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Preventative Measures for Managing IT Band Syndrome
The most important thing to remember when managing IT band syndrome is that prevention is key.
Preventive measures vary depending on the person, activity level, and anatomical structures affected.
Maintaining flexibility and strength in the low back, hips, knees, and leg muscles is essential for both preventing and managing IT band syndrome.
You will likely be provided and instructed on specific exercises based on subjective and objective examination findings.
For example, if the gluteal muscles are tight, the leg can externally rotate, causing tension on the IT band (1,2).
Alternatively, if the gluteal muscles are inactive or weak, a compensatory gait pattern could be present, causing different strains to the IT band (3).
The question then remains what exercises should one do to prevent IT band syndrome from developing or worsening.
If clinically recommended, exercises to strengthen the muscles that help bring the leg out to the side away from the body and back in towards the body (hip abductors and adductors) might be beneficial.
Because the hip abductor and adductor muscles work closely with the IT band, weakness of these muscles can be problematic – thus, strengthening them can help prevent symptoms!
We’ve put together a small reference list providing a few examples of easy-to-complete exercises for managing IT band syndrome.
This list is not comprehensive, and it’s always best to see a health care provider before beginning prescriptive exercises.
IT Band Exercises
1. Side-lying Leg Lift (Hip Abduction)
One of the most common exercises prescribed to target a small gluteal muscle, the gluteus medius.
This exercise can be done without a resistance band to begin and progresses over time to include a resistance band to increase the difficulty.
1. For this exercise, begin by lying on your side.
You may find it comfortable to place a pillow beneath your head to ensure your spine is in a neutral position.
2. Slightly bend the bottom leg and make sure your top leg is not bent.
3. Take a breath in, leave the top leg up to the ceiling, and slowly back down to the floor.
4. Repeat this on each leg.
It is important to focus on slowly bringing your leg back down in this exercise to keep the muscle under tension for as long as possible, improving your results.
2. Banded Lying Bridge
The bridge exercise is well-known for benefitting the outcomes of many conditions.
For this exercise, it is important to have a resistance band around the knees to provide proprioceptive feedback to the body.
1. This exercise begins by placing an appropriately sized resistance band around the knees, ensuring the skin is not pinched.
2. Assume a lying position where your knees are bent, push your hips up to the ceiling, and slowly return to the starting position.
There are 3 things to focus on in this exercise.
The first is to ensure that you actively push your knees out against the resistance band to create tension.
There is no need to push extremely hard, just enough so that it is taut.
The second thing to remember is to keep your pelvis neutral throughout this exercise.
An excellent way to do this is to make sure your low back is touching the ground when you are in the starting position before pushing up.
The last thing to remember is to return to the starting position slowly and with control.
3. Standing Resisted Hip Abduction
This exercise will help you practice balance and strengthen each leg.
1. Stand near a wall or have a chair close by to help stabilize.
2. Begin by lifting one leg slightly off the ground and moving your leg to the side, then bringing it slowly back in.
This exercise is important to keep the hips level and the torso in an upright and engaged position.
If this feels too simple, you can progress this exercise by placing an appropriately sized resistance band around the ankles.
This will help to strengthen the muscles after they are properly trained to stabilize in the single-leg standing position.
4. Hip Hikes
This exercise again targets the gluteus medius muscle, a critical muscle for gait.
1. To begin this exercise, find a small step or short stool to use.
If needed, use a chair or another sturdy object to keep your balance.
2. Standing sideways on the stair, make sure your core is engaged and your hips are level.
3. Keeping both legs straight, stabilize one leg on the step and allow the other to slowly drop towards the ground below the step.
4. Slowly and with control, hike your hip back up to the starting position and repeat on the other side!
5. Banded Monster Walks
Once you have progressed through the above exercises that focus on balance and stabilization, you can progress to functional strength-focused exercises.
The banded monster walk allows you to train the muscles attached to the IT band in a movement-based way.
1. To begin this exercise, place an appropriately sized resistance band around the knees.
2. Stand with the core engaged, hips slightly wider than shoulder-width, and toes forward.
3. Bend into the beginning of a squat, stopping about in about a quarter of a squat position.
Be sure to maintain tension on the resistance band throughout this movement and push out with your knees.
4. Keeping your weight in the middle of your foot and maintaining the slight squat, take some small steps sideways.
5. Then take some small steps back in the other direction.
As with many of the exercises mentioned above, it is important to perform this motion slow and controlled!
6. Standing Single Leg Lift
This motion is similar to a single-leg deadlift.
Still, it is specifically helpful for managing IT band syndrome to develop the functional motion of lowering the weight on the body onto a single leg.
For safety with this exercise, if balance is a problem, be sure to complete it near a wall or other sturdy object.
1. Begin this exercise by standing up straight on one leg.
2. Engage your core and slightly bend the leg you are standing on to help you feel more comfortable and stable.
3. As you bring the opposite leg back behind you, bend your torso forward.
If it is helpful, touch an object on the floor; and repeat this sequence with the other leg.
This exercise is important to maintain a neutral and level hip position and complete the movement with control.
7. Side Plank
The last exercise we’ll break down is a general strength exercise that helps work the entire side-body.
It can be used to improve core strength and endurance but can also inadvertently prevent IT band syndrome.
1. To begin this exercise, start by lying on your side with your legs straight and on top of one another.
If this feels too difficult, you can also perform this exercise with your knees bent and stacked on top of one another.
2. Use your forearm to stabilize the top of your body, and make sure your elbow is in line with your shoulder so that the joints are ‘stacked.’
If this is uncomfortable, a towel or yoga mat may be best to use beneath the elbow.
3. With an engaged core, lift your hips to the ceiling, and hold this position (your shoulders, hips, knees, and ankles should be in a straight line).
The critical piece of this exercise is keeping your hips high, so if this feels difficult, you can shorten the amount of time you are holding the position at the top of the plank.
4. Slowly lower back to the ground and repeat on the other side.
Conservative Care First
Like how the exact cause of IT band syndrome varies from patient to patient, current literature is also undecided on whether it is caused by muscular weakness, overuse, or gait abnormalities.
The research does, however, support the use of exercise for promoting symptom relief.
Conservative care, including preventive and corrective exercise, has a 90% success rate! (4)