Orthopedics Physical Therapy Exercises Print Physical Therapy Exercises for Iliotibial Band Friction Syndrome By Brett Sears, PT Updated May 08, 2019 Medically reviewed by a board-certified physician More in Orthopedics Physical Therapy Exercises Sprains & Strains Fractures & Broken Bones Orthopedic Surgery Osteoporosis Pediatric Orthopedics Sports Injuries Shoulder & Elbow Hip & Knee Hand & Wrist Leg, Foot & Ankle Assistive Devices & Orthotics Medication & Injections View All If you have iliotibial band friction syndrome (ITBS), what should you expect from a physical therapy exercise program? Iliotibial band friction syndrome is a painful condition that typically affects runners and athletes, although anyone can experience it at one time or another. The symptoms include sharp or burning pain on the lateral, or outside, aspect of your knee. Pain is usually worse with running and better with rest, although people with severe cases of ITBS may experience pain while resting. If you have ITBS, you may benefit from physical therapy to help control your symptoms and to help restore your normal activity level. The goals of physical therapy are: Decrease pain and inflammationImprove flexibilityImprove strengthRegain normal functional mobility. One of the most important components of your ITBS rehab is exercise. Your physical therapist should prescribe exercises that you can do in the PT clinic and as part of a home exercise program. Exercises should focus on specific impairments that you have that may be causing your Iliotibial band pain. Here is a sample exercise program for ITBS that your PT may prescribe for you. It starts with gentle stretches for your IT band and progresses to strengthening, balance, and plyometric exercises. Remember, each person's injury is unique, and your specific exercise program for ITBS may be different. You must check in with your doctor before starting this, or any other, exercise program for Iliotibial band friction syndrome. 1 Iliotibial Band Stretches Hero Images/Getty Images Your physical therapist may prescribe iliotibial band stretches as part of your rehab program for ITBS. These exercises help to gently elongate your iliotibial band, improving the tissue's ability to withstand stretching forces to it. Iliotibial band stretches may include: The standing iliotibial band stretchThe side lying iliotibial band stretchThe pigeon stretch Perform each stretch 3 times, holding the stretch for thirty seconds. Be sure to relax fully while stretching. If you feel any pain while stretching your iliotibial band, stop and check in with your physical therapist. 2 Hamstring and Quadriceps Stretches Thinkstock/ Getty Images Sometimes, other muscles of your thighs and legs may be implicated as a culprit in your ITBS pain. Your physical therapist may prescribe stretches for your quadriceps or hamstrings to help improve the overall flexibility around your thigh and knee joint. Stretches may include: The towel quad stretchThe towel hamstring stretchThe standing hamstring stretchThe side lying quad stretch Hold each stretch for thirty seconds and perform each stretch 3 times. If you feel any pain while stretching, stop and check in with your physical therapist. 3 Hip Strengthening Exercises Ben Goldstein Research indicates that ITBS and other forms of repetitive strain injuries in the knee may be caused by weakness in your hip muscles. The gluteus medius muscle is responsible for keeping your knees In the correct alignment while you are walking, running, or jumping. If they are weak, you may suffer from a "collapsing kinetic chain;" your knee may turn inwards as you are running. This can place incredible stress and strain on your knee and iliotibial band. If you have ITBS, you may benefit from hip strengthening exercises. These may include: Straight leg raisesBridges and single leg bridgesClam shellsLateral band walksHip hikes Perform 10 to 15 repetitions of each exercise, 3 to 4 times per week. You should stop the exercises and see your physical therapist if you feel any pain in your knee. 4 Quadriceps Strengthening Exercises Bill Oxford/E+/Getty Images Your physical therapist may prescribe exercises to help strengthen your quadriceps muscles if you have ITBS. Quad exercises may be done to help improve the neuromuscular control of your VMO, a specific part of your quad that can help control the position of your kneecap and knee. Quad exercise may include: Quad setsThe short arc quad (SAQ) exerciseStraight leg raisesMini squatsLeg extension exercises Perform 10 to 15 repetitions of each exercise, 3 to 4 times per week. Be sure to stop if you feel pain in your knee or leg as you work on strengthening your quads. 5 Balance and Proprioception Exercises Rollover/Getty Images Many patients with ITBS have impaired balance and proprioception and benefit from performing specific balance exercises. Proprioception is your body's sense of where it is in its environment. Specific nerve endings and report to your brain about the position of your joints and muscles and the amount of strain on your muscles. Impaired proprioception may cause your knee to be in the wrong position while running, leading to excessive stress on your iliotibial band. Balance exercises that your physical therapist may prescribe may include: Single leg stanceThe T-stanceBOSU or wobble board standingThe BAPS board Your PT can instruct you on how to make the most of your balance program and how to perform the exercises as part of your home program. 6 Plyometrics John Fredele/Getty Images Running requires that you go through a flight phase—no part of your body is in contact with the ground. This means that you will have to land on one foot and then push off again when you run. Your physical therapist may have you work on your ability to accept weight through your leg and push off again with plyometric exercises. Learning to jump and land with your knee in the correct position may be necessary to keep strain off your IT band while running. The drop-jump test may also be used as an exercise for you to practice keeping your knees in the optimal position while you run and jump. 7 Putting It All Together Westend61/Getty Images If your iliotibial band friction syndrome is keeping you from running, your ultimate goal of rehab is to get back on the road. This means that after a few weeks of working on flexibility, balance, strength, and leaping it may be time to test out your running tolerance. Your physical therapist may offer you specific strategies to get you back to running form again. These may include: Video running analysisChanging your running formPutting together a return to running plan with a gradual increase in mileage and running pace Iliotibial band friction syndrome can be a difficult condition to treat. It may require that you take a break from running for a few weeks. Working on specific impairments with exercises that your physical therapist prescribes may be necessary to improve your body's ability to manage the forces that are placed upon it while running. Exercises, like the ones in this program, should be the foundation of your rehab program. By working closely with your PT and by working to improve your strength, mobility, and balance you can improve your chances of returning to pain-free running and activity quickly and safely. Was this page helpful? Thanks for your feedback! Get exercise tips to make your workouts less work and more fun. Email Address Sign Up There was an error. Please try again. Thank you, , for signing up. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Louw, M and Deary, C. The Biomechanical Variables Involved in the Aetiology of Iliotibial Band Syndrome in Distance Runners – A Systematic Review of the Literature. Physical Therapy in Sport. 15(1); 2014: 64-75.