The last major injury I had was a severe illiotibial band (IT Band) injury after the New York City Marathon in 2008. I took 9 days off from running after the race and then started to slowly run a little bit, only to have sharp pain on the outside of my left knee. I couldn’t run for six months.
After seeing several physical therapists and spending countless hours researching the best treatment programs, I developed the ITB Rehab Routine. This strength protocol strengthens the glutes, hips, and quadriceps and allowed me to finally resume training after six months of inactivity.
Even though my IT Band injury has fully healed, I still do this routine because I think hip strength is very important to runners. New research shows that weak hips are to blame for lower leg injuries. More aggressive rehabilitation for IT Band injuries can be done in the gym with dead lifts and squats to strengthen the glutes, which are often weak in distance runners and the reason the IT Band can get inflamed.
Note that this routine is not a complete rehabilitation program for IT Band Syndrome. This is just one piece of the puzzle.
The ITB Rehab Routine consists of seven exercises done in a row with minimal rest. I do one set. Below is a demonstration of the exercises, using a Thera-Band. The video isn’t perfect, but it works:
- Lateral Leg Raises: lie on your right side with a theraband around your ankles. Lift your left leg to about 45 degrees in a controlled manner, then lower. I do 30 reps per side.
- Clam Shells: lie on your right side with your knees together and a theraband around your lower thighs. Your thighs should be about 45 degrees from your body and your knees bent at 90 degrees. Open your legs like a clam shell but don’t move your pelvis – the motion should not rock your torso or pelvic girdle. Keep it slow and controlled. I do 30 reps on each leg.
- Hip Thrusts: lie on your back with your weight on your upper back your feet. Your legs will be bent at the knee. Lift one leg so your weight is all on one leg and your back. Lower your butt almost to the ground and thrust upward by activating your glutes. This exercise is great for glute strength and hip stability. I do 25 reps on each leg.
- Side-Steps / Shuffle: with a theraband around your ankles and knees slightly bent, take ten steps laterally. The band should be tight enough so it provides constant resistance during all steps. Still facing the same direction, take another 10 steps back to your starting position. That is one set. I like to do 5 sets. This exercise will look like a slow-motion version of a basketball “defense” drill.
- Pistol Squats: These are simply one-legged squats. The key to a successful pistol squat is to not lean forward, keep the motion slow and controlled, and make sure your knee does not collapse inward.
- Hip Hikes: Stand on your right foot. With your pelvis in a neutral position, drop the left side so it is several inches below the right side of your pelvic bone. Activate your right hip muscle and lift your left side back to its neutral position. I do 20 reps per side.
- Iron Cross: This dynamic stretch will help you feel loose after the previous strength exercises. Lie on your back with your arms out to your sides and swing your right leg over your torso and up to your left hand. Repeat with your left leg and do 20 reps in total.
After my experience paying $30 to go to a physical therapist twice every week, this video is easily worth hundreds of dollars to the runner who applies it to their injury. If you use a foam roller for myofascial release after the routine, you are getting almost all of the benefits of a PT without the cost.
The only thing you need is a good Thera-Band.
Here are a few things to keep in mind when doing this strength routine:
- If you currently have ITB pain, you can do this routine as often as every other day.
- Always modify the number of reps or recovery period if you need to.
- Even if you don’t have ITBS, you can do this routine 1-2 times per week for prevention.
- You can do this routine in addition to running (do it when you finish).
- Increase reps or add weight to any exercise to increase its difficulty.
- If you can’t do pistol squats, here is a progression to get you there safely.
- Get the low/medium resistance Thera-bands at first (or a combo pack so you can progress).
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