Conditioning: Phase 4
The following is the final of four phases that will guide you from IT Band Syndrome toward healthy running. From here, you should be ready to return to full running.
Duration: 2 Weeks
Goal: Through plyometrics, to increase tensile load tolerance to the IT Band at higher functional levels.
Frequency of Exercises: Daily, 2-3 days per week
Warm Up: For at least 5 minutes before activity (e.g. Pre-Run Warm up).
- Split Squat (Knee In): 3 x 10 reps (slowly, 3 second down, 3 second up). Standing with one leg forward and the other leg back, come slowly straight down towards the ground by bending your knees. At the bottom, bring your knee in and then out. Your body should not lunge forward during the movement. Come slowly back up and repeat movement. Perform this on both sides. Purpose: increase loading and tensile capacity to the patellar tendon.
- Single Leg Squat (Against Wall): 3 x 8 reps (slowly, 3 second down, 3 second up). With your foot near wall with the other leg off the ground, slide your body down slowly. This will place more pressure on your knee and quad. Then slowly come back up. The emphasis should be slow, with pressure and tension for a prolonged period of time for tissue adaptation. Purpose: increase demand on knee loading.
- Front Plank: 3 x 30 seconds or until fatigue. On your elbows and knees, bring your knees off the ground and hold. Try to keep your body level throughout this exercises by keeping your hips level and engaging your abdominals and glutes. Keep your elbow below your shoulders and push up to engage your scapular muscles. Purpose: strengthen core and glutes for running form stability.
- Jump Squats: (on box first, then on ground) 3 x 8-10 reps. Legs shoulder width apart, bend down by bringing hips back and knees bent, and then come back up. As you land, try to make the landing quiet indicating shock absorption. If too loud, then you are not landing with enough knee bend/hip bending. Do this one at a time at first, then do intervals over time (sets of 3, 4, etc.). Purpose: increase loading capacity of knee and IT Band.
- Up and Backs: 3 x 30 seconds. Go up and back in a running pace. This will increase load capacity on the knee, and get back into more sprinting type activities. Do this for 30 seconds, then add time as endurance improves. Purpose: increase demand on running for IT band resilience..
- Single Leg Calf Raises: 2 x 20 reps (each side). Place your toes on a step with heel off of the step. Come up and down, raising straight up in the air without moving forward. Purpose: increase calf strength to support the knee/IT Band when loading.
- Single Leg Balance (On Toes): 3 x 30 seconds. Stand with both hands on your hips with your feet directly under you. Keeping your pelvis stable, bring one leg up without causing your pelvis to tilt or rotate. Once stable, come up on your toes as best as you can. Purpose: improve calf/ ankle stability and strength.
- Run/Walk Progression.
- Stretching:
- Calves: 1 minute per side. Standing with one foot back, place your toes on a half roll or rolled up towel to increase stretch. Lean forward while keeping your knee straight. Purpose: improve calf mobility to decrease strain on the IT band.
- Quads: With one leg on the table/couch/bed, the other leg is off the table. Grab a belt or two (or Resistance Strap) and hook one end on your foot that is on the table. With your body aligned up straight, begin to pull your heel towards your hips until you feel a moderate stretch in the front of the thigh. Hold for at least one minute. If pain increases, place a towel under your thigh to pre-stretch the quad.
- Hip Flexors: In the kneeling position with your arms supported on the wall, engage your abdominals by doing a posterior pelvic tilt (i.e. low back is flattened with a limited curve). Engage your glutes on your kneeling side and keep your body as a unit until you feel a stretch in the front of your hip. You may increase your stretch by leaning away from the side.
TO GRADUATE FROM PHASE 4
Pain is minimal and manageable, and you are continuing to progress with running while implementing exercises from previous phases as needed or desired to maintain form. After 2 weeks of plyometric training, return to strengthening and loading exercises (3 x per week) to maintain strength and change routines to allow for muscle and tissue adaptation.
Principles of IT Band Syndrome: A Review
- CAUSE – overuse with increased compression forces
- NEED – strengthen glutes and reduce quad/IT band tension
- PLAN – offload IT Band, gradually reloading it per pain tolerance
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