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In this article, we’ll explain what muscles you should foam roll when your iliotibial band (IT band) feels tight and why foam rolling the IT band itself isn’t that useful. We’ll also point out what areas of the IT band you should best avoid when foam rolling. Remember, if you need more help with an injury, you're welcome to consult one of our physios online via video call. Some of the links in this article are to pages where you can buy products discussed or mentioned here. We might earn a small commission on sales at no extra cost to you. In this article: Why foam rolling the IT band itself isn’t that useful What muscles should you foam roll if your IT band feels tight? How long should you foam roll for? Why foam rolling over the IT band is so painful How to use a foam roller for it band syndrome How we can help Why foam rolling the IT band itself isn’t that useful The IT band is a thick fibrous band of tissue that runs down the outside of your leg and attaches to the side of the knee. It is mostly made up of collagen fibres. Unlike muscle fibres, collagen fibres don’t really stretch or contract. The IT band has no active control over how tight it feels. It’s actually the muscles that attach onto the IT band (the glutes, tensor fascia latae, lateral quads) that can cause it to feel tight when they are in tone and pull it tight. This is why focusing your foam rolling efforts on the IT band itself won’t really make it feel less tight. Instead, you should aim to relax the muscles that attach onto it. What muscles should you foam roll if your IT band feels tight? The muscles to target when you want to reduce the strain on the IT band are the ones that attach onto it. These include glute max, glute med, tensor fascia latae (TFL), and the lateral quad. I prefer to use a massage ball rather than a foam roller when I do my glutes, but this is just personal choice. I demonstrate how to roll these areas in this video: How long should you foam roll for? There is no definitive answer to this yet, but the methods used in the research are as follows: Longitudinal strokes along the muscle belly - spend about 2 minutes per leg Point pressure. This is when you sustain pressure on a painful point for between 30 and 60 seconds. The pressure you apply should be "comfortably uncomfortable" rather than painful. The whole idea is to get the muscles to relax. If a massage is too painful, it actually has the opposite effect. Why foam rolling over the IT band is so painful The IT band itself has lots of little nerve endings in it and not a lot of padding, as that area of your leg naturally has less muscle and fat. The reason it’s so painful to foam roll over your IT band is because you’re basically pinching the poor nerve endings between your thigh bone and the foam roller. More pain does NOT equal more gain. And if you’re too aggressive with the amount of pressure you place through the foam roller in the area close to the knee, you can actually cause a compression injury or, if you have IT band syndrome, you can make it worse. How to use a foam roller for IT band syndrome Foam rolling can help to reduce pain and tightness when you have IT band syndrome, but this relief is transient. To get rid of it permanently and prevent it from coming back, you have to address the underlying cause of your specific case. 👉 We’ve written an article dedicated to the different treatments for IT band syndrome . The areas to focus your foam rolling efforts on when you have IT band syndrome are exactly what we discussed higher up in this article: The glutes, TFL, and lateral quads. Our ultimate guide to foam rolling has more general advice on how to use a foam roller. DON’T foam roll the painful area on the side of your knee. IT band syndrome is caused by excessive compression between the IT band and the thigh bone in that area and you will just make it worse by squashing it on a foam roller. How we can help Need more help with your injury? You’re welcome to consult one of the team at SIP online via video call for an assessment of your injury and a tailored treatment plan. We're all UK Chartered Physiotherapists with Master’s Degrees related to Sports & Exercise Medicine. But at Sports Injury Physio we don't just value qualifications; all of us also have a wealth of experience working with athletes across a broad variety of sports, ranging from recreationally active people to professional athletes. You can meet the team here . About the Author Maryke Louw is a chartered physiotherapist with more than 15 years' experience and a Master’s Degree in Sports Injury Management. Follow her on LinkedIn and ResearchGate . References Capote Lavandero G, Rendón Morales PA, Analuiza A, et al. Effects of myofascial self-release. Systematic review. Revista Cubana de Investigaciones Biomédicas 2017;36(2):271-83. Friede, M. C., et al. (2021). "Conservative treatment of iliotibial band syndrome in runners: Are we targeting the right goals?" Physical Therapy in Sport. Macgregor LJ, Fairweather MM, Bennett RM, et al. The Effect of Foam Rolling for Three Consecutive Days on Muscular Efficiency and Range of Motion. Sports Medicine-Open 2018;4(1):26. Morales‐Artacho A, Lacourpaille L, Guilhem G. Effects of warm‐up on hamstring muscles stiffness: Cycling vs foam rolling. Scandinavian Journal of Medicine & Science in Sports 2017;27(12):1959-69. Mueller-Wohlfahrt H-W, Haensel L, Mithoefer K, et al. Terminology and classification of muscle injuries in sport: a consensus statement. Br J Sports Med 2012:bjsports-2012-091448. Schroeder AN, Best TM. Is self myofascial release an effective preexercise and recovery strategy? A literature review. Current Sports Medicine Reports 2015;14(3):200-08. Zazac A. Literature Review: Effects of Myofascial Release on Range of Motion and Athletic Performance. 2015

Will a TENS unit help for your plantar fasciitis? We can break the answer down into TENS for speeding up the healing process, and using it for pain management. I take a look at what the research says about this, and I give some tips on TENS electrode placement for plantar fasciitis as well as the best TENS settings. Remember, if you need more help with an injury, you're welcome to consult one of our physios online via video call. This article contains affiliate links. We might earn a small commission on sales at no extra cost to you. In this article: TENS for plantar fasciitis pain relief TENS for plantar fasciitis healing My recommendation on TENS for plantar fasciitis How to use your TENS unit for plantar fasciitis TENS side effects How we can help We've also made a video about this: The two ways in which TENS might help for plantar fasciitis is by providing pain relief  and by speeding up the healing process . Let’s look at what we can learn from the people in the white lab coats about each of these. TENS for plantar fasciitis pain relief There's a substantial body of research into TENS for acute pain – in the case of plantar fasciitis, when its onset has been fairly recent – as well as for chronic pain – when you’ve been suffering from plantar fasciitis for several months or even longer. In both cases, TENS seems to be effective for pain relief (1,2) , but only for in-the-moment pain, i.e. while you’re hooked up to the TENS unit. In some cases, it also alleviates pain for a few hours afterwards, but no longer. So, yes, TENS is indeed effective if you want to use it to calm down severe plantar fascia pain temporarily, especially if pain medication doesn’t work for you or if you want to avoid taking medication. TENS for plantar fasciitis healing I was quite surprised when I couldn’t find a single research study that investigated whether TENS could speed up the healing process when treating plantar fasciitis. As for TENS being able to heal other things, I was able to find only three studies into TENS for wound healing and another three into TENS for tendon healing. These are of some use to us, because your plantar fascia is mostly made up of collagen, which is also the main building block of your skin and your tendons. The studies into wound healing show that TENS might help for this, but the evidence is not very strong, and the researchers used quite small samples. So, based on these studies, we cannot really say for sure that TENS will help to heal your plantar fasciitis – we need larger-scale studies to be sure either which way. The same goes for the three studies into TENS for Achilles tendon healing. Only one was on a small sample of humans; the other two were on rats. Two studies found that TENS helps to speed up healing in injured Achilles tendons, and one found that it actually impeded healing. And again, these were not high-quality studies. My recommendation on TENS for plantar fasciitis From my own experience, I have not seen that my plantar fasciitis patients who used TENS on a regular basis recovered any quicker or slower than my other plantar fasciitis patients. So, in the absence of a definitive answer from science, I don't think it influences healing either which way. However, I have seen that patients benefit from TENS to decrease their pain – and the science backs this up – which enabled them to get on with other, proven plantar fasciitis treatments . Therefore, I would not recommend that you use TENS as a standalone treatment for plantar fasciitis – your condition won’t improve even if you use TENS day in and day out. But you can use it for pain relief while you work on healing your plantar fasciitis with some of the other tried and tested treatment methods. 👉 What are those treatment methods? Here’s our article with an overview of plantar fasciitis treatments , and here are three more articles with details on three of the most commonly used treatments for plantar fasciitis: strength and control exercises stretches massage . If you would like help with figuring out your rehab plan and what exercises may be best for you, check out the Plantar Fasciitis rehab plan in the Exakt app . I've helped to design the app to guide you through the rehab process from the moment your foot becomes painful all the way back to your sport. It uses your feedback after each workout to help you adjust your exercise intensity to the right level. 🎉 Discount Code: MARYKE How to use your TENS unit for plantar fasciitis Where to place the electrodes The research shows that it doesn't really matter where you stick the electrode pads, as long as the current passes through the painful area. So, for plantar fasciitis you could either: place one electrode right at the back of the bottom of your heel and the other under the arch of your foot, or place one electrode to the left and the other to the right of the painful area. 💡 Top tip:  If you have small feet, look for a TENS unit with small electrode pads – I have found that they stick on easier. These are three examples of what I’m talking about: TENS unit settings What seems to work best, according to the research, is an intensity setting that is as high as you can tolerate without it causing you pain. Also, the current shouldn’t cause any muscle contractions. So, if you find that the muscles in your foot start contracting or twitching when you’re hooked up to the TENS unit, dial it down. 💡 Top tip: Your body will get used to the intensity and frequency of the current if it stays the same for a whole session, and then the TENS treatment will be less effective. It’s like when you’re aware of a noise initially, but if it becomes repetitive, you tune out and no longer notice it. If your TENS unit has a setting that automatically varies the intensity and frequency of the current, use it. How often and for how long? According to the research, you can’t really overdo TENS in this regard. So, it’s safe to use it as often and for as long as you feel is necessary. TENS side effects The only possible serious side effect of TENS is that it might interfere with the electrical current of another device you might have. For instance, if you have a pacemaker, you don't want to be using the TENS near it. However, using it on your foot for plantar fasciitis should be fine. Possible minor side effects are that you may be allergic to the electrode pads and that you may get a rash if you keep the pads stuck to your skin for too long. How we can help Need more help with your injury? You’re welcome to consult one of the team at SIP online via video call for an assessment of your injury and a tailored treatment plan. We're all UK Chartered Physiotherapists with Master’s Degrees related to Sports & Exercise Medicine or at least 10 years' experience in the field. But at Sports Injury Physio we don't just value qualifications; all of us also have a wealth of experience working with athletes across a broad variety of sports, ranging from recreationally active people to professional athletes. You can meet the team here . About the Author Maryke Louw is a chartered physiotherapist with more than 20 years' experience and a Master’s Degree in Sports Injury Management. Follow her on LinkedIn and ResearchGate . References Paley, C. A., et al. (2021) "Does TENS reduce the intensity of acute and chronic pain? A comprehensive appraisal of the characteristics and outcomes of 169 reviews and 49 meta-analyses" Medicina 57(10): 1060. Johnson, M. I., et al. (2022) "Efficacy and safety of transcutaneous electrical nerve stimulation (TENS) for acute and chronic pain in adults: A systematic review and meta-analysis of 381 studies (the meta-TENS study)" BMJ Open 12(2): e051073. Gürgen, S. G., et al. (2014) "Transcutaneous electrical nerve stimulation (TENS) accelerates cutaneous wound healing and inhibits pro-inflammatory cytokines" Inflammation 37: 775-784. Perez Machado, A. F., et al. (2012) "The effects of transcutaneous electrical nerve stimulation on tissue repair: A literature review" Canadian Journal of Plastic Surgery 20(4): 237-240. García-Pérez, S., et al. (2018) "Effectiveness of Transcutaneous Electrical Nerve Stimulation Energy in Older Adults: A Pilot Clinical Trial" Adv Skin Wound Care 31(10): 462-469. Burssens, P., et al. (2005) "Influence of burst TENS stimulation on collagen formation after Achilles tendon suture in man. A histological evaluation with Movat’s pentachrome stain" Acta Orthop Belg 71(3): 342-346. Casagrande, S. M., et al. (2021) "Histological evaluation of the effect of low-frequency electric stimulation on healing Achilles tendons in rats" Acta Cirúrgica Brasileira 36. Folha, R. A., et al. (2015) "Can transcutaneous electrical nerve stimulation improve achilles tendon healing in rats?" Brazilian Journal of Physical Therapy 19: 433-440.

Learn when a knee brace is necessary for an MCL sprain and discover why hinged braces (with adjustable hinges or high‑thigh/low‑shin design) are most effective for moderate to severe injuries. Remember, if you need more help with an injury, you're welcome to consult one of our physios online via video call. This article contains affiliate links. We may earn a small commission on sales at no extra cost to you. In this article: Do I need a brace for my MCL sprain or tear? What does a brace do? What type of brace is best for MCL sprains? Not all hinged braces are the same When should you wear your brace? How long to wear an MCL brace for How we can help We've also made a video about this: Do I need a brace for my MCL sprain or tear? Grade 1 MCL sprains can usually be treated without a brace. Grade 2 and Grade 3 sprains usually require a brace. 👉 This article has more detail about how MCL sprains are graded . What does a brace do? The correct type of brace will support your MCL and allow it to heal while you continue to move and exercise. The research shows that starting rehab exercises and weightbearing early leads to better recovery, and an MCL brace can help you to do this safely. What type of brace is best for MCL sprains? Stay away from braces that don’t allow your knee to bend at all; the same goes for plaster casts. Total immobilisation reduces the formation of new collagen fibres; these are what your ligaments are made of and what your MCL needs to replace the torn fibres. The best type is a hinged brace with metal or carbon fibre rods on the sides. The hinge ensures that your knee can still bend and straighten, while the rods limit the side-to-side movement. It can also be set to avoid straigtening the leg fully during the first couple of weeks, which further reduces the strain on the MCL. The rods temporarily take over the job of your MCL. Your MCL prevents your knee joint from gapping on the inner (medial) part. Now that it is injured, you want to reduce that strain for a while to allow the ligament to heal. A hinged brace will also allow you to start doing weight-bearing exercises much sooner, which will stimulate the production of new collagen fibres, help them to realign correctly, and then strengthen them. Soft knee braces or sleaves are not useful, as they don’t provide enough support. Not all hinged braces are the same Most stable brace with adjustable hinge The most stable knee braces are the ones that come high up the thigh and low down on the shin. They usually also have a hinge that you can lock in a certain place to stop your knee from straightening fully if this is required. Such a brace may be needed if you have a Grade 3 MCL tear, but may be overkill for a Grade 2 tear. Examples available on Amazon: Medium stability with adjustable hinge These braces don’t reach as far up and down the leg, and therefore provide a medium level of support. Their hinges are also adjustable and can be set to avoid certain ranges of movement. Medium stability braces are more appropriate for Grade 2 MCL sprains. Examples on Amazon: Medium stability with non-adjustable hinge These braces provide a similar level of support to that of the ones above, but their hinges can’t be adjusted to restrict how far your knee bends or straightens. They may be appropriate for some Grade 2 MCL sprains. Examples on Amazon: When should you wear your brace? Your should wear your brace whenever you’re standing, walking, or doing your exercises. Your doctor may even advise that you wear it while sleeping during the early stages. 👉 You can find more information about what exercises to do for MCL tears here. How long to wear an MCL brace for The current expert opinion is: Grade 1 MCL sprains: No brace needed Grade 2 MCL tears: At least 3 weeks Grade 3 tears: At least 6 weeks. How we can help Need more help with your injury? You’re welcome to consult one of the team at SIP online via video call for an assessment of your injury and a tailored treatment plan. We're all UK Chartered Physiotherapists with Master’s Degrees related to Sports & Exercise Medicine. But at Sports Injury Physio we don't just value qualifications; all of us also have a wealth of experience working with athletes across a broad variety of sports, ranging from recreationally active people to professional athletes. You can meet the team here . About the Author Maryke Louw is a chartered physiotherapist with more than 20 years' experience and a Master’s Degree in Sports Injury Management. Follow her on LinkedIn and ResearchGate . References Vosoughi, Farzad, et al. "Medial collateral ligament injury of the knee: a review on current concept and management." Archives of Bone and Joint Surgery 9.3 (2021): 255. In: Brukner P, Clarsen B, Cook J, Cools A, Crossley K, Hutchinson M, McCrory P, Bahr R, Khan K. eds. Brukner & Khan’s Clinical Sports Medicine: Injuries, Volume 1, 5e . McGraw Hill; 2017. (You can buy the book from this link.)

Exercises are an important part of treating meniscus tears . For an exercise plan to be effective, it has to start at the correct intensity that matches the severity of your symptoms and then progress until you regain full strength and control. In this article, we demonstrate 23 exercises and stretches that are typically prescribed for meniscus tear rehab. It explains why these types of exercise are important, how to do them properly, and how to safely make them more challenging as you improve. Remember, if you need more help with an injury, you're welcome to consult one of our physios online via video call. Some of the links in this article are to pages where you can buy products or brands discussed or mentioned here. We earn a small commission on the sale of these products at no extra cost to you. In this article: Read this first Early-stage rehab exercises for meniscus tears Later-stage rehab exercises for meniscus tears Read this first Before we get to what exercises you can do for your meniscus tear rehab, there are a few things that are important to understand. Have your injury assessed These exercises may not be right for you, and you should only do them if a physiotherapist has assessed you and confirmed that they are right for you. Pain It is usually OK to feel a bit of discomfort while doing the exercises, but they should not cause pain, and your knee should not feel more painful or be more swollen after you’ve done them. Check also for a delayed symptom response. Sometimes, an exercise session may feel absolutely fine while you’re doing it, but then it can cause your knee to feel worse several hours later or the next day. If this happens, it is usually a sign that the exercises (type, repetitions, or weights) were not right for you, and they have to be adjusted. Repetitions The number of repetitions and recommendations for how often the exercises should be done are only guidelines. Everyone’s meniscus injury is different, and your rehab plan should be tailored to you. Never strain to complete an exercise. If you find an exercise hard, do what you can while maintaining good technique without discomfort, and then gradually increase the repetitions when it starts to feel easy after a few sessions. Frequency People often make the mistake of thinking that the more they do their exercises, the quicker they will recover. This is NOT how it works. Your body needs a period of rest to recover and rebuild itself after each exercise session. If you do your rehab exercises too often, your body won’t be able to adapt quickly enough, and it can end up making your injury worse. It is usually OK to do low-load exercises daily. Higher-load exercises (like squats) should only be done every other day and maximum three times a week. Regaining range of motion Initially, your knee may not be able to move through its full range of motion (straightening and bending fully), and it can take up to four weeks to regain this. Don’t try and force the movement. Just keep doing your exercises in your comfortable range, and it will improve as your meniscus recovers and the swelling reduces. Early-stage rehab exercises for meniscus tears These exercises are usually appropriate when your knee is newly injured and still quite painful and swollen. They can help you to: Regain full range of motion Decrease pain and swelling Activate and strengthen the muscles that control your knee and leg in positions that don’t place too much strain on your injured meniscus Relax your leg muscles. I demonstrate some of the exercises that are usually prescribed during this stage in the video. Below that, I have provided quick-reference suggestions for sets and reps. Knee flexion-extension on bed Main benefits: The repetitive action helps to feed your joint Improves both bending and straightening range of motion Activates hamstring (back of thigh) muscles 📽️ Video demo Frequency: Twice a day Repetitions: 10 Rest: 30 seconds to 1 minute between sets Sets: 3 End-of-range knee extension Main benefits: Improves extension range of motion Activates your quadriceps (front of thigh) muscles 📽️ Video demo Frequency: Once a day Hold for: 10 seconds Rest for: 10 seconds Repetitions: 10 End-of-range knee extension over foam roller or towel Main benefits: Improves extension range of motion Strengthens your quadriceps muscles in the last few degrees of knee extension. It is in this range of motion that our quads have to work hardest to stabilise our legs when we walk. 📽️ Video demo Frequency: Once a day Hold for: 10 seconds Rest for: 10 seconds Repetitions: 10 Knee extension sitting in chair Main benefits: Improves extension range of motion Strengthens the quadriceps muscles through full range 📽️ Video demo Frequency: Once a day Hold for: 10 seconds Rest for: 10 seconds Repetitions: 10 Standing hamstring curls Main benefits: Improves bending range of motion Strengthens your hamstring muscles 📽️ Video demo Frequency: Once a day Hold for: 10 seconds Rest for: 10 seconds Repetitions: 10 Calf raises Main benefits: Strengthens your calf muscles 📽️ Video demo Frequency: 3 times a week – you can do them daily if you find them easy Repetitions: 15 Rest: 1 minute Sets: 3 Gentle hamstring stretch Main benefits: Reduces tension and discomfort in your hamstring muscles Improves knee extension range of motion 📽️ Video demo Frequency: 3 times a week. You can do it daily if needed. Hold for: 30 seconds Rest for: 30 seconds Repetitions: 3 Calf stretch Main benefits: Reduces tension and discomfort in your calf muscles Improves knee extension range of motion 📽️ Video demo Frequency: 3 times a week. You can do it daily if needed. Hold for: 30 seconds Rest for: 30 seconds Repetitions: 3 For the past 5 years, I’ve been working with Exakt to create the ultimate app for runners. It includes a dedicated meniscus rehab plan that adapts to your feedback, helping you recover step by step at your own pace. Download the Exakt app from the app stores and use my code MARYKE for a discount 🎉 Later-stage rehab exercises for meniscus tears When to start with these exercises You can usually start with these exercises once you are able to: Fully extend your knee with only mild discomfort, Bend your knee nearly all the way (about 95% of normal), And can walk short distances with only mild discomfort. Remember, these exercises may not be right for you, so please check with your physio before you start doing any of them. Benefits of these exercises for meniscus tears These exercises are designed to: Gradually get your meniscus used to carrying weight again. Strengthen the muscles that support and control your knee and leg (gluteal muscles, hamstrings, quads, and calf muscles). Develop your position sense and balance. Position sense refers to your brain’s ability to know exactly where your knee is and to control it properly without you actually having to look at it. Position sense is often decreased when you get injured, and restoring your position sense can help you to avoid strains and sprains. What exercises to do The list of exercises you could do during this stage of rehab is endless. For this article, I have demonstrated three of the most important types of movements (squats, bridges, balancing), plus suggestions for how to progress them (make them more challenging as you improve). How often to do the exercises These exercises work your knee and muscles much harder than those in the previous section, and your body will need a recovery period of at least 48 hours after each session. My general advice is: Do them two to three times a week, And never on consecutive days. Please check with your physio what is right for you. How to progress them A typical rehab plan for a meniscus tear will start with low-load exercises done in stable positions (usually supported on two legs). As your knee recovers, these will then be progressed to exercises that gradually place more load through your knee and increasingly challenge your balance and control (usually single-leg exercises on unstable surfaces). Once you’ve regained your full strength and control, it is then important to ease back into your sport. How do you know when you’ve regained full strength and control? This will be different for every person and depends on the sport or activity you want to do. A physiotherapist can help you to determine this. I demonstrate the exercises discussed lower down in this video: Squat exercise progression examples Start with: Wall sits 📽️ Video demo Hold: 10 seconds Rest: 10 seconds Repetitions: 10 Build up to 30sec hold x 3 When to progress: When you can do this exercise without effort and less than two out of ten (2/10) discomfort. Progression 1: High box squats 📽️ Video demo Repetitions: 15 Rest: 1 minute Sets: 3 When to progress: Once you are comfortable doing the full recommended dose using a high surface, you should gradually lower the surface until you can comfortably do them to the level of a regular dining table chair (knees bent about 90 degrees). Only then can you usually safely move on to the next exercise. Progression 2: Free squats 📽️ Video demo Repetitions: 15 Rest: 1 minute Sets: 3 When to progress: When you can do the full recommended dose of this exercise with minimal effort and without pain. Progression 2: Squats with weight 📽️ Video demo Weight: Use a weight that makes you tired within 10 repetitions. Repetitions: 10 Rest: 1 to 2 minutes Sets: 3 When to progress: Train at this intensity for at least two to four weeks before attempting the next progression. Progression 4: Single-leg box squat 📽️ Video demo Repetitions: 10 Rest: 1 minute Sets: 3 When to progress: When you can do the full recommended dose of this exercise with minimum effort and no pain. The next step would be more dynamic, plyometric, and sport-specific exercises. Bridge progression examples Start with: Double-leg floor bridge, knees 90 degrees 📽️ Video demo Hold: 20 seconds Rest: 20 seconds Repetitions: 5 When to progress: When you can do the full recommended dose of this exercise with minimal effort and without pain. Progression 1: Double-leg floor bridge, knees 45 degrees 📽️ Video demo Hold: 20 seconds Rest: 20 seconds Repetitions: 5 When to progress: When you can do the full recommended dose of this exercise with minimal effort and without pain. Progression 2: Double-leg high bridge 📽️ Video demo Hold: 20 seconds Rest: 20 seconds Repetitions: 5 When to progress: When you can do the full recommended dose of this exercise with minimal effort and without pain. Progression 3: Marching high bridge 📽️ Video demo Repetitions: 16 Rest: 1 minute Sets: 3 When to progress: When you can do the full recommended dose of this exercise with minimal effort and without pain. Progression 4: Single-leg high bridge 📽️ Video demo Repetitions: 15 Rest: 1 minute Sets: 3 When to progress: When you can do the full recommended dose of this exercise with minimum effort and no pain. The next step would be more dynamic, plyometric, and sport-specific exercises. I designed the meniscus tear rehab plan in the Exakt app to safely guide you through each stage of healing. It even includes a return-to-running plan to help you ease back into running with confidence. Download the Exakt app from the app stores and use code MARYKE for a discount. Balance progression examples Start with: Balance with progressively less support 📽️ Video demo Hold: Build up to holding for 30 seconds. Initially, you can stabilise yourself by placing a finger against a wall, but you should aim to be able to complete this exercise without holding on. Rest: 30 seconds, or rest one leg while you do the other Repetitions: 3 times each leg When to progress: When you can do the full recommended dose of this exercise without holding on for support, with minimal effort, and no pain. Progression 1: Balance while moving head 📽️ Video demo Hold: 30 seconds Rest: 30 seconds, or rest one leg while you do the other Repetitions: 3 times each leg When to progress: When you can do the full recommended dose of this exercise with minimal effort, good control, and no pain. Progression 2: Single-leg deadlift with knee bent 📽️ Video demo Repetitions: 10 slow repetitions Rest: 60 seconds Sets: 3 sets each leg When to progress: When you can do the full recommended dose of this exercise with minimal effort, good control, and no pain. Progression 3: Single-leg deadlift with knee straight Do without weights to start with 📽️ Video demo Repetitions: 10 slow repetitions Rest: 60 seconds Sets: 3 sets each leg When to progress: When you can do the full recommended dose of this exercise with minimal effort, good control, and no pain. Progression 4: Balance on unstable surface Perform the same balance exercises as before (e.g. single-leg deadlift) while standing on an unstable surface. 📽️ Video demo Repetitions and sets depends on the type of exercise you choose to do. When to progress: When you can do the full recommended dose of this exercise with minimal effort, good control, and no pain. The next step would be more dynamic, plyometric, and sport-specific exercises. How we can help Need more help with your injury? You’re welcome to consult one of the team at SIP online via video call for an assessment of your injury and a tailored treatment plan. We're all UK Chartered Physiotherapists with Master’s Degrees related to Sports & Exercise Medicine. But at Sports Injury Physio we don't just value qualifications; all of us also have a wealth of experience working with athletes across a broad variety of sports, ranging from recreationally active people to professional athletes. You can meet the team here . About the Author Maryke Louw is a chartered physiotherapist with more than 15 years' experience and a Master’s Degree in Sports Injury Management. Follow her on LinkedIn and ResearchGate . References: Hutchinson, M., et al. (2016). BRUKNER & KHAN'S CLINICAL SPORTS MEDICINE: INJURIES, VOL. 1, McGraw-Hill Education.

Are tendon repair supplements a fad, or do they really help you to recover quicker from your tendon injury? We take a look at the research into eight tendonitis supplements and tendon tear recovery supplements. Remember, if you need more help with an injury, you're welcome to consult one of our physios online via video call. This article contains affiliate links. We might earn a small commission on sales at no extra cost to you. In this article: Tendon injury overview Research on tendon repair supplements What supplements help tendon repair? Some words of caution Our tendon repair supplement recommendations How we can help We've also made a video about this: Tendon injury overview Tendon anatomy and function Our tendons connect our muscles to our bones and therefore play an active role in how we move – every time you contract a muscle, it pulls on its tendon, and something moves. They also act like springs – absorbing forces and then releasing them, for example the Achilles tendon when we walk, run, or jump.   Tendons are mostly made up of collagen fibres. Collagen is the most abundant form of protein in our bodies and is also found in various forms in our bones, cartilage, ligaments, and skin. Types of tendon injury There are two main types of tendon injury: a tendinopathy (sometimes called a tendonitis or a tendinosis ) and a tendon tear or rupture .   A tendinopathy  occurs when a part of the tendon is injured (most commonly through overuse), causing the collagen fibres to move away from each other and lose their strong, parallel arrangement. This results in the tendon losing strength in that area. Typical tendinopathies (click or tap to read more about each): Achilles tendinopathy Patellar tendinopathy  (in the front of your knee) Lateral epicondyle tendinopathy  (tennis elbow) High/proximal hamstring tendinopathy Lower/distal hamstring tendinopathy Gluteal tendinopathy Tibialis posterior tendinopathy Peroneal tendinopathy.   Tendon tear  is self-explanatory, but when the tendon is fully torn, it is usually referred to as a rupture .   Research-backed treatments The best research-backed treatment for a tendinopathy is a progressive rehab programme that consists of the right combination of rest and exercise to replace and strengthen the weakened collagen fibres.   Most partial tears will benefit from the same type of rehab programme. On the other hand, some complete ruptures need surgery and others don’t. In any event, a rehab programme as mentioned above will also be necessary post-surgery, after the torn tendon ends have grown back together. Research on tendon repair supplements   Because tendons heal through replacing and strengthening their collagen fibres, the people in the white lab coats are interested in studying the effects of supplements that are known or thought to help with: the formation of new collagen cells in our bodies or that might reduce inflammation in the injured tendon.   Some of the studies discussed below focused on people with tendinopathies, some on people who have had tendon surgery, and some on healthy people who exercise. The latter is useful, because it is generally accepted that a supplement is not a stand-alone silver bullet that will get your injured tendon back to normal – it is meant to enhance the effects of a recognised tendon rehab treatment such as an exercise programme.   Also, most of the studies below had two groups of subjects: a treatment group who was given the supplement plus a conventional tendon rehab treatment, as well as a placebo group who received a “fake” supplement (without knowing it) plus the same conventional treatment. This enabled the scientists to figure out whether a supplement had a real effect or whether any improvements were “all in the mind” and/or thanks to the conventional treatment. What supplements help tendon repair?   Most of the supplements that have been tested either consist of some form of collagen (the main building block of tendons), substances that are known to play a role in creating collagen in the body, or substances that may help to regulate inflammation. Hydrolysed collagen Vitamin C-enriched gelatine Tendoactive® Tendisulfur® Forte Tenosan® Essential fatty acids and antioxidants Omega-3 polyunsaturated fatty acids High-leucine whey protein hydrolysate   1. Hydrolysed collagen What is hydrolysed collagen? Hydrolysed collagen is collagen that is broken down into smaller particles/peptides, which makes it easier for the body to absorb. The study: Praet et al. (2019) Test subjects: Twenty people with midportion Achilles tendinopathy. Dosage:  2.5 g of hydrolysed collagen OR a placebo, taken 30 mins before rehab exercises (twice daily) for 6 months. Additional treatment: Eccentric heel raises  and running exercises for the treatment group and the placebo group. Results: The group receiving the hydrolysed collagen supplement gained more benefits from their rehab exercises than the placebo group. Limitations of the study:  Very small sample size – the results may not be accurate. The study was sponsored by GELITA AG, Germany, a company that sells collagen supplements, so the results may be biased towards showing a positive effect. The supplements below are similar the one used in the study: 2. Vitamin C-enriched gelatine What is Vitamin C-enriched gelatine? In addition to its well-known health benefits, Vitamin C is involved in the formation of collagen. Gelatine is a derivative of collagen that is used in food, and therefore easy to ingest. The study: Shaw et al. (2016) Test subjects: Eight men, not injured. Dosage:  5 g of gelatine with 48 mg of Vitamin C OR 15 g of gelatine with 48 mg of Vitamin C OR a placebo, taken one hour before skipping rope. Additional treatment:  Rope skipping for 6 minutes, three times a day, for three days for the treatment group and the placebo group. Results: The subjects that took 15 g of gelatine had a better increase in collagen formation (due to the rope skipping exercise) than the 5 g group and the placebo group. We cannot say from this study whether Vitamin C played a role. Limitations of the study:  Very small sample size – the results may not be accurate. This supplement is similar to the one used in the study: 3. Tendoactive® What is Tendoactive? Tendoactive is a food supplement that has been formulated to help with the formation of connective tissue such as tendons and ligaments. Its main ingredient is mucopolysaccharide, which is thought to play a role in tendon strengthening. It also contains collagen and Vitamin C (see above for an explanation of what these are). The study: Arquer et al. (2014) Test subjects: 98 tendinopathy patients (Achilles tendon, patellar tendon, tennis elbow). Dosage:  Three capsules of Tendoactive per day (totalling 435 mg mucopolysaccharide, 75 mg Vitamin C, and 75 mg collagen) for 90 days. (Please note that the manufacturer recommends only two capsules per day for at least 90 days.) Additional treatment: None. Results: Reduced pain at rest and during activity, improved tendon function, and reduced tendon swelling. Limitations of the study:  This study didn’t have a placebo group, nor did they ask the participants about other treatments they may have received during this period, so the improved symptoms might have been wholly or partly thanks to the passage of time or something else entirely. There is also no mention of who paid for the research, so we can’t tell whether the results may be biased.   4. Tendisulfur® Forte What is Tendisulfur Forte? According to the manufacturer, it is a food supplement containing methylsulfonylmethane (which has been shown to reduce pain and inflammation in arthritis), hydrolysed collagen, D-glucosamine, chondroitin sulphate, arginine, lysine, with vegetable extracts of Boswellia, turmeric, myrrh, and Vitamin C.   This was researched in two studies.   A) First study: Vitali et al. (2019) Test subjects: 90 people: 30 with Achilles tendinopathy, 30 with a shoulder tendinopathy, 30 with tennis elbow. Dosage:  For the treatment groups, two sachets of Tendisulfur Forte per day for a month, and then one sachet per day for a month ( see here for sachet contents and the manufacturer’s recommended dosage ); for the control groups, zero dosage. Additional treatment: Shockwave therapy  for the treatment and the control groups. Results: For all three types of injury, a combined treatment of shockwave therapy and the supplement led to a faster recovery than just shockwave therapy. Limitations:  The control group did not receive a placebo supplement, which may mean that the positive results are actually due to a placebo effect rather than a true clinical effect. A medical company sponsored the supplements. ______________ B) Second study: Merolla et al. (2015) Test subjects: 100 patients who had had surgery to repair torn rotator cuff tendons. Dosage:  Two sachets daily for 15 days OR a placebo, and then one sachet per day for 45 days OR a placebo. Additional treatment: Painkillers for the treatment group and the placebo group. Results: The group that received the Tendisulfur Forte had better pain relief in the short term (after 1 week) and somewhat better pain relief in the medium term (after 2 weeks) but no better pain relief than the placebo group after that. Limitations: No mention of who funded the research. 5. Tenosan® What is Tenosan? According to the manufacturer, it is a supplement that promotes the formation of collagen. It contains L-arginine alpha ketoglutarate, TruBeet®, ViNitrox®, hydrolysed collagen type I, Vitamin C, and Vitamin D3. The study: Notarnicola et al. (2012) Test subjects: 64 patients with insertional Achilles tendinopathy . Dosage:  Two sachets of Tenosan (500 mg arginine-L-alpha-ketoglutarate, 550 mg methylsulfonylmethane, 300 mg hydrolysed collagen type I, 125 mg Vinitrox, 50 mg bromelain, 60 mg Vitamin C) OR a placebo, every day for 60 days. ( See here for sachet contents and the manufacturer’s recommended dosage .) Additional treatment: Three sessions of shockwave therapy for the treatment group and the placebo group. Results: There was no significant difference in perceived Achilles pain between the two groups after two months, but after six months, the group that received the real McCoy had less pain. The treatment group had better Achilles tendon function two months after the treatment started and after six months. Limitations: We don’t know who funded the research.   6. Essential fatty acids and antioxidants What are essential fatty acids and antioxidants? Essential fatty acids are a type of fat essential to several functions in our bodies, but we have to ingest them because our bodies cannot manufacture them. Researchers are interested in fatty acids because they may play a role in controlling inflammation. Antioxidants prevent the formation of free radicals, which can damage our cells; examples of antioxidants are Vitamins A, C, and E. The main rationale for including them in this supplement was to protect against any negative effects that ingesting such large quantities of fatty acids may have. The study: Mavrogenis et al. (2004) Test subjects: 31 recreational athletes with chronic tendon disorders (tendinitis, tendinopathy, para-tenonitis with or without tendinopathy). Dosage: Daily for 32 days, a placebo OR the following supplement: Essential fatty acids: 376 mg eicosapentaenoic acid, 264 mg docosahexaenoic acid, and 672 mg gamma-linolenic acid. Antioxidants: 100 µg selenium, 15 mg zinc, 1 mg Vitamin A, 2.2 mg Vitamin B6, 90 mg Vitamin C, and 15 mg Vitamin E. Additional treatment: Ultrasound for the treatment group and the placebo group. Results: The group treated with essential fatty acids and antioxidants had a greater reduction in pain during activities, and their participation in sports activities increased by more than that of the placebo group. Limitations: It is a small study, and we don’t know who funded it.   7. Omega-3 polyunsaturated fatty acids What are omega-3 polyunsaturated fatty acids? These are a type of fatty acid, typically found in fish oil and certain plant oils, which plays various roles in human physiology. The rationale underpinning fish oil supplementation lies in the anti-inflammatory effects it may have. The study: Sandford et al. (2018) Test subjects: 73 patients with rotator cuff injuries. Dosage:  Nine capsules per day, each containing 170 mg eicosapentaenoic acid (EPA), 115 mg docosahexaenoic acid (DHA), and 2 units/g tocopherols acetate (vitamin E) OR a placebo, for two months. Additional treatment: Weekly rotator cuff injury exercises for eight weeks for the treatment group and the placebo group. Results: The treatment group had a slight improvement over the placebo group after three months, but the injuries of both groups showed similar improvements after 12 months. Limitations: Seven Seas Ltd. provided the active and placebo capsules but did not commission or fund the full study. These supplements might not have the same concentrations of Omega-3 as that used in the research. Please follow the manufacturer's dosage instructions.   8. High-leucine whey protein hydrolysate What is high-leucine whey protein hydrolysate? Leucine is an essential amino acid (i.e. the body can’t manufacture it; it has to be ingested), and whey (a by-product of cheese production) is one way to ingest it. Hydrolysate is a type of whey that is easily digested. Amino acids have been shown to play a role in collagen production and may hence help tendon repair. The study: Farup et al. (2014) Test subjects: 22 healthy young recreationally active men. Dosage: 19.5 g high-leucine whey protein hydrolysate OR a placebo, on each of 33 exercise days over 12 weeks. Additional treatment: Patellar tendon exercises (leg extensions) for the treatment group and the placebo group. Results: The patellar tendons of the group taking the supplement grew thicker (due to the exercises) than those of the placebo group. The strength of both groups increased about equally (due to the exercises). Limitations: Again, this was a small study. Arla Foods Ingredients Group P/S DK funded the study, but it is not clear whether they just provided the supplements or actually commissioned the study. This whey protein supplement may not have the same concentrations as the one used in the study. Please follow the manufacturer's dosage instructions. Some words of caution   Anti-inflammatory effects of some tendon repair supplements Some of the pain reduction caused by some tendon repair supplements could be due to a reduction in inflammation.   However, it should be noted that inflammation plays a vital role in the healing process of a tendon injury (tendon tears specifically), especially in the first few days. So, reducing the inflammation could suppress the healing process .   Also, in many cases of tendinopathy, especially chronic / long-term tendinopathy, there is little or no inflammation, even though the tendon might be painful. In such cases, taking a supplement with the sole purpose of reducing inflammation will be useless, and there is some evidence that it may limit your strength gains after workouts , including rehab workouts.   Overdosing and interaction with other supplements / medication It is easy to overdose on certain minerals and vitamins if you take several supplements that contain the same thing – check the contents of any supplements you take carefully.   There are also several medications that can be affected by some of the substances included in these supplements (stopping them from working as effectively), so if you are taking any medication, check with your doctor before you start taking supplements.   Sports doping Supplements are not regulated by the USA’s FDA and similar bodies elsewhere, and therefore not all the ingredients have to be listed. This could cause you to test positive for prohibited drugs.   Our tendon repair supplement recommendations As I pointed out above in my discussion of the various research studies, they have some limitations: Some had small sample sizes. Some were sponsored by medical companies with skin in the game, and others didn’t disclose who funded the study. Some lacked a placebo group or a control group.   So, at this stage, we can’t tell for sure whether these supplements work or not. However, none of the studies reported any negative effects. So, this is something that you might add to your treatment, but I would not spend crazy money on it, and I wouldn’t depend on it as a standalone to get my tendon injury to heal properly. Please follow the dosage instructions on these supplements if you do get them. How we can help Need more help with an injury? You’re welcome to consult one of the team at SIP online via video call for an assessment of your injury and a tailored treatment plan. For help with an Achilles injury, you can head over to our specialists at Treat My Achilles . We're all UK Chartered Physiotherapists with Master’s Degrees related to Sports & Exercise Medicine or at least 10 years' experience in the field. But at Sports Injury Physio we don't just value qualifications; all of us also have a wealth of experience working with athletes across a broad variety of sports, ranging from recreationally active people to professional athletes. You can meet the team here . About the Author Maryke Louw is a chartered physiotherapist with more than 20 years' experience and a Master’s Degree in Sports Injury Management. Follow her on LinkedIn and ResearchGate . References Praet S, Purdam C, Welvaert M, et al. (2019) “Oral Supplementation of Specific Collagen Peptides Combined with Calf-Strengthening Exercises Enhances Function and Reduces Pain in Achilles Tendinopathy Patients” Nutrients 11(1):76. Shaw G, Lee-Barthel A, Ross ML, et al. (2016) “Vitamin C–enriched gelatin supplementation before intermittent activity augments collagen synthesis” The American Journal of Clinical Nutrition 105(1):136-43. Arquer A, García M, Laucirica JA, et al. (2014) “Efficacy and safety of an oral treatment based on mucopolysaccharides, collagen type i and vitamin C in patients with tendinopathies” Apunts Medicina de l’Esport 48(182):31–36. Vitali, M., Naim Rodriguez, N., Pironti, P., Drossinos, A., Di Carlo, G., Chawla, A., & Gianfranco, F. (2019) “ESWT and nutraceutical supplementation (Tendisulfur Forte) vs ESWT-only in the treatment of lateral epicondylitis, Achilles tendinopathy, and rotator cuff tendinopathy: a comparative study” Journal of Drug Assessment 8(1):77–86. Merolla, G., Dellabiancia, F., Ingardia, A. et al. (2015) “Co-analgesic therapy for arthroscopic supraspinatus tendon repair pain using a dietary supplement containing Boswellia serrata and Curcuma longa: a prospective randomized placebo-controlled study” Musculoskelet Surg 99 (Suppl 1):43–52. Notarnicola A, Pesce V, Vicenti G, et al. (2012) “SWAAT study: extracorporeal shock wave therapy and arginine supplementation and other nutraceuticals for insertional achilles tendinopathy” Adv Ther 29(11):992. Søren Mavrogenis, Egil Johannessen, Pål Jensen, Christian Sindberg (2004) “The effect of essential fatty acids and antioxidants combined with physiotherapy treatment in recreational athletes with chronic tendon disorders: A randomised, double-blind, placebo-controlled study” Physical Therapy in Sport 5(4):194–199. Farup, J., Rahbek, S.K., Vendelbo, M.H., Matzon, A., Hindhede, J., Bejder, A., Ringgard, S. and Vissing, K. (2014) “Whey protein and tissue hypertrophy” Scand J Med Sci Sports 24:788–798. Balius R, Álvarez G, Baró F, et al. (2016) “A 3-arm randomized trial for achilles tendinopathy: eccentric training, eccentric training plus a dietary supplement containing mucopolysaccharides, or passive stretching plus a dietary supplement containing mucopolysaccharides” Curr Ther Res Clin Exp 78:1–7. Hijlkema, A., Roozenboom, C., Mensink, M., & Zwerver, J. (2022). “The impact of nutrition on tendon health and tendinopathy: a systematic review” Journal of the International Society of Sports Nutrition, 19(1):474–504 . Qiu, F.; Li, J.; Legerlotz, K. (2022) “Does Additional Dietary Supplementation Improve Physiotherapeutic Treatment Outcome in Tendinopathy? A Systematic Review and Meta-Analysis” J Clin Med 11(6):1666 .

Discover which knee braces truly support meniscus tear recovery – comparison of soft sleeves, hinged and unloader designs, plus expert advice on when to use and when to remove them. Remember, if you need more help with an injury, you're welcome to consult one of our physios online via video call. This article contains affiliate links. We may earn a small commission on sales at no extra cost to you. In this article: Who needs a brace for their meniscus tear? Soft knee braces for meniscus tears Unloader braces for meniscus tears Hinged support braces for meniscus tears When to remove your meniscus tear brace immediately How we can help We’ve also made a video about this: Who needs a brace for their meniscus tear? Not everybody with a meniscus tear needs a brace. Unlike ligaments, which help to stabilise your knee and which often need a brace for added stability when they are injured, your meniscus doesn’t play that big a part in knee stability. So, if the ligaments are fine, a knee with a torn meniscus is quite stable. The most important treatment for meniscus tears is to reduce the load through the knee for a while so that the meniscus can recover and doing gentle exercises to strengthen the knee. 👉 Read more about lateral meniscus tear treatment , medial meniscus tear treatment , and rehab exercises for meniscus tears . However, there are specific instances where a brace may be useful: Providing the confidence to move If your knee is very swollen and painful, it can feel as if it wants to give way even though it isn't structurally unstable. In such cases, wearing a brace can just give it that extra bit of support and make it feel more comfortable – as if you can trust it a bit more – and that can help you to move around more easily.   Movement is very important for the meniscus because it helps with the healing process. So, anything that helps you to move around with more confidence is good.   Signalling to others that you’re injured A brace signals to other people that you knee is injured. This is especially useful when you're in crowded places.   I once had to walk through London’s very busy Victoria Station with an injured knee, and it wasn’t fun being jostled all the time. If I had a brace, people might have noticed and been more considerate. A knee brace can signal to others to move carefully around you. Note to self … A knee brace can act as a reminder to yourself that your knee is injured.   People are often not aware of what types of movement can be painful for an injury. For instance, you may be doing housework and having to squat, not realising that it will hurt your injured knee until it’s too late.   A brace can make you think twice when doing certain movements and realise that, “Ah, I shouldn't be doing that right now.”   When a knee ligament is also injured If you have injured one of the major ligaments in your knee in addition to your meniscus, it might mean that your knee is somewhat unstable. This can place extra strain on the meniscus and hinder its recovery.   In that case, a brace can provide extra stability, and then the meniscus can recover better. Soft knee braces for meniscus tears   Soft knee braces typically just wrap around the knee; they don't provide that much stability. So, if you also have a ligament injury, they're not appropriate. But if it's just an isolated meniscus tear, they can be useful. A soft knee brace with velcro can easily be adjusted if your meniscus injury causes your knee to swell more. Typical uses: To provide support if you've got a painful, swollen knee, because they're easy to adjust for the amount of swelling you've got. They give you a bit of security to have the confidence to move. If you are doing something active, they will allow you to bend and straighten your knee but avoid those extreme ranges of motion that can hurt your knee. They indicate to other people in crowded places that you have a knee injury. They act as a reminder to yourself that you've got a knee that needs looking after.   I prefer a soft knee brace that wraps around and fastens with Velcro , because you can adjust it if your knee swells during the day, as is sometimes the case with a meniscus injury, and tighten it up again when the swelling goes down. If the support is too tight, it can cut off your circulation. A brace that just pulls on over your leg can’t be adjusted, and this will be bad for your circulation if your knee swells.   Four good soft knee braces for meniscus tears available on Amazon:   Unloader braces for meniscus tears   Unloader braces are a lot sturdier that the soft ones. They’re called that because they can be adjusted to unload/relieve the pressure in a specific part of the knee. They are typically used by people with osteoarthritis in a part of their knee. The idea with a meniscus tear is that it can be adjusted to relieve pressure on either the inside or the outside of the knee, depending on where the tear is, to make walking and other activities a lot more comfortable.   Unloader knee braces can be adjusted to reduce the pressure on specific parts of the meniscus. However, whether it works as it is thought to work for meniscus tears has only been tested on cadavers (dead people). So, although the researchers have found that it seems to work in this way, this does not necessarily mean that it works in real life. Also, the study was funded by a manufacturer of these braces.   So, we’ll have to wait for some more research before can say for sure that unloader braces work for meniscus tears. It’s not my first choice of brace for a meniscus tear, but if you’ve done everything right and your meniscus is still painful, you could consider giving it a go.   The braces below are specifically for the left knee or the right knee, so if you order one, take care to select the correct side.   Hinged support braces for meniscus tears   These braces have hinged metal rods on the sides, and you can adjust them to allow the knee to move only in a certain range of motion. They provide the most support. Hinged knee braces are only needed if you've also injured a ligament. You probably won’t need one of these if it’s only your meniscus that’s injured. But they will contribute to your meniscus’s healing process if you have also injured a ligament in your knee and now your knee is unstable because of that.   The specific type of brace will rather depend on your ligament injury and not your meniscus injury. You can find more advice on the various types of knee brace in our articles on medial collateral ligament injuries  and lateral collateral ligament injuries . When to remove your meniscus tear brace immediately   Some people feel that they should wear a brace at all costs and not take it off even if it's uncomfortable. That is just not the case. If a brace is uncomfortable, it's not doing its job.   And if it's causing weird symptoms, it could mean that it's squashing your nerves or it's cutting off your blood supply, and that's not good at all.   Please remove your brace immediately if you have any of these symptoms. If the symptoms persist for more than 10 minutes after taking your brace off, please see your doctor. Significant swelling either above or below the brace. Your leg below the brace or your foot turns blue. Tingling, pins-and-needles, or numbness in the leg with the brace. A throbbing or burning sensation anywhere in that leg. How we can help Need more help with your injury? You’re welcome to consult one of the team at SIP online via video call for an assessment of your injury and a tailored treatment plan. We're all UK Chartered Physiotherapists with Master’s Degrees related to Sports & Exercise Medicine or at least 10 years' experience in the field. But at Sports Injury Physio we don't just value qualifications; all of us also have a wealth of experience working with athletes across a broad variety of sports, ranging from recreationally active people to professional athletes. You can meet the team here . About the Author Maryke Louw is a chartered physiotherapist with more than 20 years' experience and a Master’s Degree in Sports Injury Management. Follow her on LinkedIn and ResearchGate . Reference Kalra, M., Bakker, R., Tomescu, S. S., Polak, A. M., Nicholls, M., & Chandrashekar, N. (2019). The effect of unloader knee braces on medial meniscal strain. Prosthetics and Orthotics International, 43(2), 132-139 .

Find out when a brace is useful for a mild knee sprain, why some injuries don’t require support, and how to choose the right type of hinged brace for your injury. Remember, if you need more help with an injury, you're welcome to consult one of our physios online via video call. This article contains affiliate links. We may earn a small commission on sales at no extra cost to you. In this article: Let’s quickly define what I mean by a sprained knee When to wear a brace for a sprained knee What types of brace work best for mild knee sprains? How we can help We've also made a video about this: Let’s quickly define what I mean by a sprained knee   When you sprain your knee, you injure the joint surfaces and the ligaments, but you may also injure the menisci (cartilage discs inside the knee). The severity of a sprain can vary from mild (just bruising the knee inside or sustaining minor injuries to the ligaments) to severe (complete ligament ruptures or meniscus tears). What treatment will work best for your specific knee sprain will depend on which parts you’ve injured and also how badly they are injured. So, I would always advise that you get your knee assessed by a physiotherapist who can help guide your treatment.   Whether you need to wear a brace and the type of brace that you need, will depend on what you’ve injured when you sprained your knee.   The advice in this article is for people who have mild to moderate sprains without any serious injuries to any of the structures around the knee. So, your knee might be swollen and painful to move into certain positions, but it’s not severe.   If, however, you’ve been diagnosed with a significant ligament or meniscus injury, you can find detailed advice here: Guide to braces for meniscus tears Guide to braces for MCL tears Guide to braces for LCL tears When to wear a brace for a sprained knee   Braces aren’t essential for recovery from a mild knee sprain, but they can be useful for the following reasons: If your knee feels a bit insecure or unstable , they can make it feel more secure and give you confidence to move. They can make it easier to walk on uneven terrain. Braces make other people aware of your injury – useful in crowded areas where people can bump into you. They can also act as a reminder to you that you need to take things easy and prevent you from moving your knee into positions that hurt.   👉 My advice is:  Only wear a brace when you feel you need it – for example, if you’re going to walk on uneven terrain or do activities where you may not be concentrating on your knee.   I’ll provide more general treatment advice for sprained knees in a future article. What types of brace work best for knee sprains?   There are two types of brace that can be helpful for mild to moderate knee sprains, depending on the injury situation.    Braces that support your knee These braces are a good option if you have to walk on uneven terrain, do an activity that might place extra strain on your injured knee, or your knee feels quite unstable when you move.   Such a knee brace should have: Plastic or metal rods or spring stabilisers on the sides of the knee, which improve stability. A hinge if the rods don't bend, so you can easily bend and straighten your knee. A gap for the kneecap.   Examples of these braces:   Braces that also prevent your knee from straightening too far Sometimes, the pain and swelling in the joint can cause your hamstring muscles (at the back of your thigh) to not function as well as usual. The hamstrings are meant to control how far your knee straightens (extends) as you walk. If they aren’t working 100%, your knee might feel unstable and keep on hyperextending.   If that is the case, it might be useful to wear a brace with: Support rods on the inside and outside and a hinge that you can adjust to stop your knee from straightening past a certain point.   Examples of braces that can prevent knee hyperextension:   It’s important that your physio rules out any serious ligament injuries if you do experience hyperextension when you walk. 👍 The good news is , if the instability is due to the hamstrings not being fully awake, this is easy to fix by getting the swelling to reduce and doing some simple rehab exercises. I’ll discuss this in more detail in a future article. How we can help Need more help with your injury? You’re welcome to consult one of the team at SIP online via video call for an assessment of your injury and a tailored treatment plan. We're all UK Chartered Physiotherapists with Master’s Degrees related to Sports & Exercise Medicine or at least 10 years' experience in the field. But at Sports Injury Physio we don't just value qualifications; all of us also have a wealth of experience working with athletes across a broad variety of sports, ranging from recreationally active people to professional athletes. You can meet the team here . About the Author Maryke Louw is a chartered physiotherapist with more than 20 years' experience and a Master’s Degree in Sports Injury Management. Follow her on LinkedIn and ResearchGate .

THE PLANTAR FASCIITIS SELF-TREATMENT SERIES: Causes and symptoms of plantar fasciitis Self-treatment – overview of the treatment options Self-treatment – stretching Self-treatment – massage (this article) Strength and control exercises for plantar fasciitis Yes, it does. Recent research has found that patients with plantar fasciitis appeared to have superior recovery rates if their physiotherapy treatment included soft tissue release (massage) – not only of the plantar fascia, but also of other tight muscles in the legs. The good news is that the current research further suggests that  self-massage techniques are just as effective as massage  done by a therapist. So, no need to break the bank! Here’s how you can do it in the comfort of your own home. We might earn a small commission on the sale of some of the products listed on this page at no extra cost to you. This article will show you: Which muscles to massage as treatment for plantar fasciitis How to massage the plantar fascia itself We have also made a video about this: It’s important to understand that massage alone will not cure your heel pain. It is only one part of the treatment plan. You can find more information about what treatments have been shown to be effective for plantar fasciitis here. Or if you're looking for a rehab plan, check out the Plantar Fasciitis rehab plan in the Exakt app . I've helped to design the app to guide you through the rehab process from the moment your foot becomes painful all the way back to your sport. 🎉 Discount Code: MARYKE Massage for plantar fasciitis: Which muscles should be included? All the muscles that run down the back of your legs are connected via thick layers of fascia and tendons. They are in turn connected to the plantar fascia via the Achilles tendon. Tight muscles further up the body can thus potentially cause more strain on the plantar fascia. You should therefore not only massage the plantar fascia but also the other muscles in the back of your legs. Because these muscles are connected, they can influence the plantar fascia. As mentioned before, treatment for plantar fasciitis should include more than just massage, and you may find better results if you combine the massage with  plantar fasciitis stretches . Jump to: How to massage your plantar fascia How to massage your hamstrings How to massage your calves How to massage your glutes Massaging the plantar fascia In the video clip below, I demonstrate three ways to massage your plantar fascia. What method works best for you may depend on how sensitive your plantar fascia is and what tools you have available. A WORD OF CAUTION: It is not a good idea to use very forceful massage on the plantar fascia itself because it usually just ends up irritating the injury and may even bruise and injure the little nerves under the foot. You are looking for comfortable or at most "comfortably uncomfortable" pressure. What you need This depends on the method you decide to use. You can buy several types of tools to massage the plantar fascia. Method 1: Using your hands This method is very convenient because you don't need any extra tools. It is especially useful first thing in the morning when you first sit up in bed, before you start walking. You don't have to worry about doing it exactly right. Just rub your foot in a way that feels comfortable and good to you. It is the rubbing action that gets the circulation going, reduces the stiffness and calms the over-sensitive sensors in the area of the injury so they don't create such an excessive pain response. Spend about 1 to 2 minutes doing this. Method 2: Using a ball A larger ball, like a tennis ball or lacrosse ball, usually provides a gentler massage than a smaller ball (golf ball size). Gently roll the ball up and down the length of your foot arch. Remember not to press too hard - massaging your plantar fascia should bring relief and feel enjoyable. If you feel tingling or stinging sensations it's a sign that you are irritating a little nerve. You can injure your nerves or bruise your foot if you are too aggressive. Spend about 1 to 2 minutes on this. Method 3: Using a frozen bottle of water or mini-roller You can find mini-rollers on Amazon that you can put in the freezer , but a frozen 500 ml bottle of water will also work. This method is especially nice at the end of the day to relieve pain that may have developed throughout the day. Gently roll your foot on the roller. It is usually best to limit any cold treatments to between 7 or 10 minutes at a time. Massaging the hamstrings Your hamstrings attach onto your calf muscles, which in turn are attached to the plantar fascia via the Achilles tendon. That’s why you should include massage for your hamstrings when you struggle with plantar fasciitis. I demonstrate my favourite method in the video clip below. What you need I use a foam roller, but some of my patients prefer a firm ball such as a lacrosse or hockey ball. Method Place the foam roller under your thighs and slowly roll backwards and forwards. Make sure that you cover the whole length of the hamstrings from its origin in the buttock to its attachment at the knee. You can target different parts of the hamstring by rolling your body slightly to the sides. Dosage You can do this once a day for one to two minutes, but two or three times a week is usually enough. Massaging the calves As mentioned before, your calf muscles attach directly to the plantar fascia via the Achilles tendon. Any treatment plan for plantar fasciitis should therefore include massage of the calf muscles. I demonstrate how I massage my own calves using a foam roller and ball in the video clip below. What you need Use a foam roller or any firm massage ball . Method You can use your opposite leg to apply pressure and make the massage more effective. Slowly roll backwards and forwards using your arms to push you. Make sure you cover the full length of the calf muscles from the knee to the Achilles tendon. Dosage You can do this once a day for one to two minutes, but two or three times a week is usually enough. Massaging the glutes (your buttock muscles) Tightness in your gluteal muscles not only contribute to plantar fasciitis due to increasing the tension in the fascia, but also by holding on to your sciatic nerve. The sciatic nerve runs through these muscles, and when it’s not allowed to slide freely it can contribute to pain in the plantar fascia. I demonstrate how I use a ball to massage my glutes in the video clip below. What you need I prefer to use a massage ball because it gives you better point pressure, but you can also use a foam roller . Method Slowly roll over the gluteals while you sit sideways on the ball or roller. You can also just maintain the pressure on painful spots for 30 seconds before moving on. Do this once a day for two minutes. Dosage You can do this once a day for one to two minutes, but two or three times a week is usually enough. This article is the last in my series of four articles on how you can treat your plantar fasciitis yourself. Massage alone will not be enough to fix your plantar fascia pain. So, if you’ve landed on this article first, please consider going back and reading the others as well. This will help you to find the best overall approach to fixing your plantar fasciitis. Learn more: What causes plantar fasciitis and the most common symptoms Plantar fasciitis treatments - complete overview Stretches for plantar fasciitis Strength and control exercises for plantar fasciitis How we can help Need more help with your injury? You’re welcome to consult one of the team at SIP online via video call for an assessment of your injury and a tailored treatment plan. We're all UK Chartered Physiotherapists with Master’s Degrees related to Sports & Exercise Medicine. But at Sports Injury Physio we don't just value qualifications; all of us also have a wealth of experience working with athletes across a broad variety of sports, ranging from recreationally active people to professional athletes. You can meet the team here . About the Author Maryke Louw is a chartered physiotherapist with more than 20 years' experience and a Master’s Degree in Sports Injury Management. Follow her on LinkedIn and ResearchGate . References Robroy, L. et al. (2014) Heel Pain—Plantar Fasciitis: Revision 2014. Journal of Orthopaedic & Sports Physical Therapy, 44(11), A1-A33.

Pain over the outside of your hip or in the gluteal area was traditionally blamed on trochanteric bursitis – a condition where the bursa (a fluid filled sac) that lies between the hip bone and gluteal tendons become inflamed and painful. But thanks to advances in imaging technology and research we now know that lateral hip pain is actually often caused by a combination of gluteal tendinopathy and bursitis and researchers have therefore proposed that a better name for pain in this area may be Greater Trochanteric Pain Syndrome. With this in mind, Alison has made a series of videos to explain what causes lateral hip pain, how it's diagnosed, what exercises should be avoided and what types of exercise are the most useful. Some of the links in this article are to pages where you can buy products or brands mentioned here. We might earn a small sales commission at no cost to you. In this video Alison explains what structures may be causing the pain that you feel over the outside of your hip: There are of course other conditions that can cause very similar symptoms and in this video Alison discusses the most typical signs and symptoms that may suggest that your pain is indeed linked to Greater Trochanteric Pain Syndrome. In Episode 8 she also discusses what other conditions may also refer pain over the side of the hip and how to diagnose or identify them. Sitting can often be very uncomfortable when you have a gluteal tendinopathy or hip bursitis and here Alison shares some tips on how to adjust your sitting position: One of the most annoying aspect of Greater Trochanteric Pain Syndrome is that it often won't allow you to sleep on either side and few people are truly comfortable with lying on their backs all night long. In this video Alison demonstrates how you can use pillows to improve your sleep: You might find this ergonomic side sleeping knee pillow useful. An alarming number of clinicians are still telling people to stretch their glutes when they have lateral hip pain. In this video Alison explains why stretching may be a very bad idea when you have either a gluteal tendinopathy or a hip bursitis: In Episode 6, Alison explains how and why the menopause may predispose you to developing outside hip pain and how you can adapt your training to mitigate this. In Episode 7 she discusses what exercises you should be doing if you have lateral hip pain and also what other factors should be taken into account when someone designs your rehab programme for you. In Episode 8 Alison explains what other conditions or structures can cause symptoms that can feel very similar to Greater Trochanteric Pain Syndrome and how we can distinguish between them. While this video is not specifically about lateral hip pain, the method that Ali shares for using pain as your guide during rehab, works really well for this condition. You may also find the following articles useful: 3 Interesting facts about Hip/Trochanteric Bursitis Top tips for runners with Gluteal Tendinopathy Running style tips for Gluteal Tendinopathy treatment Need more help with your injury? You’re welcome to consult one of the team at SIP online via video call for an assessment of your injury and a tailored treatment plan. About Alison: Alison Gould is a chartered physiotherapist and holds an MSc in Sports and Exercise Medicine. You can follow her on LinkedIn , Facebook , Instagram , and Twitter . References Brukner, P, et al. Brukner & Khan's Clinical Sports Medicine. Vol 1: Injuries. (2017) McGraw-Hill Education. (Links to Amazon) Grimaldi, A. and A. Fearon (2015). "Gluteal tendinopathy: integrating pathomechanics and clinical features in its management." Journal of Orthopaedic & Sports Physical Therapy 45(11): 910-922. Grimaldi, A., et al. (2015). "Gluteal tendinopathy: a review of mechanisms, assessment and management." Sports Medicine 45(8): 1107-1119. Leblanc D, Schneider M, Angele P, et al. The effect of estrogen on tendon and ligament metabolism and function. The Journal of steroid biochemistry and molecular biology 2017;172:106-16. Mellor, R., et al. (2018). "Education plus exercise versus corticosteroid injection use versus a wait and see approach on global outcome and pain from gluteal tendinopathy: prospective, single blinded, randomised clinical trial." British Journal of Sports Medicine 52(22): 1464-1472. Oliva F, Piccirilli E, Berardi AC, et al. Hormones and tendinopathies: the current evidence. British medical bulletin 2016;117(1):39-58.

When we exercise, our bodies sustain micro-damage. This is normal, but also the reason why recovery after training is so important. If you get it right, your body will repair itself stronger than before. If you keep on pushing your training and don’t implement good recovery habits, all of this micro-trauma will add up and cause an injury. In this article: What happens in the hours after exercise? What is needed for a good recovery? Summary of useful recovery techniques Injured? We can help Here's the video of the livestream I did on this topic: What happens in the hours after exercise? As mentioned before, exercise causes micro-trauma in your bones, ligaments, muscles, tendons and joints. This micro-trauma is the trigger that tells your brain to repair your body stronger. In order for your body to repair it has to: get rid of all the damaged cells and waste products that was formed during your exercise session and replace the damaged cells with new, stronger ones that can cope with more exercise than before. The end result is a body that is now stronger than before you did your last training session! What is needed for a good recovery after training? Inflammation Inflammation is an important part of your healing process . Your body uses inflammation to get rid of all the damaged cells. I’ve often heard of people taking anti-inflammatory drugs e.g. ibuprofen after exercise to take the muscle soreness away and allow them to train again. There are several reasons why this is a bad idea: By decreasing your inflammatory response, you may be blunting your body’s response to exercise. This means that you may not get the same strength gains from a training session as you would have done without taking the tablets! If you have to take pain medication in order to train, it’s a clear sign that your body has not repaired the damage from your previous session. You will give yourself an over-use injury if you do this often. This type of drug can affect your kidney function if you use it too often. Cold water immersion, e.g. ice baths , is also a popular method that athletes use to recover from exercise, but it’s important to understand that they aren’t always the best choice. They too can decrease your inflammatory response. There’s research that shows that if you take an ice bath regularly after every strength training session you do, you may actually blunt your body’s ability to build muscle. But at the same time there’s evidence that shows that if you take an ice bath after a hard training or competition session, it allows you to perform better the next day. So what should you do? The current advice is to use ice baths when you need them. If it’s important to perform well the next day (e.g. multi-day races), take one. If you’re looking for more long term gains from training, don’t take them too regularly. Ice baths should also not be too cold. Between 11 and 15 degrees centigrade seems to be the optimal temperature . Circulation Your blood carries nutrients and oxygen to your cells and it’s quite obvious that good circulation is important for recovery after exercise. Compression socks helps to improve your circulation by helping your blood flow back up your legs to your heart. They have been shown to decrease fatigue as well as the amount of muscle soreness you feel after exercise (DOMS). Athletes who use compression socks have also been shown to recover their strength, power and endurance quicker than athletes who don’t wear them. An active recovery (e.g. jogging or gentle cycling) is often advocated after training as it is thought to improve you circulation and help you get rid of things like lactic acid. The research has found that it does help your lungs and heart recover more quickly, but that it doesn’t have any effect on things like lactic acid or DOMS. Lymph drainage Your lymphatic system is a network of “veins” that run through your body, but instead of blood it has lymph fluid running in it. All the waste products that your cells produce during normal life and exercise are removed via your lymph system. Compression socks and intermittent pneumatic compression boots are also thought to improve your lymph drainage. Using them might speed up your recovery because it helps you get rid of the waste products from exercise more quickly. There is strong evidence that both massage and foam rolling after exercise can decrease the pain you feel from DOMS. It’s not quite clear why this work but some researchers think that it is due to increased lymph drainage. Food Your body can only repair the damage caused by exercise if you provide it with the building blocks it needs. These include protein, carbohydrates, fat, minerals and vitamins. Exercise nutrition is a complex field and there is no one-size-fits-all. What you need and when you need it will all depend on your own body, the type of exercise you do and what your aims are. For that reason I’ve decided to only provide a few basic principles that should benefit most people. You should already be getting all your minerals and vitamins if you’re eating a balanced diet that includes all the main food groups and stay away from processed food. Your total calorie consumption is very important, but not for the reasons you may think. People tend to associate calorie counting with weight loss, but there is strong evidence to suggest that you can cause yourself injuries like stress fractures if you train very hard and (on a regular basis) don’t replace the energy (calories) you use. This is often most relevant for athletes who do high volumes of training e.g. endurance athletes and triathletes. Protein is the main building block for muscles. The current research suggests that you’ll gain the most from eating protein if you can do it within the 2 hours following an exercise bout. Did you know that protein can also help endurance? Research has found that eating protein after exercise increases your mitochondrial proteins in your cells. Your mitochondria are the batteries of the cells and they have a direct impact on how well your muscles can use the oxygen that’s available to them. Read more about how to best use protein here . Athletes who consume high protein diets also seem to have better immune systems than ones that don’t. Carbohydrate intake during and after sports has become a hotly debated subject over the last few years with some athletes preferring to follow very low carb and high fat diets while others are sticking to more traditional higher carb diets. From what I could find by looking at the current research it still looks as if the quickest way to restore your muscle energy stores is still by eating a carbohydrate rich meal after exercise. How much do you need? That will vary depending on your body size, training session and ultimate goals. In general I'll advise that you steer clear of any refined carbohydrates unless you have to compete again in a couple of hours. In summary: Make sure that you eat a balanced diet and time at least one of your meals within 2 hours after your training session. Rest It should be clear by now that your body needs rest after exercise in order to restore itself. Plan your days. It’s not a good idea to go walking around town for several hours if you’ve just completed a long run. Several studies in the last few years have shown that getting enough quality sleep is a very important part of recovery. This is the time that your body uses to repair. Not only does a lack of sleep affect your mood and brain function, but some studies have shown direct links between lack of sleep and an increased risk of getting injured. Most adults need between 7 and 9 hours of sleep. The problem is that hard training can affect the quality of your sleep. There are plenty of things that could help you sleep better e.g. limiting screen time, watching how much caffeine you use, not eating too late at night etc. Summary of useful techniques for recovery after training Rest & Sleep: This is very important. Compression socks and compression boots: They might help recovery by improving circulation and lymph drainage. Ice baths: Yes and No. These can be useful depending on your specific goals for that day. Food: Eating a balanced meal within 2 hours of exercise will give you best recovery results. How much you need of what will depend on your body, training type and goals. Massage/foam rolling: Can reduce the amount of DOMS you experience in the days following exercise. Active recovery: This can help your lungs and heart recover quicker. Stretching: This can help you regain your flexibility and range of motion. It does not have any effect on DOMS. Injured? We can help Need more help with an injury? You’re welcome to consult one of the team at SIP online via video call  for an assessment of your injury and a tailored treatment plan. We're all UK Chartered Physiotherapists with Master’s Degrees related to Sports & Exercise Medicine or at least 10 years' experience in the field. But at Sports Injury Physio we don't just value qualifications; all of us also have a wealth of experience working with athletes across a broad variety of sports, ranging from recreationally active people to professional athletes. You can meet the team here . About the Author Maryke Louw  is a chartered physiotherapist with more than 20 years' experience and a Master’s Degree in Sports Injury Management. Follow her on LinkedIn  and ResearchGate . References Burke LM, Hawley JA, Wong SH, et al. Carbohydrates for training and competition. Journal of sports sciences 2011;29(sup1):S17-S27. Diet And Stress Fractures In Male Athletes – Has The Research Finally Caught Up? https://www.sports-injury-physio.com/blog/diet-stress-fractures Do compression socks work? https://sports-injury-physio.com/blog/do-compression-socks-work/ Dupuy O, Douzi W, Theurot D, et al. An evidence-based approach for choosing post-exercise recovery techniques to reduce markers of muscle damage, soreness, fatigue and inflammation: a systematic review with meta-analysis. Frontiers in physiology 2018;9:403. How to use protein to boost running, training and recovery https://www.sports-injury-physio.com/blog/how-to-use-protein-supplements Ice Baths for Recovery- Black, white or somewhere in between? http://www.mysportscience.com/single-post/2016/06/16/Ice-Baths-for-Recovery-Black-white-or-somewhere-in-between Is your spiky ball or foam roller as effective as a sports massage? https://www.sports-injury-physio.com/blog/foam-roller-massage/ Simpson, N. S., Gibbs, E. L. and Matheson, G. O. (2017), Optimizing sleep to maximize performance: implications and recommendations for elite athletes. Scand J Med Sci Sports, 27: 266-274.

Iliotibial band syndrome (IT band syndrome) can be a pesky problem to get rid of, and its one of the few injuries that affect more male runners than females. I actually did my masters dissertation on this subject and found that, like with most sports injuries, IT band syndrome can have many causes. And the key to finding an effective treatment plan for your case lies in figuring out exactly what caused yours. Remember, if you need more help with an injury, you're welcome to consult one of our physios online via video call. Some of the links in this article are to pages where you can buy products discussed or mentioned here. We might earn a small commission on sales at no extra cost to you. In this article: Anatomy of the iliotibial band What does the IT band do? What causes IT band syndrome? Iliotibial band syndrome symptoms How long does IT band syndrome take to recover? What treatments work for IT band syndrome? How we can help We also made a video about this: Anatomy of the iliotibial band The iliotibial band (IT band or ITB) is made of thick fibrous fascia that is extremely strong. Facia is the white sinewy stuff that you find in meat. It may help to imagine it as the same material that a car’s safety belt is made of. It runs from the top of the pelvis over the side of the hip, down the side of the thigh and attaches to the outside of the knee and kneecap. The IT band itself is sinewy and not very flexible, and it’s not really possible to stretch it. I know! You’ve been taught stretches for the IT band in the past, but give me a moment to explain. There are several muscles that attach into the IT band, including the Glute Max, Tensor Fasciae Latae, and Lateral Quadriceps muscle. If these muscles become tight and inflexible, they pull the IT band taut and then people wrongly blame the IT band for being 'too tight'. In fact, it’s the fault of the muscles that are attached into the IT band. So, instead of trying to stretch the IT band, it works much better if you direct your stretches at the muscles that attach onto it. I’ll give you some examples later in the article. What does the IT band do? It helps to stabilise your pelvis (keeps it level) on your leg when you walk or run or jump. As mentioned above, the IT band itself cannot contract, but it can get pulled tight when the muscles that attach into it contract and tug on it. What causes IT band syndrome? IT band syndrome is caused when the IT band is pulled too tight over the outside of the knee, causing it to squash excessively against and rub on the bone as you bend and straighten your knee during running. Traditionally, IT band syndrome was described as being caused by excessive friction, but these days researchers think it may actually be due to excessive compression. This not only causes the IT band itself to become inflamed and sore, but also the fat pad and bursae between the IT band and the bone. A bursa is a small fluid-filled sac, and you find them everywhere in the body where tendons and bones are close to each other. Their job is to decrease friction, but they can become inflamed and very painful when exposed to excessive compression or friction. Interestingly, researchers have reported that when they scan the painful area of the IT band, they most often find that it is this tissue (fat pad and bursae) between the IT band and the thigh bone that shows signs of injury, rather than the IT band itself. Some of the reasons why the IT band may be pulled too tight include: If the muscles that attach into the IT band (glute max, TFL, lateral quad) are tight and pull it too taut. If your hip muscles aren’t strong and allow your pelvis to drop or your knee to turn in excessively as you run – the glute max and glute med muscles are usually the main culprits. Because the IT band attaches onto the pelvis and knee, it gets pulled tight when this happens. Weak glutes on one side will cause the pelvis to drop on the other side and/or the knee to turn in, pulling the IT band tight. Excessive pronation in your foot (when your foot rolls in) can cause your lower leg to turn in more. Because the IT band attaches onto the lower leg, this can potentially cause the IT band to pull tight and compress more against the outer knee. Excessive foot pronation can cause the knee to turn in and pull the IT band tight. If you’ve done a really tiring run, e.g. a long downhill race. You may normally have strong hip muscles, but if you tire them out a lot, they may not be able to stabilise the pelvis, also causing it to drop and pull the IT band taut. Downhill running can cause trouble. I’m often guilty of just letting go and plonking down a hill, but this can cause a lot more impact on your legs. Running on an incline or camber of a road can also cause the IT band on your one leg (the one at the top of the camber) to pull tight over the side of your knee. If your one leg is shorter than the other, it can cause the IT band of the longer leg to pull tight. Iliotibial band syndrome symptoms When you have IT band syndrome, you may feel a sharp or burning pain on the outside of your knee. It usually only hurts while you're running, but if it's very irritated, even walking may make it hurt. Iliotibial band syndrome causes pain on the outside of the knee. The point in the running gait cycle when the IT band compresses most against the thigh bone is just after your foot touches the ground and when your knee is flexed at about 30 degrees. So, you will likely experience the most pain at that point and then less during the rest of the movement. You will likely be able to locate a painful area in the lower part of the IT band close to where it attaches to the outer knee. A test we do in clinic to test for IT band syndrome involves us pressing down on the IT band (increasing compression) in the area of the knee and then repeatedly flexing the patient's leg through 30 degrees of knee flexion. This will usually elicit pain if their IT band and the structures under it are irritated. You may initially only feel the pain towards the end of a run or training session. But if you've ignored it for a while and continued to train through it, it may be painful right from the start of your run. You may notice a slight puffiness over the outside of the knee, but this is not the case for everyone. How long does IT band syndrome take to recover? If you’re lucky and you treat it right from the start, it will take between 6 and 12 weeks. If you neglect it and try to run through it for a while, it can take a lot longer. If you want it to recover quickly, get some guidance and a treatment plan early on from someone who knows what they’re talking about. What treatments work for IT band syndrome? As we have seen, IT band syndrome can have many causes, and that’s why there is no one-size-fits-all treatment for it. You have to identify your cause and work on that. Relative rest This is key to getting rid of IT band syndrome. You have to cut out all aggravating activities so that the irritated tissue can settle down. This doesn’t mean that you necessarily have to stop running. Some of our patients find that they just have to keep their runs short or play with their running style. For example, running up stairs is often tolerated better than running on the flat. If you find that you can’t run, you can try and maintain your fitness by doing other activities, like swimming with a pool buoy between your legs. Cycling is often not that well tolerated during the early stage of rehab, because it involves too much repetitive movement in the knee. Anti-inflammatory medication (NSAIDS) Using anti-inflammatory medication (like ibuprofen or naproxen) may be useful during the early stages of treatment, as it is thought to reduce the inflammation in the fat pad. Please discuss this with your doctor before you take any medication, because it may not be right for you and can cause other issues. This should not be seen as a cure. Medication may decrease your pain, but if you want to get rid of IT band syndrome and prevent it from coming back, you have to address the underlying causes discussed above. Ice Icing the painful area on the side of your knee may be a useful way to decrease pain and inflammation in the fat pad when you have IT band syndrome. Just like with anti-inflammatory medication, ice should not be seen as a cure. It might be a useful short-term solution to help calm the sensitivity down, but you still have to address the underlying causes. You can read more about how to use ice for sports injuries in this article . Strengthening exercises If you have poor hip stability , you may likely benefit from strengthening up your glute max and glute med . Make sure that you choose exercises that do not cause pain in your knee! Exercises like single leg squats or lunges are usually not useful at the start, when the IT band is still very sore. Leave them for later and choose exercises where the knee stays stationary (e.g. the clam or double leg glute bridge) to start with. Strength training alone may not be enough to improve your movement patterns when you run. Research has found that runners often have to do specific running style drills if they want to improve the way their legs move when they run. We discuss running tips for IT band syndrome in more detail in this article . IT band stretches Whilst the IT band itself cannot really be stretched (it's too sinewy), you may find benefit from stretching the muscles that attach onto the IT band . These include the glutes, TFL, and lateral quad. Stretching these muscles reduces their tone, which in turn reduces the pull on the IT band. Getting into the habit of stretching these areas after you've done a workout may be a useful way of preventing them from becoming overactive and tight. Just make sure that, during the early stages of rehab when your knee is still very painful, you choose stretches that don't put a lot of strain on the injured area. We'll discuss this in more detail in a future blog post. Massage and foam rolling Physios will often use massage as part of their treatment for iliotibial band syndrome or recommend that patients use a foam roller. This can be useful, as it can help reduce pain and relax the muscles that attach onto the IT band. But the positive effects, both from massage by a therapist as well as self-massage using a foam roller, are transient. So massage/self-massage can be useful during the early stages to help reduce pain and discomfort, but it too is not a cure. Please don't hammer the poor IT band when you foam roll. Remember, this injury is caused by too much compression, and you will make your symptoms worse if you are too aggressive. Rather massage all the muscles that attach onto the IT band (glute max, TFL, lateral quad). I discuss all the dos and don'ts of foam rolling the IT band and the relevant muscles in this article . Running style The research has shown that changing your running style to giving lighter, quicker steps can work well to treat ITB syndrome. Increasing your cadence (how many steps you take in a minute) by as little as 5% can significantly reduce the impact forces on your body when you run. We've written a whole article just about running with IT band syndrome where you can find more tips and advice about this. Orthotics or supportive insoles You may benefit from wearing some orthotics or supportive insoles if you have one leg shorter than the other or if your feet roll in too much (over-pronate) when you run. I would consult a podiatrist if you have a leg length difference, but below are some affiliate links to orthotics on Amazon that may help correct over-pronation. IT band straps/braces Some of my patients have found that using IT band straps or braces helped them. They work by changing how the IT band makes contact with the bone. For some people this can off-load the painful part and allow them to train pain-free. Are you causing more damage by using them? I usually advise people to see how they feel within the next 24 hours. If, when using the IT band support, they are pain-free during their run and their symptoms are no worse during the 24 hours after the run, they are very likely OK to use it. If, however, they find that their pain is significantly worse after their run or the next morning, I would say that they are better off not using the support. Below are examples of IT band braces/straps on Amazon. In summary: Every person’s case of IT band syndrome will have a specific set of factors that caused it and your treatment plan needs to address all of them. How we can help Need more help with an injury? You’re welcome to consult one of the team at SIP online via video call for an assessment of your injury and a tailored treatment plan. We're all UK Chartered Physiotherapists with Master’s Degrees related to Sports & Exercise Medicine. But at Sports Injury Physio we don't just value qualifications; all of us also have a wealth of experience working with athletes across a broad variety of sports, ranging from recreationally active people to professional athletes. You can meet the team here . About the Author Maryke Louw is a chartered physiotherapist with more than 15 years' experience and a Masters Degree in Sports Injury Management. Follow her on LinkedIn or ResearchGate . References Aderem J, Louw QA. Biomechanical risk factors associated with iliotibial band syndrome in runners: a systematic review. BMC Musculoskeletal Disorders 2015;16(1):356. Allen DJ. Treatment of distal iliotibial band syndrome in a long distance runner with gait re‐training emphasizing step rate manipulation. International Journal of Sports Physical Therapy 2014;9(2):222. Balachandar, V., et al. (2019). "Iliotibial Band Friction Syndrome: A Systematic Review and Meta-analysis to evaluate lower-limb biomechanics and conservative treatment." Muscles, Ligaments & Tendons Journal (MLTJ) 9(2). Barton, C. J., et al. (2016). "Running retraining to treat lower limb injuries: a mixed-methods study of current evidence synthesised with expert opinion." British Journal of Sports Medicine 50(9): 513-526. Dodelin D, Tourny C, Menez C, et al. Reduction of Foot Overpronation to Improve Iliotibial Band Syndrome in Runners: A Case Series. Clin Res Foot Ankle 2018;6(272):2. Friede, M. C., et al. (2021). "Conservative treatment of iliotibial band syndrome in runners: Are we targeting the right goals?" Physical Therapy in Sport. McKay, J., et al. (2020). "Iliotibial band syndrome rehabilitation in female runners: a pilot randomized study." Journal of Orthopaedic Surgery and Research 15(1): 188. Louw, Maryke, and Clare Deary. "The biomechanical variables involved in the aetiology of iliotibial band syndrome in distance runners–A systematic review of the literature." Physical Therapy in Sport 15.1 (2014): 64-75. Phinyomark A, Osis S, Hettinga B, et al. Gender differences in gait kinematics in runners with iliotibial band syndrome. Scandinavian Journal of Medicine & Science in Sports 2015;25(6):744-53. Van der Worp MP, van der Horst N, de Wijer A, et al. Iliotibial band syndrome in runners. Sports Med 2012;42(11):969-92.

BPC-157 is often marketed as a game-changing peptide for muscle repair, injury recovery, and athletic performance. But does the science back up these claims? And is it even safe or legal to use? In this article, we take a closer look at what BPC-157 is, why athletes are interested in it, and what the risks are. Remember, if you need help with an injury, you're welcome to consult one of our physios online via video call. In this article: What is BPC-157? Why do people use BPC-157? Does BPC-157 enhance athletic performance? Does BPC-157 speed up injury recovery? Is BPC-157 safe and legal? My recommendation How we can help 👉 We don't have total control over what ads are being shown on this page. If you see ads selling BPC-157 here,  follow the advice in this article and ignore them. What is BPC-157? BPC stands for “body protection compound”. It is a substance that occurs naturally in our gastric juices. It protects the stomach lining from stuff like alcohol, acid, and nonsteroidal anti-inflammatory drugs and helps to heal ulcers caused by these substances. BPC-157 is a peptide that scientists have derived from human gastric juices. In experiments  on various animal species (mostly rats), its healing properties have been shown to extend to various other tissue types, including muscles, tendons, and ligaments. It also acts as an anti-inflammatory in some of the animals on which it has been tested. Why do people use BPC-157? The healing and anti-inflammatory properties of BPC-157 in lab animals are thought to work in the same way in humans. So, it might enable athletes to recover faster from hard training sessions, which would enhance their performance in the long run. It might also help athletes to recover faster from injuries. BPC-157 has been dubbed “the Wolverine peptide” among some weightlifters due to their belief in its ability to speed up healing. Some medical professionals tout and prescribe BPC-157 as a treatment for various conditions and injuries, including gastric ulcers, irritable bowel syndrome (this sounds plausible, given the role of natural BPC in our stomachs), ligament, tendon, and joint injuries, and erectile dysfunction. ❓ But is there any evidence that BPC-157 actually works as expected in humans? Just because something works a certain way when tested on a rat does not mean it will work the same way in humans. Does BPC-157 enhance athletic performance? 💡 The answer is short and simple: We don’t know. No credible, published research has been done on whether BPC-157 helps athletes to perform better. Does BPC-157 speed up injury recovery? 💡 Again, the answer is: We don’t know.  Only two small pilot studies  have been done on humans thus far. One looked at the effect of BPC-157 on bladder pain (12 people) and the other looked at knee pain (16 people). In both studies, BPC-157 seemed to provide pain relief. However, we can’t draw any definitive conclusions from such small studies. Small sample sizes can make drugs look much more or less effective than what they really are. Is BPC-157 safe and legal? Safety 💡 We don’t know yet whether BPC-157 is safe for humans. No adverse effects were reported in the two studies on humans discussed above. But, as mentioned, those studies were much too small to really know whether it is safe. The U.S. Anti-Doping Agency  warns that “there is a concerning lack of published clinical trial data because studies appear to have been cancelled or stopped without any published conclusions”. Legality 💡 The use of BPC-157, either for sport or for medical treatment, is not legal in most countries. The World Anti-Doping Agency  (WADA) has declared it a prohibited substance as of 2022. In 2024, a 19-year-old American speed skater, Kamryn Lute, received a one-year ban  after using a supplement containing BPC-157 that was recommended by a medical provider. WADA does not state why it has banned BPC-157, but presumably there are concerns about the lack of research into its safety and the (also unresearched) possibility that it does indeed enhance athletic performance. As for medical use, BPC-157 may only be used for research purposes with special permission (as in the two pilot studies mentioned above) and may not be sold to the public or even prescribed by medical doctors, according to the U.S. Food & Drug Administration . It also has not been approved by the European Medicines Agency or any other major health regulator in other countries. However, it is freely available online, and sellers mostly target athletes and weightlifters. Certain medical practitioners are also quite open online about the fact that they prescribe it. My recommendation The mere lack of research into the safety of BPC-157 means that I won’t take it for either sport or medical reasons – the difference between useful and harmful often lies in getting the dosage right, and at this stage we’re flying blind. BPC-157 is so widely available that I doubt any pharmaceutical company would invest in the necessary research to prove or disprove its efficacy and safety, since they are unlikely to gain from it financially. The only way it might be done is if a group of researchers could convince a non-profit organisation to provide a grant. From an athlete’s perspective, I also won’t consider using it until it has been approved by anti-doping authorities. But I’m not holding my breath. How we can help Need help with your injury? You’re welcome to consult one of the team at SIP online via video call for an assessment of your injury and a tailored treatment plan. We're all UK Chartered Physiotherapists with Master’s Degrees related to Sports & Exercise Medicine or at least 10 years' experience in the field. But at Sports Injury Physio we don't just value qualifications; all of us also have a wealth of experience working with athletes across a broad variety of sports, ranging from recreationally active people to professional athletes. You can meet the team here . About the Author Maryke Louw is a chartered physiotherapist with more than 20 years' experience and a Master’s Degree in Sports Injury Management. Follow her on LinkedIn and ResearchGate . References DeFoor, M.T. and Dekker, T.J. (2025) “Injectable Therapeutic Peptides—An Adjunct to Regenerative Medicine and Sports Performance?” Arthroscopy: The Journal of Arthroscopic & Related Surgery 41(2): 150-152. Matek, D. et al. (2025) “Stable Gastric Pentadecapeptide BPC 157 as Therapy After Surgical Detachment of the Quadriceps Muscle from Its Attachments for Muscle-to-Bone Reattachment in Rats” Pharmaceutics 17(1): 119. Gwyer, D. et al. (2019) “Gastric pentadecapeptide body protection compound BPC 157 and its role in accelerating musculoskeletal soft tissue healing” Cell Tissue Res 377: 153-159. World Anti-Doping Agency (2021) “World Anti-Doping Code International Standard Prohibited List 2022” U.S. Food & Drug Administration (2023) “Certain Bulk Drug Substances for Use in Compounding that May Present Significant Safety Risks” Chuanyang Xu et al. (2020) “Preclinical safety evaluation of body protective compound-157, a potential drug for treating various wounds” Regulatory Toxicology and Pharmacology 114: 104665. Lee, E. et al. (2024) “Effect of BPC-157 on Symptoms in Patients with Interstitial Cystitis: A Pilot Study” Altern Ther Health Med 30(10): 12-17. U.S. Anti-Doping Agency (2020) “BPC-157: Experimental Peptide Prohibited”