The
functional anatomy of the iliotibial band during flexion and extension of the
knee: implications for understanding iliotibial band syndrome.
Fairclough, J., Hayashi, K., Lyons, K., Bydder, G., Phillips, N., Best,
T. and Benjamin, M. Journal of Anatomy, 2006; 208: 309 – 316.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2100245/
Iliotibial
Band Syndrome (ITBS) is a very common overuse injury seen in endurance
athletes, especially runners and cyclists. It is believed to be associated with
excessive friction between the tract and the lateral femoral
epicondyle-friction which ‘inflames’ the tract or a bursa. Authors conducted
this study to challenge the view by evaluating clinical anatomy of the region.
Gross anatomical and microscopical studies were conducted on the distal portion
of the ITB in 15 cadavers. Additionally, magnetic resonance (MR) imaging of six
asymptomatic volunteers and studies of two athletes with acute ITB syndrome
were undertaken.
Based on
the results, authors suggest that the injury may not be the consequence of
friction of the ITB over the epicondyle, but of compression against a layer of
highly innervated fat that intervenes between the ITB and the epicondyle. The ITB
is unlikely to roll forwards and backwards during flexion and extension of the knee,
but could move slightly in a medial–lateral direction. The presence of fat deep
to the ITB in the region of its fibrous attachments to the femur and its rich
vascularity could explain the localized oedema often seen in patients diagnosed
with ITB syndrome. Authors conclude that the anatomical re-evaluation of the
ITB has indicated that ‘ITB friction syndrome’ is a misnomer and that fascia lata
compression syndrome may be more accurate. Finally, their view is that ITB
syndrome is related to impaired function of the hip musculature and that
resolution of the syndrome can only be properly achieved when the biomechanics
of hip muscle function are properly addressed.
All rights
reserved to the Journal of Anatomy.
No comments:
Post a Comment