Stretching and Releasing the ITB
A narrative review.
This narrative review explored the role of stretching and release techniques in managing Iliotibial Band Syndrome (ITBS), a common overuse injury that causes lateral knee pain, particularly in runners and other athletes. The study critically evaluated existing evidence on these methods and their effectiveness in ITBS rehabilitation.
This study aimed to assess the benefits of iliotibial band (ITB) stretching and release techniques in treating ITBS by reviewing available literature. The study also seeks to identify research gaps and provide practical insights for clinicians.
Key Points
Prevalence of ITBS: ITBS is most common among runners, with prevalence rates ranging from 1.6% to 14%. It also occurs in cyclists, rowers, field athletes, and occasionally non-athletes.
Symptoms: Pain localised to the lateral knee, often exacerbated by activities like running downhill or prolonged sitting with a flexed knee.
Treatment Landscape: Conservative treatments such as rest, activity modification, stretching, and hip strengthening are common. However, there is no consensus on a standard treatment protocol.
Focus on Stretching/Release: The study explores whether ITB stretching or release methods (e.g., foam rolling) contribute meaningfully to symptom relief.
Methods
The authors conducted a narrative review using databases like PubMed, Scopus, and PEDro. Articles included:
Studies on acute or chronic effects of stretching/release methods.
Research involving ITBS patients or healthy participants.
Peer-reviewed publications.
Excluded materials included conference abstracts, opinion pieces, and preprints.
Results
Stretching Techniques:
Common stretches involve lateral trunk flexion with the leg extended and adducted over the other leg.
Variations include arm positioning (overhead or diagonal) and hip rotation for enhanced stretch intensity.
Side-lying stretches (e.g., Proprioceptive Neuromuscular Facilitation or PNF) showed potential benefits in improving range of motion (ROM).
Release Methods:
Foam rolling and massage are widely used but lack robust evidence for their efficacy in ITBS management.
These methods may provide short-term pain relief but do not address underlying biomechanical issues.
Effectiveness:
Stretching may help alleviate symptoms when combined with other treatments like hip strengthening.
Evidence supporting the standalone effectiveness of stretching or release techniques is limited.
Safety:
No evidence suggests negative effects from incorporating these methods into rehabilitation programs.
