Iliotibial band: returning to sport step by step

Why it happens

Rising volume, downhills, cambered surfaces, track always run in the same direction, weak hip muscles.

Coming back in four stages

1. 1

   Pain-free walking and light cycling, 20 to 30 minutes.

2. 2

   Hip strengthening prescribed or approved by your physiotherapist.

3. 3

   Alternating walking and running on flat ground, varied surfaces and routes, no downhills or camber.

4. 4

   Easy continuous running, then slopes introduced gradually.

Move on to the next stage after 2 sessions in a row with discomfort of 2 out of 10 or less and no pain the next day. Each stage usually lasts 1 to 2 weeks, depending on your healthcare professional’s advice. For the IT band, pain often comes on after a certain time running: move on only if the whole session goes by without it appearing.

Movements to postpone

• côtes et descentes from stage 4
• changements de direction et pivots from stage 3

Strengthening exercises

• Clamshell

  from stage 1 of the plan

  Lying on your side, knees bent, feet together: open the top knee without moving the pelvis. Add a band later.

  To start: 3 sets of 15 per side, every other day.

  Variations, mistakes and progression

  Easier

  Smaller opening, no band.

  Harder

  Band around the thighs, then a 2-second hold at the top.

  Common mistakes

  • Rolling the pelvis back to open wider.
  • Going fast and feeling it in the back rather than the buttock.

  Moving on

  When 3 × 20 with a band is easy: move on to the side plank or band walks.

• Glute bridge

  from stage 1 of the plan

  Lying on your back, knees bent, lift the hips squeezing the buttocks, hold 2 seconds, lower slowly. Later: on one leg.

  To start: 3 sets of 12, 2 seconds at the top, every other day.

  Variations, mistakes and progression

  Easier

  Smaller range, feet closer to the buttocks.

  Harder

  On one leg, then with your shoulders on a sofa.

  Common mistakes

  • Arching the lower back instead of squeezing the glutes.
  • Letting the knees drift apart or together.

  Moving on

  When 3 × 12 on one leg is easy, with the pelvis staying level.

• Side plank

  from stage 2 of the plan

  On your elbow, knees bent (later legs straight), hold 20 to 30 seconds with the pelvis aligned.

  To start: 3 holds of 20 seconds per side, every other day.

  Variations, mistakes and progression

  Easier

  Knees bent on the floor.

  Harder

  Legs straight, then lifting the top leg.

  Common mistakes

  • Letting the hip sag towards the floor.
  • Leaning the trunk forward.

  Moving on

  When you can hold 45 seconds with straight legs and the pelvis aligned.

• Lateral band walk

  from stage 3 of the plan

  Band around thighs or ankles, knees slightly bent, take 10 steps sideways each way.

  To start: 3 rounds of 10 steps each way, every other day.

  Variations, mistakes and progression

  Easier

  Band above the knees, short steps.

  Harder

  Band around the ankles, deeper knee bend, or a stronger band.

  Common mistakes

  • Letting the knees cave in.
  • Swaying the trunk at each step.

  Moving on

  When 3 × 15 steps with the band at the ankles is easy.

• Low step-up

  from stage 3 of the plan

  Step up onto a 10 to 20 cm step with the affected leg, come down slowly, pelvis steady.

  To start: 3 sets of 10 per leg, slow on the way down, every other day.

  Variations, mistakes and progression

  Easier

  10 cm step, one hand on the rail.

  Harder

  Higher step (20 to 30 cm), then with weights in your hands.

  Common mistakes

  • Pushing off with the leg on the floor.
  • Knee drifting inwards.

  Moving on

  When 3 × 12 on a 20 cm step is clean and causes no discomfort the next day.

The doses are starting points. Stay at 2 out of 10 discomfort at most, during and the next day; otherwise switch to the easier version or go back to the previous exercise.

Rehab’s advice

First avoid downhills and cambered surfaces. Vary routes and surfaces rather than always repeating the same one.

What the Rehab plan does for this injury

The plan starts at 35% of your previous training volume and builds up to 85%, with a consolidation week every three weeks. If your discomfort reaches 5 out of 10, it stops and refers you to your doctor or physiotherapist.

In which sport?

• Trail runningLong descents often trigger the pain: limit them and resume on flat ground first.
• Indoor cyclingRaise the saddle slightly if the outer knee hurts, and avoid high resistance.