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Iliotibial band syndrome by blair zhang
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Iliotibial band syndrome |
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Definition
ITBS is one of the leading causes of lateral knee pain in runners. The iliotibial band is a superficial thickening of tissue on the outside of the thigh, extending from the outside of the pelvis, over the hip and knee, and inserting just below the knee. The band is crucial to stabilizing the knee during running, moving from behind the femur to the front while walking. The continual rubbing of the band over the lateral femoral epicondyle, combined with the repeated flexion and extension of the knee during running may cause the area to become inflamed.
Symptoms
ITBS symptoms range from a stinging sensation just above the knee joint (on the outside of the knee or along the entire length of the iliotibial band) to swelling or thickening of the tissue at the point where the band moves over the femur. The pain may not occur immediately during activity, but may intensify over time, especially as the foot strikes the ground. Pain might persist after activity. Pain may also be present below the knee, where the ITB actually attaches to the tibia.
ITBS can also occur where the IT band connects to the hip, though this is less likely as a sports injury. It commonly occurs during pregnancy, as the connective tissues loosen and the woman gains weight -- each process adding more pressure. ITBS at the hip also commonly affects the elderly. ITBS at the hip is studied less; few treatments are generally known.
Sports activities to avoid while symptomatic
Running
Stair climbing
Deadlifts or squats
Court sports, such as tennis, basketball, or similar
Martial arts, such as karate (especially where being bare foot emphasises any symptoms being caused by leg/foot abnormalities)
Bowling
Wrestling
Cycling
Dancing
Parkour
Rowing
Causes
ITBS can result from one or more of the following training habits, anatomical abnormalities, or muscular imbalances:
Training habits:
Always Running on a banked surface (such as the shoulder of a road or an indoor track) bends the downhill leg slightly inward and causes extreme stretching of the band against the femur
Inadequate warm-up or cool-down
Excessive up-hill and down-hill running
In cycling, having the feet "toed-in" to an excessive angle
Running up and down stairs
Hiking long distances
Rowing
Abnormalities in leg/feet anatomy:
High or low arches
Supination of the foot
The force at the knee when the foot strikes
Uneven leg length
Bowlegs or tightness about the iliotibial band.
Excessive wear on the outside heel edge of a running shoe (compared to the inside) is one common indicator of bowleggedness for runners.
Muscle imbalance:
Weak hip abductor muscles
Weak/non-firing multifidus muscle
Treatment
This section does not cite any references or sources.
Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed. (December 2008)
While pain can be acute to quite painful, the iliotibial band can be rested, iced, compressed and elevated (RICE) to reduce pain and inflammation, followed by stretching. Massage therapy may also be beneficial. Using a foam roller to loosen the iliotibial band can help prevent and treat pain although the treatment itself can be very painful to some. Also, an ultra sound machine can be used around the area to relax it, followed by a machine that utilizes electrode stimulation to the area to further relax it. This can result in more comfort and/or a wider range of motion. Consulting with a doctor or referring to a registered physiotherapist or athletic therapist would be the best solutions. In severe cases where a conservative approach has failed, surgery can be a good option.
See also
Runner's knee
References
^ Ellis R, Hing W, Reid D (2007). "Iliotibial band friction syndrome - a systematic review". Manual therapy 12 (3): 2008. doi:10.1016/j.math.2006.08.004. PMID 17208506.
2. Martens M, Libbrecht P, Burssens A: Surgical treatment of iliotibial band friction syndrome. Am J Sports Med 1989;17(5):651-654 http://www.drpribut.com/sports/spitb.html Iliotibial Band Syndrome]
v d e
Soft tissue disorders / Rheumatism / Connective tissue arthropathy (M65-M79, 725-727)
Capsular
Synoviopathy
Synovitis/Tenosynovitis (Calcific tendinitis, Stenosing tenosynovitis, Trigger finger, DeQuervain's syndrome) Transient synovitis Ganglion cyst
osteochondromatosis (Synovial osteochondromatosis) Plica syndrome
villonodular synovitis (Giant cell tumor of the tendon sheath)
Bursopathy
Bursitis (Olecranon, Prepatellar, Trochanteric, Subacromial) Synovial cyst (Baker's cyst)
Noncapsular
Fasciopathy
Fasciitis: Plantar Nodular Necrotizing Eosinophilic
Fibromatosis/contracture
Dupuytren's contracture Peyronie's disease Plantar fibromatosis Aggressive fibromatosis Knuckle pads
Tendinopathy/
Enthesopathy/Enthesitis
upper limb (Adhesive capsulitis of shoulder, Rotator cuff tear, Golfer's elbow, Tennis elbow)
lower limb (Iliotibial band syndrome, Patellar tendinitis, Achilles tendinitis, Calcaneal spur, Metatarsalgia) Bone spur
other/general: Tendinitis Tendinosis
joint navs: anat, non-congenital arthropathies/deformities/dorsopathies/soft tissue arthropathy/congenital, eponymous signs, proc
muscle, DF+DRCT navs: anat/hist/physio, acquired myopathy/congenital myopathy/neoplasia, symptoms+signs/eponymous, proc
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