Background: A tight iliotibial band (ITB) may lead to lateral patellar maltracking, compression, and tilt, and dominant vatus lateralis (VL) muscle activation relative to vastus medialis oblique (VMO) can laterally displace the patella, which leads to anterior knee pain. Therefore, an effective management technique is needed to stabilize the patella in individuals with tight ITB. Increased stability during the modified Thomas test has the potential to decrease compensatory motion and thus to selectively stretch the ITB. Objects: The purpose of this study was to determine the effects of ITB stretching in the modified Thomas test position on ITB flexibility, patellar translation, and muscle activities of the VMO and VL during quadreceps-setting (QS) exercise in individuals with tight ITB. Methods: Twenty-one subjects with tight ITB were recruited. Digital inclinometer was used to measure the hip adduction angle during the modified Ober test. Universal goniometer was used to measure the hip abduction angle during the modified Thomas test. Ultrasonography was used to measure the patella-condylar distance. Electromyography was performed to collect data of muscle activities. Paired t-test was used to determine the statistical significance between pretest and posttest. Results: The range of hip adduction in modified Ober test increased (p=.04) and the range of hip abduction in the modified Thomas test decreased after ITB stretching (p<.01). There was no difference between lateral patellar translation (p=.18). VMO muscle activity significantly increased after ITB stretching during QS (p<.01). VL muscle activity had no difference after stretching. Conclusion: The ITB stretching in the modified Thomas test position can be suggested as a management method for improving ITB flexibility and VMO muscle activity in individuals with tight ITB.

The purpose of this study was to identify the effects of tensor fasciae latae-iliotibial band (TFL-ITB) self-stretching exercise on the lumbopelvic movement patterns during active prone hip lateral rotation (HLR) in subjects with lumbar extension rotation syndrome accompanying TFL-ITB shortness. Eleven subjects (9 male and 2 female) were recruited for the two-week study. A three dimensional ultrasonic motion analysis system was used to measure the lumbopelvic movement patterns. The TFL-ITB length was measured using the modified Ober's test and was expressed as the hip horizontal adduction angle. The subjects were instructed how to perform TFL-ITB self-stretching exercise program at home. A paired t-test was performed to determine the significant difference in the angle of lumbopelvic rotation, movement onset time of lumbopelvic rotation, TFL-ITB length, and LBP intensity before and after the two-week period of performing the TFL-ITB self-stretching exercise. The results showed that after the intervention, the lumbopelvic rotation angle decreased significantly (p<.05), the movement onset time reduced significantly (p<.05), and LBP intensity decreased slightly but not significantly (p=.07). The hip horizontal adduction angle increased significantly (p<.05) after the intervention. These findings indicate that TFL-ITB stretching exercise increased TFL-ITB length, decreased lumbopelvic rotation angle, and delayed the movement onset time of lumbopelvic rotation after two-weeks. In conclusion, the TFL-ITB self-stretching exercise performed over a period of two weeks may be an effective approach for patients with lumbar extension rotation syndrome accompanying TFL-ITB shortness.

The aim of this study was to investigate the effectiveness of self-stretching exercises for iliotibial band (ITB) (Side-lying; right hip and knee were flexed to support the pelvis while left hip was extended and adducted, Standing A; side-bending of the trunk on standing with crossed leg, Standing B; same as Standing A, except the hands were clasped overhead and shifted right side, and Standing C; same as Standing B, except moving the arms diagonally downward) to help determine the most effective self-stretching method to stretch ITB. Twenty-one healthy subjects who do not have ITB shortness from Yonsei University (14 men and 7 women) between the ages of 18 to 28 years voluntarily participated. Ultrasound was performed to measure the thickness of the ITB between the long axis of the ITB and the level parallel to the lateral femoral epicondyle during four self-stretching exercises. All data were found to approximate a normal distribution. We used a one-way repeated-measures analysis of variance (ANOVA) to compare the thickness of the ITB among all self-stretching exercises. The level of significance was set at =.05. The ANOVA was followed by Bonferroni's correction. The overall mean of ITB thickness was mm ( standard deviation) in resting status. The change in the ITB thickness in percentages between the tested position of each self-stretching exercises and resting status was significant (p<.05) (Side-lying with 95% confidence interval [CI]=21.99~31.25%; Standing A with 95% CI=22.09~36.84%; Standing B with 95% CI=37.31~50.81%; Standing C with 95% CI=48.25~59.29%). Results indicated significant differences among four self-stretching exercises except Side-lying versus Standing A (p<.01). Based on these findings, the Standing C self-stretching exercise was the most effective in stretching the ITB thickness among four types of ITB self-stretching exercises. Additionally, the Side-lying self-stretching exercise using gravity to stretch the ITB is recommended as a low-load (low-intensity), long-duration stretch.