Figure 6: ITB stretch using Ober test position

a: ITB stretch using Ober test position – start

b: ITB stretch using Ober test position – finish

floor and the side of the body, just above the pelvis. The aim is to press down hard on the towel throughout the exercise (Figure 6).

The Ober stretch targets the whole of the ITB. However, where trigger points are present within the TFL-ITB, clinical massage techniques are used to reduce pain and tissue tension prior to stretching.

Clinical massage techniques The following techniques are taken from Norris, 2013 (20) to which the reader is referred for further details.

Figure 7: Upper ITB fascial release. (Reproduced with permission from Complete Guide to Clinical Massage, A & C Black, 2013)

Upper ITB fascial release To release fascia tension in the upper portion of the ITB begin with your client lying on their side with their affected leg on top (Figure 7). Their knee is bent to 90° with the side of their knee resting on the treatment couch. Fix their leg with your left hand (flat) and use the edge of your right forearm as your massage tool. Apply deep massage to the ITB from the greater trochanter downwards. Also address the tensor fascia lata muscle in front of the trochanter and the front portion of the gluteus maximus behind. Search out trigger points in both muscles. For the TFL the trigger point is often found midway between the trochanter and the iliac crest and for the gluteus maximus, in the space between the trochanter and the sacrum. You may find it more comfortable for you to sit (perch) on the couch below your client’s knee where light local pressure is applied. Consider also that if your client has a very tight ITB, the side lying starting position may be uncomfortable. If so, begin with their knee supported on a folded towel or block (yoga block). As the ITB tension releases you may find their knee lowers and you no longer need the block.

Figure 8: Lower ITB fascial release. (Reproduced with permission from Complete Guide to Clinical Massage, A & C Black, 2013)

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Figure 9: Abductor muscle acupressure. (Reproduced with permission from Complete Guide to Clinical Massage, A & C Black, 2013)

Lower ITB fascial release Have your client lie on their back and bend their unaffected left leg. Move their affected right leg across the couch into adduction and hold the crossed left leg over it. Stand to your client’s left side (Figure 8). Using the curved fingers on one hand drawn into a straight line supported by your other hand,

sportEX dynamics 2012;34(October):15-23