces so it's less of a chance of you to go like that when you're running so if you think of slow long runs you go bunk bunk bunk if you're giving faster steps and lighter steps it's before it reaches that big bump it just does that so instead of that and proper pulling it just does that so some of my patients in the past have managed to get away with choosing really flat terrain soft surfaces like grass keeping this stride short others have found that they could actually run stairs not down though just up because when you run up stairs you immediately on your toes giving quick shot steps and your form is really really good so play with things like that and see if you can still get away with a bit of running if it's that important to you if you can take a little bit of time out you may find your recovery is quicker the big thing to avoid though is long slow runs because by the end of that you will definitely be losing your form and also down hills because when we run downhill there's just so much more impact so play with that there's no need to stop all running if you can do something without pain but if you flare up every time that you've done a run then I would say see if you can cross strain for a little bit do other types of exercise that doesn't annoy the knee if we think of your anatomy if you think that you've got one leg shorter than the other or one leg longer than other things like orthotics can be useful so remember Glen who spoke about the podiatrist who spoke about bunions last week I'll send a patient to him if I find that there's a leg lift length difference and he'll usually create a nice custom orthotic for them that evens out the legs because otherwise they'll always be a little bit of a dip there look at the terrain you're running on is it being caused by a big camber that you keep on running on can you just change that it will that solve the problem so go and have a look at the whole picture basically your treatment is identify the cause because that tells you what treatment you need there's no one-size-fits-all some people need to stretch but not the IT band all the muscles that attaches to the IT band some people need to strengthen up which is mainly the gluts gleets mat glute max as well as glute meet and teach themselves proper pelvic control others actually just need to look at their training volume and adjust where they run and how they run to get better from that but the big thing is that you identify your goals thank you for watching if would like to learn more about preventing sports injuries make sure you hit the subscribe button see you next time

Channel: Sports Injury Physio

Views: 24,736

Rating: 4.9147425 out of 5

Keywords: ITB, ITB syndrome, itb syndrome treatment, itb syndrome exercises, itb syndrome stretches, it band stretches, it band massage, it band syndrome, it band foam roller, it band exercises, it band knee pain, it band pain, itb syndrome massage, itb syndrome foam roller, how to treat itb syndrome, how to treat it band syndrome, how to treat it band pain, what treatment is best for itb syndrome, what treatment works best for it band

Id: 5RNaPIKtams

Length: 15min 38sec (938 seconds)

Published: Sun Nov 25 2018