IT Band Syndrome Exercises

Iliotibial band syndrome (ITBS) is common among people who run, bike, and play certain sports that require a lot of bending. People who sit, squat, or kneel for long periods of time are also at risk. But this condition doesn’t have to sideline you from activity forever. In fact, movement is encouraged for people with ITBS. Exercise can benefit knee pain, hip pain, and other common symptoms of IT band inflammation. The key is to know what IT band syndrome exercises are safe—and which ones to skip—so you don’t end up feeling worse.

What Is IT Band Syndrome?

We can’t talk about safe exercises for IT band pain without briefly discussing the knee’s anatomy. The iliotibial band is a flexible, fibrous tendon that runs along the outside of the leg from the top of the hip bone to the knee. If the IT band is too tense or tight, it may rub against the bone. That friction leads to IT band swelling, irritation, and pain that is usually felt just above the knee.

Endurance sports and some anatomical traits are shown to increase the risk of ITBS. Bowed legs and muscle weakness in the hips, glutes, and abs are just a few conditions that increase the likelihood of IT band pain. The goal of exercise with IT band syndrome is to avoid the repetitive motions that trigger IT band inflammation while staying active and reaping all of the benefits that come with physical activity.

Physical Therapy Exercises for IT Band Syndrome

Physical therapy and temporary lifestyle changes are typically the first line of treatment. Research shows ITBS responds well to conservative therapies. Here are some safe, gentle, and effective exercises and stretches to practice with your physical therapist and at home for relief from. Before starting any new fitness regimen, consult your healthcare provider to ensure exercise is safe for your condition.

Iliotibial Band Stretch

1. Begin in a standing position, gently resting one side of the body against a wall.
2. Place the leg with the affected hip close to the wall. Cross the other leg in front of it.
3. Allow the affected hip to drop toward the wall. Lean away from the affected hip until you begin to feel a gentle stretch.
4. Hold that stretch for 15-30 seconds. Repeat this stretch three more times.
5. If both legs are affected, repeat this stretch on the other side.

Clamshell

1. For this gentle stretch, lay down on one side.
2. Bend your knees and rest one leg on the other with your feet together.
3. Keep your feet together and slowly lift the top knee.
4. Repeat 15 times. Switch sides and repeat if both legs are affected.

Hamstring Stretch

1. For this stretch, we will move to the floor in front of an open doorway.
2. Lie down on your back and extend the unaffected leg through the opening.
3. Raise the affected leg up and place it against the wall straightening your knee until you feel a stretch in the back of the thigh.
4. Hold that stretch for around a minute. Rest before lengthening your leg a bit further. You can hold this stretch for as long as six minutes.
5. Repeat on the other side if both legs have IT band pain.

Piriformis Stretch

1. Lie on your back with your legs extended straight out.
2. Lift the affected leg and bend at the knee.
3. Use the opposite hand to reach across the body and gently pull the outer knee toward the opposite shoulder.
4. Hold that stretch for 15-30 seconds. Repeat this stretch three more times.
5. Switch legs and repeat.

Windmill

1. Start in a standing position, keeping your front leg slightly bent.
2. Slowly lean forward while raising the back leg up.
3. Bring your trunk down toward the ground until you can pick up an object on the floor.
4. Repeat this exercise 10 times and switch legs if needed.

Standing Hip Motions

1. Return to a standing position, keeping your hips level and trunk upright.
2. Stand on one leg and swing the opposite leg forward. Repeat 10 times.
3. Next, stand on one leg and swing the opposite leg out to the side. Repeat 10 times.
4. Now, swing the raised directly to the back. Repeat 10 times.
5. Complete the same movements with the opposite leg raised if you have bilateral IT band pain.
6. As you progress, you can add a fitness band for more resistance.

IT Band Syndrome Exercises to Avoid

So, are there any activities you should avoid if you have IT band pain and inflammation? Yes. As a rule, reduce the movements that caused your condition in the first place until your physical therapist gives you the okay. These activities and exercises include lunges, squats, running, and cycling.

If they are part of your regular workout routine, ask your PT when and how to resume your favorite activities safely. For example, distance runners may start out with a half-mile or mile instead of jumping right back to a 5K or they may stick to level surfaces and avoid running downhill which can stress the knees.

More Tips to Exercise Safely with IT Band Syndrome

Warm up and Stretch

Stretching and warming-up before intense physical activity are always recommended to prevent injuries. Dynamic stretches activate the specific joints and muscles to be used during activity. A static stretch involves moving a single muscle into position and holding it for several seconds. Static stretches are good after activity to reduce stiffness and prevent strains. Someone prone to IT band syndrome should focus on stretching the IT band, hamstrings, hips, and thighs.

Foam Rolling

Foam rolling helps to reduce pain at the IT band, increase circulation, and promote muscle recovery. Doing this after exercise can help prevent IT band stiffness and pain. Lay on your side with the injured leg resting on the foam roller just below the hip. Cross the opposite leg out in front of you to help support your body weight (along with your hands.) Roll back and forth in a slow, steady motion from below the hip to just above the knee. Do this for one minute per muscle.

Work with a Physical Therapist

Physical therapists are trained to assist with individuals experiencing ITBS pain and stiffness. They incorporate stretching and strengthening exercises, manual therapy, and other modalities to promote good alignment and reduce discomfort. Physical therapists also recommend modifications to reduce stress on the knees and hips.

For example, they might suggest lowering your seat when you ride a bike or tweaking your running form to encourage healthy body alignment. They assess your progress over time and adjust your treatment plan accordingly.

Let Pain Be Your Guide

Pain provides vital clues about what is happening in the body. Severe pain is a sign that something is wrong. Never try to push through the pain. If pain is getting worse, dial back your activity, and wait to discuss your symptoms with your physical therapist. Pushing too hard can lead to further injury. Find a physical therapy clinic near you.