Physical Therapy Guide to IT Band Syndrome

Dear Friends,

Not long ago, a patient came into our clinic after a fall, prior to visiting his physician. He had fallen on his left shoulder, and wanted me to examine him. He had pain with certain overhead movements and had some difficulty sleeping. He wanted to know if he should go see his family practitioner or an orthopedic surgeon. He believed, because he couldn’t lift his arm that he had a torn rotator cuff.

After examining his shoulder, I gave him a few exercises and told him he should do well without seeing either physician. I called him 10 days later to follow up and was pleased to hear that he had no more pain. He thanked me and said that it was unfortunate that I wasn't a doctor. He thought we should be marketing McDonald Physical Therapy to be the first provider to be seen if a person has a muscle strain of any kind. He made it clear that we needed to get this message out to the public.

As a result of this recent conversation, I decided to write about this case. Many people don’t know that in July 2013 a law was changed allowing people to see a physical therapist before a physician, if they wish. The present law states that a patient can come to a physical therapist for an evaluation and treatment for up to a 42-day period before needing to see a physician. What many patients do not understand is that we will and do send them to the proper specialist, immediately, if their injury is severe.

Most people don't realize that physical therapists are now required to get their Doctorate of Physical Therapy degree (DPT). It is not an MD by any means. However, we are the experts in the world of movement, strength, conditioning and function.

So, how might this new information help you in your life? If you have muscle pain in your back, neck, knee, shoulder, hip, etc., or a problem walking, getting in and out of a chair or car, getting up and down stairs, you should consider seeing one of our physical therapists. They will be able to examine and assist you, even if you need a referral to another medical provider. We will help you find a direction and plan to get your strength, balance and endurance, as you work your way back to normal activities in your life.

We hope you are staying healthy and safe during these very challenging times. If you need direction for any back, neck, sprains, strains, endurance or movement issues, please call and we will get you in as soon as possible. We have 18 treatment rooms to keep you safely distanced, if that is a concern. We also have 14,000 sq feet of treatment area to also help anyone if they are worried about social distancing as they try to overcome their pain.

McDonald Physical Therapy has been a privately owned healthcare provider for over 32 years in our community. Our main purpose is to evaluate each patient and help them get back to their best functioning self. As we journey with the patient during this healing process, we also educate that patient to help them better understand how they may be aggravating their condition and how they may be able to change a few things and add a few exercises to prevent the re-occurrence of their pain and injury. If you are having any of the challenges listed above or you are frustrated and feel lost, please call and we will be glad to help you regain control of your life.

Thanks for believing in us all these years.

Enjoy,

Fran McDonald, PT,DPT,OCS

Physical Therapy Guide to Iliotibial Band Syndrome (ITBS or "IT Band Syndrome")

What is Iliotibial Band Syndrome (ITBS)?

ITBS occurs when excessive irritation causes pain at the outside (or lateral) part of the knee. The iliotibial band, often referred to as the "IT band," is a type of soft tissue that runs along the side of the thigh from the pelvis to the knee. As it approaches the knee, its shape thickens as it crosses a prominent area of the thigh bone (femur) called the lateral femoral condyle before attaching to the tibia. Near the pelvis, it attaches to two hip muscles, the tensor fascia latae and the gluteus maximus.

Irritation and inflammation arise from friction between the IT band and underlying structures when an individual moves through repetitive straightening and bending of the knee. Typically, ITBS pain occurs with overuse during activities such as running and cycling.

ITBS can occur in:

Athletes performing repetitive activities, such as squatting, and endurance sports, such as running and cycling.
Individuals who spend long periods of time in a specific position, such as sitting or standing for a long workday, climbing or squatting, or kneeling.
Individuals who quickly start a new exercise regimen without proper warm-up or preparation.

Signs and Symptoms

With ITBS you may experience:

Stabbing or stinging pain along the outside of the knee.
A feeling of the IT band “snapping” over the knee as it bends and straightens.
Swelling near the outside of your knee.
Occasional tightness and pain at the outside of the hip.
Continuous pain following activity, particularly with walking, climbing, or descending stairs, or moving from a sitting to standing position.

Pain is usually most intense when the knee is in a slightly bent position, either right before or right after the foot strikes the ground. This is the point where the IT band rubs the most over the thigh bone.

How Can a Physical Therapist Help?

Your physical therapist will use treatment strategies to focus on:

Range of motion. Often, abnormal motion of the hip, knee, and foot joint can cause ITBS because of how the band attaches to hip muscles. Your physical therapist will assess the motion of your involved leg compared with expected normal motion and the motion of the hip on your uninvolved leg.

Muscle strength. Hip and core weakness can contribute to ITBS. The core refers to the muscles of the abdomen, low back, and pelvis. Core strength is important, as a strong midsection will allow greater stability through the body as the arms and legs go through various motions. For athletes performing endurance sports, it is important to have a strong core to stabilize the trunk and pelvis during repetitive leg motions. Your physical therapist will be able to determine which muscles are weak and provide specific exercises to target these areas.

Manual therapy. Many physical therapists are trained in manual therapy, which means they use their hands to move and manipulate muscles and joints to improve motion and strength. These techniques can target areas that are hard to treat on your own.

Functional training. Even when an individual has normal motion and strength, it is important to teach the body how to perform controlled and coordinated movements so there is no longer excessive stress at the previously injured structures. Your physical therapist will develop a functional training program specific to your desired activity or sport. This means creating exercises that will replicate your activities and challenge your body to learn the correct way to move.

Your physical therapist also will work with you to develop an individualized treatment and training program specific to your personal goals. They will offer tips to help you prevent your injury from recurring.