Exercises For Iliotibial Band / ITB Pain

The nearly universal mistake that is made with exercise prescription for IT Band Syndrome is to make the main focus on stretching and foam rolling. The superior approach is to make the main focus on addressing the reason for the IT Band to repeatedly tightening up.

The real reason for most IT Band Pain is a lack of healthy stability and alignment in the lower limb – therefore strength and balance exercises are the most appropriate approach for longer term results. Until the strength and alignment is addressed the band will remain under strain – and tighten up endlessly.

The type of strength exercises that you really need if you have iliotibial pain are those that target your stabilising muscles!

The good news is that effective rehab for IT Band Syndrome doesn’t need to be fancy, in fact it’s better if it isn’t. Rather than getting lost in a variety of complex movements it is better to focus on total mastery of a few simple but highly targeted ones. For these reasons, this exercise sheet contains very simple exercises, but with fairly in depth explanations on the how’s & why’s of their execution.

Single Leg Squats – For IT Band Stability 

  • Balance on one leg and make sure you are steady. If you need to use a piece of furniture or a door frame for support please be certain to do so.
  •  Once you have your balance under control slowly execute a very small & slow single leg squat. The key to this squat is that it be very very slow and controlled, eliminating any wobble and maintaining weight slightly along the outside of the foot. As you can see from the following 2 pics it is not a deep squat!!!
  • Repeat this slow controlled ‘mini-squat’ 10 times on your most painful or weak side. Then repeat it on your good side. Do 5 sets in total (50 squats all together).

**The essence of this exercise is control, controlling any wobbles clears weakness and ‘spasticity’ from your leg and hip muscles. ITB syndrome sufferers usually have poor balance caused by muscle weakness, that’s why you may  wobble a bit on this exercise. If you wobble excessively just practice standing on 1 leg for a minute at a time until your balance improves. After a couple of months you may find you can start to more effectively control some mini-squats like those shown here. 

*The whole point of this exercise is to functionally activate your glutes and your quads in a way that is supportive to your entire leg. It is just as beneficial for knee and hip issues.

*GO SLOW!!! CONTROL IS THE NAME OF THE GAME. Analyse and micro-manage this movement as you perform it – making it as smooth, slow and controlled as you can.

Gentle Lunge – Strength Exercise For Knee Pain & Glute Activation

Stand naturally but symmetrically in preparation for your gentle forward lunge. Maintaining good posture while lunging is important – so gently press your shoulders down and hold your chin down slightly, and expand your chest at the front. Maintain this posture throughout the lunge.

Step 1. Step forward about the length of a long step, there is no need to step as far as you possibly can or anything like that. Just take a long step forward and plant your foot on the ground.

Step 2. Once your front foot is planted and your back heel is up off the ground you can begin to lunge, before you do though make sure the outer ⅔ of your front foot is bearing your weight. *this will mean your knee comes slightly wide of your body which is the key to activating your glutes!!  The lunge itself is simply a shallow bend of your knee maintaining the weight over the outer ⅔ of the foot and keeping the knee nice and wide ( as per the the pic below )

Step 3. Push yourself back out of the lunge and reverse to the starting position and location. Focus on good control as you reverse the lunge and keep observing all the postural and alignment pointers you read above.

Step 4. Repeat steps 1-3 on the opposite leg carefully observing all the same postural and alignment rules.

Step 5. Start with 10 lunges on each side (20 in total). Have a rest for a few minutes then repeat. Some people may wish to start on 3 or 4 sets of 20, for others 1 or 2 will be an adequate start point. Don’t do so many that they get sloppy!!!

*If you have scar tissue in your ITB you may well find this exercise makes your knees start to feel slightly worse over a period of days or weeks. This means you need to STOP and see a practitioner who can use specific massage type techniques to break up the scar tissue before you can continue. 

*These lunges don’t need to be deep, do them quite shallow (Knee less than 90 degrees at deepest point). Focus on control of the movement that’s where the benefits are. The 3 goals of successful ankle pain rehabilitation are to restore mobility to the joint – stretch out scar tissue – strengthen the ankles stabilising muscles.

Wobble Pad – Strength Exercise For Iliotibial Pain

Step 1. Stand one legged on the pad, on the same side as your dominant hand.

Step 2.  Find your balance, engage your weight along the outer ⅔ of your foot ie. without leaning your weight inwards onto your big toe.

Step 3. Hold yourself as steady as you can for a full minute maintaining the same alignment. Try to be steady and control any side to side wobble to the best of your ability.

* SAFETY FIRST – If you don’t feel safe and steady unassisted, use a hand on a wall, door frame or a piece of furniture to keep yourself steady. You can gradually reduce the amount of assistance you give yourself until you only need a single finger for support, and then no support.

*a good way to think of balance is this –  if your weight leans in and on to your big toe (below) your ankle has collapsed and you have lost control.

*This may be a simple exercise but don’t underestimate its power, it restores strength to the muscles of the entire leg which is vitally important if you want to have a chance of resolving your pain and maintain mobility in the longer term.