Iliotibial Band Syndrome (ITBS) is a frequent overuse injury, particularly among athletes such as runners, cyclists, and weightlifters. It causes discomfort on the outer knee. While it was once believed to be a friction syndrome, recent research has shown that the iliotibial band is tightly anchored to the leg, offering new insights into its underlying causes.
Our Success Rate is Over 90%
Our 90% success rate in treating Iliotibial Band Syndrome (ITBS) underscores the effectiveness of our multimodal, interdisciplinary approach, focusing on pain relief and improved function.
Article Index
Iliotibial Band Structure and Function
The iliotibial band (ITB) is a thickened portion of the fascia lata, a connective tissue that envelops the leg like a snug sleeve. Running along the outer thigh, the ITB is integrally connected to the fascia lata, limiting its ability to move independently. This interconnected structure makes the idea of it sliding back and forth less plausible.
The ITB also plays a key role in the "Pelvic Deltoid Complex." Within this complex, the gluteus maximus at the back of the hip and the tensor fascia lata at the front merge into the ITB. Together, these muscles aid in hip abduction—lifting the leg to the side—and work with the gluteus medius to keep the pelvis stable when standing on one leg, as during the Stance Phase of walking.
The Role of Hip Strength in IT Band Tension
Weak hip muscles can lead to excessive inward movement of the leg, particularly during the Stance Phase of walking. This inward shift increases the strain on the iliotibial band, compressing the outer side of the knee. During this movement phase, individuals with ITBS typically exhibit weaker gluteal muscles and greater hip adduction.
Rethinking the Source of Pain in ITBS
Previously, it was thought that ITBS pain stemmed from the compression of a bursa. However, MRI studies have debunked this theory, showing no bursa between the IT band and the lateral knee. Instead, a nerve-rich fat layer is present in this area, and its compression is now believed to be the primary cause of the lateral knee pain associated with ITBS.
Diagnosis of ITBS
A thorough examination, incorporating orthopedic, neurological, and vascular assessments, is vital when diagnosing ITBS. These evaluations are essential for confirming the condition and ruling out other underlying issues. Beyond identifying symptoms, these assessments delve into the root cause, guiding more targeted and effective treatment strategies. Upcoming videos will demonstrate some common diagnostic procedures we use with our patients.
Orthopedic Knee Assessment
The following video showcases a selection of standard orthopedic tests we employ in our patient knee examinations. These methods are essential tools in our diagnostic toolkit, helping us understand the complexities of each patient's condition.
Neurological Assessment of the Lower Limbs
The neurological assessment of the lower limbs is pivotal in the comprehensive neurological examination. This video delves into evaluating motor and sensory neurons of the lower extremities, helping detect any nervous system irregularities.
Peripheral Vascular Examination
A peripheral vascular examination is a crucial diagnostic tool employed to exclude indications of vascular-related disorders. Recognizing and treating Peripheral Vascular Disease (PVD) can significantly reduce the risk of cardiovascular and cerebrovascular complications.
Imaging
The effectiveness of imaging for Iliotibial Band Syndrome (ITBS) varies depending on the modality. X-rays are generally useless for diagnosing soft tissue issues like ITBS but can rule out other bone-related conditions. Dynamic and affordable ultrasound is valuable for real-time visualization of tissue inflammation and abnormalities. While highly detailed, MRI can be expensive and unnecessary for straightforward ITBS cases. Choosing the right imaging technique should be based on clinical necessity, balancing the need for accurate diagnosis with cost-effectiveness.
Treatment Iliotibial Band Syndrome
Managing Iliotibial Band Syndrome (ITBS)Â often involves advanced techniques like myofascial release, including Motion Specific Release (MSR). These targeted therapies focus on the entire kinetic chain, from the hip to the foot. Attention to the sacroiliac (SI) joints, which connect the spine to the hips, is critical for ensuring stability. Additionally, addressing limitations in peripheral joints, particularly in the knee and ankle, is essential for restoring full lower limb function and effectively resolving symptoms.
Knee Pain Protocol - MSR Video Demonstration
Knee pain presents differently in every individual, with the source of pain ranging from localized structures to a broader kinetic chain. MSR can significantly enhance mobility and alleviate pain by targeting specific pain-triggering zones and movements.
Fascial Expansion: The MSR Knee Pain Protocol
Fascial expansions play a crucial role in managing iliotibial band syndrome (ITBS) by integrating modern fascial research, kinetic chain dynamics, and principles from acupuncture. This approach effectively addresses the pain and inflammation associated with ITBS and improves overall joint function. By focusing on the health and biomechanics of the fascia, the MSR protocol helps to alleviate ITBS symptoms, reduce discomfort, and restore mobility.
4 Point Knee Joint Mobilization (MSR) - Video Demonstration
Knee joint mobility is crucial in treating ITB Syndrome and ensuring the kinetic chain's proper function. ITB Syndrome often restricts knee movement, affecting the entire kinetic chain.
Treatment Frequency
To effectively manage Iliotibial Band Syndrome (ITBS), patients can opt for either two 15-minute sessions or one 30-minute session per week, depending on the severity of symptoms and personal preference.
Initial Phase (2-3 weeks):
MSR Manual Therapy:Â 2 sessions per week.
Home Exercises:Â Daily functional exercises tailored by the practitioner.
Assessment:
Positive Response:Â If symptoms improve, reduce therapy to 1 session per week and continue daily exercises.
Persistent Symptoms:Â Maintain therapy frequency and re-evaluate the exercise plan.
Maintenance Phase:
MSR Manual Therapy:Â Monthly sessions or as needed.
Home Exercises:Â Continue daily to sustain benefits and prevent recurrence.
The Role of Exercises in Addressing ITBS
Physical exercises are essential in effectively managing Iliotibial Band Syndrome (ITBS). A comprehensive exercise regimen for ITBS should include flexibility, mobility, strength training, balance, and proprioception exercises. These targeted activities enhance muscle function, improve joint mobility, and reduce ITBS symptoms.
We recognize that no single exercise program fits all concerning ITBS. While general exercise examples can guide treatment, we focus on personalized exercise prescriptions. This approach ensures that each patient receives exercises tailored to their specific needs and conditions, optimizing recovery and management of ITBS.
Myofascial Release With a Ball
This video showcases how to employ a ball to ease tension in the Iliotibial Band, a resilient bodily structure vital as a movement facilitator. Though rolling and stretching exercises won't extend the IT Band, they are essential for managing ITB Syndrome, helping to lessen pain and optimize the band's functionality.
Effective Gluteal Muscle Release - Lacrosse Ball
This is an extremely effective way (combined with stretching) to release restrictions in the gluteal muscles. Remember to strengthen the glutes.
15-Minute Butt and Thigh Workout
Strengthen and Tone Your Glutes—Incorporating this exercise program into your fitness routine can yield impressive results in strengthening your buttocks, thighs, and legs. Doing this program every other day for 4-6 weeks with consistency and commitment can lead to substantial gains.
Improve Your Balance - Advanced Exercise
Balance exercises can benefit people of any age. They improve one's ability to control and stabilize one's body's position, significantly reducing injury risk, rehabilitating current injuries, or increasing sports performance.
Why Choose Our Approach for Iliotibial Band Syndrome (ITBS)
When ITBS interrupts your active lifestyle, you deserve an effective treatment plan tailored to your unique needs. Our approach consistently delivers a high success rate in reducing pain and restoring lower limb function, allowing you to return to the activities you love confidently.
Established Expertise:Â Our team, led by Dr. Brian Abelson, brings over 30 years of clinical experience and the successful treatment of more than 25,000 patients. With our extensive background, we deeply understand the challenges of ITBS and are dedicated to helping you overcome them.
Thorough Assessments:Â We take a comprehensive approach to your care, thoroughly evaluating all factors contributing to ITBS, including hip strength, gait mechanics, and fascial restrictions. This in-depth assessment ensures that every aspect of your condition is addressed, leading to a personalized treatment plan designed for your needs.
Powerful MSR Procedures:Â Our Motion-Specific Release (MSR) techniques precisely target the fascial and muscular imbalances contributing to ITBS. By restoring proper function and reducing tension in the iliotibial band, our advanced procedures help alleviate pain and improve mobility, empowering you to move freely again.
Customized Exercise Programs: Recovery from ITBS isn’t a one-size-fits-all process. That’s why we design individualized exercise programs focusing on enhancing flexibility, strengthening key muscles, and improving overall biomechanics. These exercises are carefully selected to support your recovery and help you maintain long-term success.
Logical, Evidence-Based Approach: Our treatment protocols are rooted in the latest research and clinical evidence, ensuring you receive the most effective care possible. We don’t just address your symptoms; we equip you with the knowledge and tools to manage and prevent ITBS in the future.
With our proven, patient-centred approach, you’re not just another patient but a partner in your recovery. Take the first step toward pain-free movement and reclaim your active lifestyle, knowing we’re with you every step of the way.
References
Is iliotibial band syndrome really a friction syndrome?Fairclough J, Hayashi K, Toumi H, Lyons K, Bydder G, Phillips N, Best TM, Benjamin M J Sci Med Sport. 2007 Apr; 10(2):74-6; discussion 77-8.
Hip abductor weakness in distance runners with iliotibial band syndrome. Fredericson M, Cookingham CL, Chaudhari AM, Dowdell BC, Oestreicher N, Sahrmann SA Clin J Sport Med. 2000 Jul; 10(3):169-75.
Fairclough J, Hayashi K, Toumi H, et al. The functional anatomy of the iliotibial band during flexion and extension of the knee:implications for understanding iliotibial band syndrome. J Anat. 2006;208:309-316
The functional anatomy of the iliotibial band during flexion and extension of the knee: implications for understanding iliotibial band syndrome J Anat. Mar 2006; 208(3): 309–316.
The Harvard Gazette - "Understanding the IT Band"
Falvey, E.C., Clark, R.A., Franklyn-Miller, A., Bryant, A.L., Briggs, C., & McCrory, P.R. (2010). Iliotibial band syndrome: an examination of the evidence behind a number of treatment options. Scandinavian Journal of Medicine & Science in Sports, 20(4), 580-587.
Fredericson, M., & Wolf, C. (2005). Iliotibial band syndrome in runners: innovations in treatment. Sports Medicine, 35(5), 451-459.
Ellis, R., Hing, W., Reid, D. (2007). Iliotibial band friction syndrome—A systematic review. Manual Therapy, 12(3), 200-208.
Noehren, B., Davis, I., & Hamill, J. (2007). ASB Clinical Biomechanics Award Winner 2006 Prospective study of the biomechanical factors associated with iliotibial band syndrome. Clinical Biomechanics, 22(9), 951-956.
Orchard, J.W., Fricker, P.A., Abud, A.T., & Mason, B.R. (1996). Biomechanics of iliotibial band friction syndrome in runners. The American Journal of Sports Medicine, 24(3), 375-379.
Straub, R.K., & Khayambashi, K. (2018). Iliotibial Band Syndrome: Evaluation and Management. Journal of Orthopaedic & Sports Physical Therapy, 48(12), 911-916.
van der Worp, M.P., van der Horst, N., de Wijer, A., Backx, F.J., & Nijhuis-van der Sanden, M.W. (2012). Iliotibial band syndrome in runners: a systematic review. Sports Medicine, 42(11), 969-992.
Fairclough, J., Hayashi, K., Toumi, H., Lyons, K., Bydder, G., Phillips, N., Best, T.M., & Benjamin, M. (2006). The functional anatomy of the iliotibial band during flexion and extension of the knee: implications for understanding iliotibial band syndrome. Journal of Anatomy, 208(3), 309-316.
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DR. BRIAN ABELSON, DC. - The Author
With over 30 years of clinical practice and experience in treating over 25,000 patients with a success rate of over 90%, Dr. Abelson created the powerful and effective Motion Specific Release (MSR) Treatment Systems.
As an internationally best-selling author, he aims to educate and share techniques to benefit the broader healthcare community.
A perpetual student himself, Dr. Abelson continually integrates leading-edge techniques into the MSR programs, with a strong emphasis on multidisciplinary care. His work constantly emphasizes patient-centred care and advancing treatment methods. His practice, Kinetic Health, is located in Calgary, Alberta, Canada.
Why Choose Our MSR Courses and MSR Pro Services?
Elevate your clinical practice with our Motion-Specific Release (MSR) courses and MSR Pro services, designed to provide a comprehensive, evidence-based approach to musculoskeletal care. Here’s why you should join us:
Proven Methodology:Â Developed by Dr. Brian Abelson, an international best-selling author with over 30 years of clinical experience, MSR integrates the most effective elements of osseous and myofascial therapies. With a success rate exceeding 90%, our approach helps set a new industry standard.
Comprehensive Training: Our courses blend rigorous academic content with innovative techniques. You’ll master essential areas like orthopedic and neurological examinations, myofascial treatment, fascial expansions, and osseous adjusting and mobilization.
Extensive Resources:Â As an MSR Pro subscriber, access a vast library of over 200 MSR procedures, fillable PDF forms, instructional videos, and in-depth articles. From patient intake to tailored exercise prescriptions, our resources equip you for clinical success.
Tailored Support:Â Refine your diagnostic skills and expand your treatment techniques with ongoing support through over 750 videos, including 200 technique videos, 250 exercise videos, and 160 MSK articles. This extensive library features over 50 musculoskeletal condition articles, all designed to support you in clinical practice. Our resources are dynamic, with regular updates to articles, technique videos, and new additions to our educational curriculum.
Innovation and Growth:Â We emphasize continuous learning and innovation, giving you the tools to adapt and thrive in complex clinical scenarios. Our courses and resources are designed to foster professional growth, keeping you at the forefront of musculoskeletal therapy.
Unlock your practice's full potential with our MSR courses and MSR Pro services. Achieve outstanding clinical outcomes and join a community of forward-thinking practitioners dedicated to excellence in patient care.
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