ITBS Prevention Exercises

Like many runners, I’ve had issues with my illotibal band (IT Band) which causes pain in the lower, outside portion of the knee. This pain is caused by the IT Band rubbing across a pocket of nerves in that area because it has become too tight. Conventional treatments for IT Band Syndrome (ITBS) have prescribed stretching the IT Band and using a foam roller to loosen the IT Band. From conversation with people who have suffered from ITBS, they have had mixed success with these treatments. The primary reason being that the IT Band is like a strap of leather. It’s impossible to stretch. It is strong enough that you could tow a car with it. The only stretching that can happen is to the tissue to which it is connected. Use a foam roller helps because it breaks up the adhesion and scar tissues that exist at the connection point of the IT Band in the hip area.

So, one might wonder, why do we get this IT Band pain in the knee when the IT Band is so inflexible? It stands to reason that, if it can’t be stretched, then it probably can’t be shortened either, right? Pretty close. What new studies show is, that when runners start to tire because of increases in mileage or pace, the fatigue manifests in the hip and core areas, cause stride misalignments. These minor misalignments can, over time, create additional tension on the IT Band, causing the rubbing across the nerve endings that creates that classic ITBS knee pain. So, how do we fix it?

About two years ago I was struggling with a bout of ITBS. My Physical Therapist, who is also an ART practitioner (, prescribed for me a set of exercises designed to strengthen the core and hip areas to help maintain the proper alignment, thereby keeping the IT Band from becoming over tensioned. Here is a list of the exercises that I did then, and still continue to do, to stave off the nasty IT Band Syndrome.

Clam Shells
Use an exercise band wrapped around both legs at the knees. Lie on your side and open the knees and slowly close them. Repeat on both sides, 3 sets of 12 to 15 repetitions.

Reverse Clam Shells
Lie on your side, knees slightly bent and lift the top leg up about 12”. Then, lift only the heel toward the ceiling and slowly back down to the starting point. You will feel the hip muscle activated during this exercise. Repeat on both sides, 3 sets of 12 to 15 repetitions.

Popup Side Plank
Start lying on your side, knees bent and propped up on your elbow. From this position, roll into a side plank and reach over your head and forward with the arm closest to the ceiling. Then roll back down to the starting position. Repeat on both sides, 3 sets of 12 to 15 repetitions.Here is a short video of my doctor, Dr. Marc Cesari, demonstrating the exercises for me.

Standing, One Legged Lifts and Chops
Here is a demonstration video of Lifts and Chops. He is preforming the exercises kneeling. I perform them standing on one foot with the other leg lifted so that the thigh is parallel to the floor and the lower leg hangs comfortably at a 90 degree angle. You can do this exercise using a pulley system like the one in the video, or you can use an exercise band attached to a sturdy end point. When doing these exercises, the leg that is off the floor is depends on the exercise. In the lift, the leg away from the band anchor point is the one off the floor. For the chop, the leg closest to the anchor point is the one that is lifted (the guy in the video has the same leg up on both exercises, which is not the way it should be). Do 3 sets of each exercise on each side, 12 to 15 repetitions each. If you start to lose your balance, take a break and reset. The idea is to engage the core on these exercises. We don’t want to cheat by leaning away from the anchor to maintain balance and to complete the repetition.

I have had great success rehabilitating an ITBS injury and also keeping the same injury at bay by dutifully performing these exercises 3 to 6 times per week. I hope they help you too.