Rehabilitation of Iliotibial Band Friction Syndrome or Runners Knee. Below we outline a rehab program including treatment and ITB exercises.
Aims of Rehabilitation
The following example is meant for information purposes only. We recommend seeking professional advice before attempting any rehabilitation
The aims of rehabilitating runners knee or Iliotibial band syndrome are:
- Reducing initial pain and inflammation.
- Stretching the iliotibial band and Tenser Fascia Latae muscle.
- Strengthen the tendon and surrounding muscles.
- Gradual return to full fitness.
- Prevention of recurrence.
Reducing Pain and Inflammation
This phase may last between two days and two weeks depending on how bad the injury is and how well it is treated.
- Rest from any activity that causes pain and inflammation. Start with at least five days of complete rest from training.
- After this period, try doing other activities such as swimming or cycling if these are pain-free. If not, then try working the upper body instead. It is important to maintain a training routine of some sort.
- Apply ice or cold therapy. This will naturally aid in reducing inflammation. Initially ice can be applied for fifteen minutes every hour. You should aim to apply ice at least three times a day.
- Anti-inflammatory medication e.g. Ibuprofen may help in the early stages (first few days). Always check with a Doctor before taking medication. Ibuprofen should not be taken by asthmatics.
Stretching the Iliotibial Band
Stretching should be done throughout the treatment of this injury and is key to early and full rehabilitation.
- Stretch gently in the early stages if there is pain and inflammation. Hold stretches for at least 10 seconds and repeat 5 times. Aim to stretch at least three times a day.
- Later in the rehabilitation process when initial pain has gone stretching can be increased. Hold stretches for up to 45 seconds and repeat 5 times. Repeat this routine three times a day. PNF stretching techniques can also be introduced when inflammation has gone.
- Apply sports massage techniques. This is essential for the fasted recovery and to avoid re-injury when running starts again.
Once initial pain has gone and a stretching routine has been established then you can begin to strengthen the structures involved.
- The whole of the thigh needs to be strengthened but in particular the abductors (Tensor Fascia Latae and Gluteus Medius muscle) should be targeted.
- Start off with two sets of 10 reps provided this is pain-free.
- As this becomes easier, gradually build up the numbers you are doing (never increase by more than 5 reps on the day before) until you can complete 3 sets of 15.
Gradual Return to Fitness
- This can often start within two weeks of starting to treat the injury, but will depend on the extent of the problem.
- Build up running time from a much lower point than you left off before the injury. A reduction to about 50% of original mileage or time should be OK.
- Apply ice to the knee for 15 minutes after training.
- Increase running time rather than distance for the first few runs. Running distance should be increased by no more than 10% a week (depending on original fitness levels). If you feel pain or the inflammation comes back then go back a couple of steps to reduce the inflammation and start again.
- It is important to maintain a high level of stretching. If the Iliotibial band (ITB) is tight then the injury is very likely to recur. Simply reducing the inflammation will not cure the injury permanently.
- Apply sports massage regularly, particularly to the iliotibial band. This will eliminate tight spots and knots that can cause the ITB to tighten.
- Plenty of stretching on a regular basis.
- Deep massage to the Iliotibial band.
- Increase weekly mileage / training time gradually.
- Check feet for biomechanical disfunction (overpronation).
- If the feet roll in then this can cause the knee to rotate inwards, stretching and tightening the Iliotibial band.