Mark J Pitcher DC, MSc
chiropractor, exercise physiologist

     www.markjpitcher.com
      www.vailhealth.com




        Ilio-Tibial Band Syndrome
            Prevention and Rehabilitation
Ilio-tibial band
A tract of thickened fascia that arises

    • Anteriorly off the tensor fascia lata




                         Tensor fascia lata
Ilio-tibial band
A tract of thickened fascia that arises

    • Anteriorly off the tensor fascia lata
    • In the middle off the iliac crest
    •
                                          Iliac crest


                               Ilio-tibial tract
Ilio-tibial band
A tract of thickened fascia that arises

    • Anteriorly off the tensor fascia lata
    • In the middle off the iliac crest
    • Blends posteriorly with the glutes
                                          Iliac crest


                               Ilio-tibial tract

                              Gluteus Maximus
Ilio-tibial band
A tract of thickened fascia that inserts

    • distally at Gerdy’s tubercle
Ilio-tibial band
It’s important to remember that the fascia
around the thigh is continuous and is just
thickened into the ilio-tibial band (IT band)
at the lateral aspect of the thigh.
Ilio-tibial band Syndrome



      Pain is usually located
      at the distal aspect of
      the tract, just above the
      joint line of the knee
Ilio-tibial band Syndrome

 Muscle imbalance of weak glutes
 coupled with overactive tensor
 fascia lata and adductor
 musculature creates a fascial pull
 that draws the ilio-tibial band
 anteriorly.

 This creates increased friction
 over the lateral femoral condyle and
 ultimately   inflammation and
 pain.
ITB Treatment:

Success of treatment depends on severity and ability to modify
current activity.

                                           Address
          RICE:                        Mechani
                                                                  ing
             Rest, Ice
                       ,                               cal Defic
                      ion,                                                its
           C ompress                          Sacroilia
                                                        c joint dy
              Elevation                                Pronation
                                                                   sfunction
                                             Talo-calc
                                                       aneal dys
                                            Internal r              function
                                                       otation a
                                                                 t the tibia

                        Myofascial
                       soft tissue work
                                ART
                               Graston
                             Foam Roller
ITB Treatment:

Success of treatment depends on severity and ability to modify
current activity.




    ry Needling                         Iontoph
   D                                    using e
                                                lectrical
                                                          oresis
                                        deliver           stimulat
                                                steroid            io
                                                        into the n to
                                                                 tissue

                                             Surgic
      ocal s teroid                       consi    al Rele
                                               dered      a     se
    L                                                a last r
          jection
                                            conser           esort o
                                                   vative
                                                          method nly if all
       in                                                        s fail.
ITB Treatment:

Success of treatment depends on severity and ability to modify
current activity.




        rcise                         Foam R
    Exe      s Maxim
                     us
                                            olling
                                                Glutes
      Gluteu        us
       Gluteus Medi                              ITB
                                              Adducto
                                                      rs

                     Stretching
                       Gluteus medius
                      Tensor fascia lata
Self Care:
Foam Rolling



      Glutes
1




      Glutes
    Glutes
2




      Glutes
    Glutes
Piriformis and
external hip rotators
   (part of the glutes)
1




    Piriformis and external hip rotato
2




    Piriformis and external hip rotato
                 Glutes/Piriformis
Adductors
(groin / inside of leg)
1




Adductors
2




   Adductors
Calves
Ilio-tibial band
 (outside of leg)




    Very tender in most athletes,
         especially runners
1




IT band
2




IT band
Self Care:
Sample Exercises
What exercises are appropriate depends on
the particular needs of the patient.


The following are examples of some
exercises we prescribe in the office.
Hip Hike
glute medius




1              2
SL Glute Bridge
glute max strength
hip flexor stretch
Crab Walk




1   2
TFL stretches
Mark J Pitcher DC, MSc
chiropractor, exercise physiologist

     www.markjpitcher.com
      www.vailhealth.com

Condition of the Week - Ilio-tibial Band Syndrome

  • 1.
    Mark J PitcherDC, MSc chiropractor, exercise physiologist www.markjpitcher.com www.vailhealth.com Ilio-Tibial Band Syndrome Prevention and Rehabilitation
  • 2.
    Ilio-tibial band A tractof thickened fascia that arises • Anteriorly off the tensor fascia lata Tensor fascia lata
  • 3.
    Ilio-tibial band A tractof thickened fascia that arises • Anteriorly off the tensor fascia lata • In the middle off the iliac crest • Iliac crest Ilio-tibial tract
  • 4.
    Ilio-tibial band A tractof thickened fascia that arises • Anteriorly off the tensor fascia lata • In the middle off the iliac crest • Blends posteriorly with the glutes Iliac crest Ilio-tibial tract Gluteus Maximus
  • 5.
    Ilio-tibial band A tractof thickened fascia that inserts • distally at Gerdy’s tubercle
  • 6.
    Ilio-tibial band It’s importantto remember that the fascia around the thigh is continuous and is just thickened into the ilio-tibial band (IT band) at the lateral aspect of the thigh.
  • 7.
    Ilio-tibial band Syndrome Pain is usually located at the distal aspect of the tract, just above the joint line of the knee
  • 8.
    Ilio-tibial band Syndrome Muscle imbalance of weak glutes coupled with overactive tensor fascia lata and adductor musculature creates a fascial pull that draws the ilio-tibial band anteriorly. This creates increased friction over the lateral femoral condyle and ultimately inflammation and pain.
  • 9.
    ITB Treatment: Success oftreatment depends on severity and ability to modify current activity. Address RICE: Mechani ing Rest, Ice , cal Defic ion, its C ompress Sacroilia c joint dy Elevation Pronation sfunction Talo-calc aneal dys Internal r function otation a t the tibia Myofascial soft tissue work ART Graston Foam Roller
  • 10.
    ITB Treatment: Success oftreatment depends on severity and ability to modify current activity. ry Needling Iontoph D using e lectrical oresis deliver stimulat steroid io into the n to tissue Surgic ocal s teroid consi al Rele dered a se L a last r jection conser esort o vative method nly if all in s fail.
  • 11.
    ITB Treatment: Success oftreatment depends on severity and ability to modify current activity. rcise Foam R Exe s Maxim us olling Glutes Gluteu us Gluteus Medi ITB Adducto rs Stretching Gluteus medius Tensor fascia lata
  • 12.
  • 13.
    1 Glutes Glutes
  • 14.
    2 Glutes Glutes
  • 15.
    Piriformis and external hiprotators (part of the glutes)
  • 16.
    1 Piriformis and external hip rotato
  • 17.
    2 Piriformis and external hip rotato Glutes/Piriformis
  • 18.
  • 19.
  • 20.
    2 Adductors Calves
  • 21.
    Ilio-tibial band (outsideof leg) Very tender in most athletes, especially runners
  • 22.
  • 23.
  • 24.
    Self Care: Sample Exercises Whatexercises are appropriate depends on the particular needs of the patient. The following are examples of some exercises we prescribe in the office.
  • 25.
  • 26.
    SL Glute Bridge glutemax strength hip flexor stretch
  • 27.
  • 28.
  • 29.
    Mark J PitcherDC, MSc chiropractor, exercise physiologist www.markjpitcher.com www.vailhealth.com