"Physical therapy is not a subspecialty of the medical profession and physical therapists are not medical doctors; we are a separate profession that provides a unique service that physicians are unable and untrained to provide."

Letter to the AMA from the APTA, Dec 2009

Sunday, March 13, 2011

Physical Therapy for Iliotibial Band Syndrome

After getting cracked, pushed, and poked around by two chiropractors, one doctor, and one masseuse over the course of five years, I’d given up on healing my hip snapping syndrome. Everyone said it was something different, and they all recommended I refrain from physical activity for one year (an entire year!) or until the snapping desisted.

It was by chance that, one day while playing tournament-style paintball with a friend, I complained about my hip problems off the field and one of the other players suggested to me that it was Iliotibial Band Syndrome. I could barely get the words out of my mouth without tying my tongue into knots, but the friend—a physical therapist—began listing common symptoms, all of which I had.

  • An audible snap or click in the hip, which may be painful or painless
  • The location is lateral (indicating the iliotibial band or gluteus maximus)
  • Occasional sensations of the hip subluxing or dislocating
  • Duration of symptoms lasting several months or years rather than days or weeks

Going to a Physical Therapist

I followed up our conversation with an appointment at his clinic. I explained to my therapist that back in 2005, whilst stretching to train for my black belt in Tae Kwon Do, I had felt sharp pain in my right hip and, after returning to my feet, felt as if my right leg wasn’t popped into the hip socket.

Snapping hip syndrome is, among athletes, most often caused by repetitive overuse. She conducted Ober’s test on my right leg (wherein I laid on my unaffected side and dropped my affected leg to the examination table; the present of pain along the lateral side of my thigh indicated a tight IT band) and surmised that I had ITB syndrome. The snapping was being caused by the iliotibial band snapping over the greater trochanter (the top bulge of the femur). As an athlete, repetitive overuse of my hip and sudden loading of it (kicking targets in my case) had caused the symptoms. This also brought my gluteous maximus into the picture, as it regulates flexion at the hip and is a powerful extensor of the thigh and trunk when the legs are fixed. Although relaxed when standing, said muscles are used extensively in running, climbing, rising from squatting positions, and the like. Strengthening these muscles as well as my core would seem to be key in healing my ITB syndrome.

Ongoing Physical Therapy

My therapist assigned me a program of light aerobic activity followed by stretching and strength training that would regulate proper hamstring, hip flexor, hip adductor, and iliotibial band movements. Although surgery, orthotics, and cortisone steroidal treatment are available, I prefer non-aggressive and holistic treatment, so I opted on physical therapy alone. Since I had already been practicing yoga for the better part of a decade, I researched poses that would prevent IT band pain. The most helpful poses have been:


Cow face pose

Half lord of the fishes pose

Reclining big toe pose

Half frog pose

Had I not visited a physical therapist, I would still be complaining about a pain I knew nothing and could do little about. Knowing exactly what was going on—and not having to spend any more money guessing what could be going on—was the first relief, but a gradual relief from the pain has been the most rewarding.

Bio: Lisa Shoreland is currently a resident blogger at Go College, where recently she's been researching creative scholarships as well as searching for scholarships. In her spare time, she enjoys creative writing, practicing martial arts, and taking weekend trips.

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Tim Richardson, PT owns a private practice at Medical Arts Rehabilitation, Inc in Palmetto, Florida. The clinic website is at MedicalArtsRehab.com.

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