Treatment algorithm
Please note that formulations/routes and doses may differ between drug names and brands, drug formularies, or locations. Treatment recommendations are specific to patient groups: see disclaimer
stretching exercises
Stretching exercises are given for early return to activity following resolution of pain and inflammation.
The patient stands and stretches the iliotibial band, with an overhead arm extension. A more transverse plane stretch is made by bending downward and diagonally, while reaching out and extending the arms with clasped hands.[Figure caption and citation for the preceding image starts]: Standing stretch exerciseFrom the personal collection of Dr J.C. Mak [Citation ends].
foam roll mobilization
Treatment recommended for ALL patients in selected patient group
Foam roll mobilization is used to improve myofascial restrictions along the lateral hip and thigh. While supporting the upper body with the hands on the floor, the patient reclines on a 3 to 6 inch foam roll placed under the side of the involved leg, which is held straight. The patient crosses the uninvolved leg over the involved leg and rolls along the outer thigh from the bottom of the hip bone to just above the knee, emphasizing tight or tender areas.[38][Figure caption and citation for the preceding image starts]: Foam roll exerciseFrom the personal collection of Dr J.C. Mak [Citation ends].
hip abductor strengthening
Treatment recommended for ALL patients in selected patient group
Once range-of-motion and myofascial restrictions have been resolved with stretching exercises and foam roll mobilization, recovery and strengthening can be started.[27][28] These involve open-chain, side-lying leg lifts, closed-chain, single-leg balance step-downs, pelvic drop exercises, eccentric muscle contractions, triplanar motions, and integrated movement patterns. Examples of 3 of these exercises are the modified matrix, wallbanger, and frontal plane lunge. For all exercises, it is advisable to start with 5 to 8 repetitions and gradually build up to 2 to 3 sets of 15 repetitions and repeat the exercise in both legs, even if only 1 side is symptomatic.
Electromyography studies suggest that contractions above 60% of the maximal voluntary isometric contraction are needed for strengthening.[39][40] This intensity is achieved with progression into single leg squat exercises and use of resistance (e.g., 5 lb [2.3 kg] ankle weight with side-lying hip abduction).[39][Figure caption and citation for the preceding image starts]: Demonstration of pelvic dropFrom the personal collection of Dr J.C. Mak [Citation ends].
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Please note that formulations/routes and doses may differ between drug names and brands, drug formularies, or locations. Treatment recommendations are specific to patient groups. See disclaimer
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