Hip Exercises for ITB Syndrome

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Article from December 14, 2013 by Andrew Foehrkolb

What Is the Best Exercise to Activate the Hip(Gluteal) Muscles while minimizing the Tensor Fascia Lata involvement for Iliotibial Band Syndrome?

Many runner and cyclists who increased there training mileage have experienced lateral knee pain due to the inflammation of the Iliotibial Band commonly referred to as Iliotibal Band Syndrome (ITBS). In a study of female runners with ITBS, Ferber (2010) found significant weakness in hip abduction, external rotation, extension and increases in knee internal rotation. These same runners demonstrated overuse of the Tensor Fascia Lata (TFL) . As a functional personal trainer, my goal is to strengthen the hip muscles , primarily the Gluteals while not activating an already overworked TFL. Based on this relationship between hip dysfunction and ITBS I like to incorporate hip exercise into a well balanced , functional strength training workout. Most typical hip exercise work the gluteals but also work the TFL- further exacerbating ITBS. What’s the most effective exercise to target the gluteal muscles while not targeting the TFL?

In a recent study of 20 health volunteers from the University of Southern California, Selkowitz (2013), evaluated 11 typical hip exercises to determine gluteal and TFL activation. Fine-wire electrode evaluation was used for the first time to target specific muscle activation and to normalize intramuscular signals.

The exercise performed and there effectiveness for minimizing TFL activation while maximizing gluteal involvement follow listed in descending order of effectiveness:

  1. Clam
  2. Sidestep
  3. Unilateral bridge
  4. Quad hip extension, knee extending
  5. Quad hip extension, knee flexed
  6. Side lying hip abduction
  7. Step-up
  8. Bilateral bridge
  9. Squat
  10. Hip hike
  11. Lunge

The evidence supports specific strength tasks for activating the gluteals while avoiding other tasks that activate the TFL. If you are uncertain of how to properly perform any of these strength exercises you may email me at drew@columbiapersonaltraining or visit http://www.columbiapersonaltraining.com for additional information.

Train smart!

Drew Foehrkolb MS, NASM-CPT,CES

Ferber R, Noehhren B Hamill J, Davis IS, Competitive female runners with a history of iliotibial band syndrome demonstrate atypical hip and knee kinematics. Journal Ortho Sports Physical Therapy 2010;40:52-58

Selkowitz D, Beneck G, Powers C, What exercises target the gluteal muscles while minimizing activation of the Tensor Fascia Lata? Electromyographic Assessment using Fine-Wire Electrodes. Journal of Orthopedic & Sports Therapy, 2013 February, Volume 43 #2 54-65.

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