Knee Medicine and Science: Iliotibial Band Syndrome

Showing posts with label Iliotibial Band Syndrome. Show all posts

BJSM Podcast: Running injuries.

In this BJSM podcast, Dr Andrew Franklyn - Miller gives his opinion on common running injuries.

The knee most commonly affected in Ironman triathletes.

High prevalence of overuse injury among iron-distance triathletes.

Andersen C., Clarsen, B., Johansen, T. and Engebresten, L. British Journal of Sports Medicine, 2013; 47: 857 – 861.

http://www.ncbi.nlm.nih.gov/pubmed/23902775

Ironman distance triathlon has recently gained a lot of popularity in both professional and amateur athletes. Due to its endurance character, overuse injuries should occur. Nevertheless, lack of studies is present investigating injuries among Iron distance triathletes.

This was a 26-week prospective cohort study including 174 participants. Study found that the majority of injury cases in this group were overuse conditions. The most common sites of the injury were the knee, lower leg, lower back and shoulder. The average prevalence of overuse problems was 56%.

Study findings seem important for developing strategies to prevent and treat overuse injuries in triathletes. The knee and lower leg were most commonly affected body sites and this seems to be in agreement to what running athletes experience. Patellofemoral pain syndrome, “shin splints”, Iliotibial band syndrome , Achilles tendinopathy appears to be one of the most prevalent overuse conditions seen in runners and triathletes. Study results indicate that it would be advisable for Ironman triathletes to incorporate specific strategies into ther normal traing routine to prevent knee and lower leg overuse problems.

Do Minimalist Shoes Really Simulate Barefoot Running?

Running in a minimalist and lightweight shoe is not the same as running barefoot: a biomechanical study.
Bonacci, J., Saunders, P., Hicks, A., Rantalainen, T., Vicenzino, B. and Spratford, W. British Journal of Sports Medicine, 2013; 47: 387 – 392.
http://www.ncbi.nlm.nih.gov/pubmed/23314887

Minimalist shoes have been designed to mimic barefoot running due to its supposed efficacy in prevention of running related overuse injuries. Nevertheless, there is little evidence that running mechanics in minimalist shoes are similar to those observed during barefoot running. The study was conducted to compare running mechanics between barefoot running and running in a “minimalist” shoe (Nike Free 3.0), racing flat (Nike Lunaracer 2), and “regular” running shoes. Ground reaction force data and kinematics were collected from 22 highly trained runners.

BJSM Podcast: Biomechanical overload and lower limb injuries.

In this BJSM podcast, Andrew Franklin – Miller, PhD, talks about biomechanical issues associated with lower limb injuries among running athletes. Chronic exertional compartment syndrome, condition commonly mistaken with MTSS, is one of the overload injuries he specifically focuses on. Also, his shares his views in regards to relationship between running technique and lower extremity overload injuries which is followed by his recommendations on how you should correct your technique to lower the risk of sustaining some of the common leg overload conditions.

Listen here.(63)
All rights reserved to the British Journal of Sports Medicine.

Sample exercises and stretches for ITBS.

As usual, at the end of, let’s call it „ITBS month”, I provide you with the video presenting sample exercises and stretches for specific injury, ITBS in this case. The video uploaded here is appropriate as it presents interventions which can be performed anywhere, are easy to remember and do not cost you anything. Which is also good about this exercises, is that they can be used as a treatment procedure, when ITBS is already present, and on the other hand, as a prevention strategy. Finally, the video address hip musculature weakness which has been frequently regarded as a risk factor.
All rights reserved to the Madden PT.

Functional anatomy of the iliotibial band and its implication for ITBS causation.

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.

Step width during running and ITBS.

Step width alters iliotibial band strain during running.

Meardon, S., Campbell, S. and Derrick, T. Sports Biomechanics, 2012; 11: 464 – 472.

http://www.ncbi.nlm.nih.gov/pubmed/23259236

Iliotibial Band Syndrome (ITBS) is characterised by pain located in the area of lateral femoral condyle, occurring after substantial distance during running/cycling activity. ITBS is thought to occur as an inflammatory and/or degenerative response due to excessive ITB rubbing against lateral femoral condyle during repetitive knee flexion and extension while running/cycling. Others suggest that it is fat pad, located between ITB and lateral femoral condyle, excessive compression which creates pain symptoms. Much attention has been recently brought to biomechanical factors and ITBS. Some authors suggested that a narrower step width during running is likely to increase hip adduction and influence knee internal rotation resulting in greater ITB strains and strain rates. This study investigated this hypothesis.

ITBS examination: Ober's Test and Noble's Test

The Ober's test is a test used in physical examination in order to identify tightness of the iliotibial band and can be indicative for Iliotibial Band Friction Syndrome (ITBS).

The Noble’s test is a provocative test of the iliotibial band and is also commonly used as an indication for ITBS (click "read more" to watch).

Kinematic factors related to iliotibial band syndrome in runners.

Kinematic classification of iliotibial band syndrome in runners.
Grau, S., Krauss, I., Maiwald, C., Axmann, D., Horstmann, T. and Best, R. Scandynavian Journal of Medicine & Science in Sports, 2011; 21: 184 – 189.
http://www.ncbi.nlm.nih.gov/pubmed/19903313

Iliotibial Band Syndrome (ITBS) is one of the most common overuse injuries experienced by runners. It is generally thought to result from excessive rubbing of the distal iliotibial band across the lateral femoral condyle. Others think that fat pad compression beneath the tractus is a major causative factor in the development of ITBS. Several biomechanical risk factors have been suggested to contribute in the development of ITBS. Nevertheless, findings are somehow inconsistent and qualities of studies could be questioned. Thus, authors decided to conduct this study to investigate differences between healthy runners and runners suffering from ITBS with regard to kinematic characteristics.

Iliotibial Band Syndrome (ITBS), often called iliotibial band friction syndrome, is another common knee condition seen in endurance athletes (runners, triathletes, cyclists). The incidence is reported to be as high as 12% of all running-related, overuse injuries. Iliotibial band (ITB) is a sheet of connective tissue originating at the iliac crest and terminating at Gerdy’s tubercle and the fibular head. The post will cover current concepts in regards to the causes, history, risk factors, diagnosis and treatment of the ITBS.

Knee Medicine and Science