How do you stretch your IT band?

[Louis]

Today I started a series of visits to the Physical Therapist to hopefully have them show / teach me some good strengthening and stretching exercises to finally put my darn left patellar tendinosis problems away for good. (I've been battling this problem for the last four years.)

One thing he noticed is that both my IT bands are very tight. He showed me one stretch which involves crossing your legs while standing and shifting your hip sideways. I felt a bit of a stretch, but not a whole heck of a lot.

I'm wondering if there are other ways of doing this.

Thanks.
Louis

[swoop]

foam roller or tennis balls. more later.. gotta go. ps.. it hurts.

[old_school]

foam roller (http://optp.com/media/Document_126.pdf)

yup, it hurts

[Ginger]

How long has that thing been tight? You don't want to feel a lot of stretch. Really...Oh...make sure you're standing straight upright...don't lean forward, you'll find a better stretch...The standing stretch doesn't work well for me because of my knee and hip issues.

I've used all of the following:
http://www.nismat.org/ptcor/itb_stretch/

However, the second self stretch, where he's laying down, and the third where he's seated work best for me.


Although, keep in mind you want to stretch your ITB without involving your patella too much. The second and the fourth are what they were doing with me when I had patellar tendinitis in both knees.

The Ober stretch is actually quite good, but you need a second person and you really have to be careful with the positioning of the back and hips...


No...I'm not a physical therapist...I've just been in physical therapy for years. :(

Ditto on the foam roller and tennis ball advice for release...yes...it hurts a lot if you do it right.

[jhcakilmer]

Are you sure it's not your Gluteus medius muscle strength that is the issue?
Your Tensor Fasciae lata (muscle of IT Band) is a pretty small muscle, and if your G. medius (or G. Maximus) is weak, it maybe trying to compensate for the weakness, every time you ambulate.

There are a variety of test, but the simplest one is.....have someone stand behind you, and watch the level of your waist (make sure you pants/underwear are straight). Then stand on one leg. Watch to see if you hip drops to the opposite side, which is indicative of G. medius weakness.

Who have you seen for this issue?

[big shanty]

stand with your left shoulder an arm's length from a wall....put your left palm on the wall, fingers facing forward....a little lower than shoulder height. Put your left leg behind your right leg and straighten it so it is fully extended, so that the outside of your left foot is touching the ground behind and to the right of your right foot....put your right hand on your right knee and then slowly lower into a squat with your right knee so that you "sit" into your left hip flexor....your whole left leg should pivot on the outside of the left foot and you should definitely feel a great stretch. Repeat on the other side.

[Ginger]

Oh...Yeah...I forgot.

If you're paying a professional, and you trust that he knows what he's doing, follow his instructions. He may introduce deeper stretches and exercises later on...when you're ready for them.

He tells you to do that standing stretch three times a day and you're still feeling a stretch with it...it's doing what it's supposed to.

And you're off the bike for a couple weeks too, right?

[sailorboy]

As a PT, I can tell you it is nearly impossible to keep this muscle stretched on folks. Try lying on your side with the side to be stretched facing the roof
-next reach back and grab around your ankle like you are doing a quad stretch
-hold that, then bring your ankle of the leg that is down and place it on top of the upper leg so it is in a position to pull downward on the leg that is on top. You will now begin to look and feel like a pretzel
-pull down toward the table so that you feel most of the stretch in the ITB down by the knee, vs. up at the hip area where the typical stretches tend to target.

+3 on the foam rollers.

This may not be the whole problem, and usually isn't in my experience. If you haven't already, make sure someone is looking at the following:

-foot alignment--too much pronation often contributes to PFPS or patellar misalignment. Sorry ATMO, but in this case misalignment is not alignment!

-strength of your hip abductor muscles and external rotators

-the possibility of taping your kneecap medially or using kineseotape. You've probably seen this before on the knees of riders in the grand tours after about week one. Not the big bandages from road rash, these are usually strips of colored tape going in different directions to re-locate the patella or lessen strain on inflamed tendons.
Hope this helps

Good luck!

[Louis]

Thanks all for the prompt responses.

1) Roller: Yes, he did the foam roller thing on my thigh, but I have a hard time seeing how I could do that myself nearly as effectively. It did hurt quite a bit.

2) Ginger, thanks for the link. I have been off the bike for a few weeks (combination of taking it easy to try to heal and the crappiest winter we've had here in years). However, interestingly my orthopedic doc said that he prefers folks just cut back, not stop exercising completely.

3) jhcakilmer, no, I'm not sure that it's not a gluteus medius muscle strength issue. Nor am I qualified to know... I went in to see an orthopedic doc and described my symptoms (pain just below the kneecap). After poking around a bit he diagnosed patellar tendinosis and prescribed PT to 1) have someone take a closer look and figure out what's going on, 2) get initial assistance in helping speed the healing, and 3) show me strengthening and stretching exercises that will promote general knee health. (#3 was what I really went in there to get).

The PT watched me walk around, and did various basic leg strength tests (pushing against him) comparing left to right. I could not tell, but he said that my left leg was clearly and noticeably weaker than my right. (did not mention any specific muscles) I'm not surprised, since I know that I've been taking it easy on the bike on that leg for ages.

4) Big Shanty and Sailorboy: thanks, I'll try those.

Thanks again guys.

Louis

[Ginger]

Look at Old School's link, that pretty much shows the self-foam roller thing, you can cause yourself as much pain as they do that way, if not more.

[Peter P.]

Stretching the IT band: You need to get what every cyclist should have, next to their maintenance manuals-the book "Stretching" by Bob Anderson.
ISBN 0-936070-01-3.

Tip: If you don't feel the tightness as you stretch, it's quite possible the muscle you're trying to affect is NOT tight. Not all individuals are tight in the same places, and even within a single person the same muscle may not be tight i.e., right IT band versus left. In fact, by comparing left to right sides you may readily confirm that the problem side is tight because while doing the stretch it feels different (i.e., less pain) than the injured side. Sometimes a particular stretch does nothing, but another stretching position for that same muscle is effective.

Andy Pruitt's book, "Complete Medical Guide For Cyclists"
ISBN 978-1-931382-80-9 is another excellent source for identifying the causes and treatments for cycling related pains.

[jhcakilmer]

I definitely agree with Sailorboy....this is not the basic issue, I think it's only one of the symptoms of a more significant dysfunction. I'd say the only way you'll figure it out is being proactive with your physician, and PT. I think that a good PT should be able to diagnosis you, and help treat you.

If you don' t feel like they're is significant progress being made, not taking it serious enough, or not looking at the big picture then go to someone else.

I know there are lots of options out there, but you might want to give a good chiropractor (mixer), or osteopathic physician.....especially one that practices manual medicine, a consideration. I'm an osteopathic student, and though I don't believe in everything they teach, I definitely think they can do a lot, and possible help you. Not all DOs practice OMM, many actually do nothing more then an MD would do. So if your not satisfied, keep looking. In my experience you have to proactive if you want to get fixed. Our medical system isn't good at treating chronic issues like this, imho.

But I'm definite convinced that the underlying issue is not the IT band. Stretching them isn't really going to do anything if there is another underlying issue.....that is not fixed.

You could have a pelvic shear, sacroiliac dysfuntion, lumbar lordosis/kyphosis ,Ilial rotation to name just a few.....all could possibly contribute to your symptoms.

If you want to fix this be open minded, and check out all of your options! Let me know how it goes! Thanks