iliotibial band syndrome (itbs)
TRANSCRIPT
Iliotibial Band Syndrome Iliotibial Band Syndrome (ITBS)(ITBS)
What is it?What is it?
DiagnosisDiagnosis
TreatmentTreatment
PreventionPrevention
StretchesStretches
Iliotibial BandIliotibial Band
A thickening of the fascia that runs up the outside (lateral) thighA thickening of the fascia that runs up the outside (lateral) thigh
Connects to 2 muscles at the hip (Gluteua Maximus and Tensor Connects to 2 muscles at the hip (Gluteua Maximus and Tensor Fasciae Latea) and then down below the outside of the knee to the Fasciae Latea) and then down below the outside of the knee to the tibia (shin bone)tibia (shin bone)
The Primary function is to provide stability to the lateral knee while The Primary function is to provide stability to the lateral knee while standingstanding
It helps to maintain hip extension in standing and hip/knee flexion in It helps to maintain hip extension in standing and hip/knee flexion in running and walkingrunning and walking
The IT-Band moves forward at the knee as the knee extends and The IT-Band moves forward at the knee as the knee extends and slides backward at the knee as the knee flexes, but is tense in both slides backward at the knee as the knee flexes, but is tense in both positionspositions
http://www.endurancesports.com/itbs.asp
Iliotibial Band SyndromeIliotibial Band Syndrome
ITBS is an overuse injury that may be ITBS is an overuse injury that may be sustained by physically active people as a sustained by physically active people as a result of training errors, anatomical result of training errors, anatomical factors, or functional characteristics. factors, or functional characteristics.
Iliotibial Band Syndrome Jerry M. Linenger and Karen Maxwell Williams - NASA
Training ErrorsTraining Errors
Abruptly increasing running mileageAbruptly increasing running mileage
Running on uneven surfacesRunning on uneven surfaces
Running on slippery surfacesRunning on slippery surfaces
Running too many hillsRunning too many hills
Improperly using a varus wedgeImproperly using a varus wedge– Varus heel wedges can be used to reduce Varus heel wedges can be used to reduce
pronation and supination by angling heel bone pronation and supination by angling heel bone either medially or laterally and when running. either medially or laterally and when running.
Contributing Anatomical Contributing Anatomical Factors Factors
Prominent lateral femoral epicondyleProminent lateral femoral epicondyle
Tight iliotibial bandTight iliotibial band
Excessive genu varumExcessive genu varum
High arch in footHigh arch in foot
High Q angleHigh Q angle
Restricted range of motionRestricted range of motion
Difference in leg lengthsDifference in leg lengths
DynamicsDynamics
Above-average maximal foot pronationAbove-average maximal foot pronation
High maximum velocity of pronation during High maximum velocity of pronation during support phasesupport phase
Excessive intoeing during the support Excessive intoeing during the support phase of the running stepphase of the running step
Excessive rearfoot movementExcessive rearfoot movement
DiagnosisDiagnosis
Renne TestRenne Test– Stand with all body weight on the affected leg. Stand with all body weight on the affected leg.
Stinging pain is felt on the lateral epicondyle when he Stinging pain is felt on the lateral epicondyle when he or she flexes the knee approximately 30 degrees.or she flexes the knee approximately 30 degrees.
Noble compression test Noble compression test – Lay on your back and the affected knee flexed 90 Lay on your back and the affected knee flexed 90
degrees. Pressure is applied to the lateral femoral degrees. Pressure is applied to the lateral femoral epicondyle as the patient extends the leg at the knee. epicondyle as the patient extends the leg at the knee. Patients with ITBS experience stinging pain at Patients with ITBS experience stinging pain at approximately 30 degrees of flexion approximately 30 degrees of flexion
TreatmentTreatment
Stage one involves resting the knee, Stage one involves resting the knee, stretching the bandstretching the band, applying ice, and , applying ice, and taking anti-inflammatory drugs. taking anti-inflammatory drugs.
Stage two includes a local steroid Stage two includes a local steroid injection, phonophoresis, and podiatric injection, phonophoresis, and podiatric evaluation. evaluation.
Stage three involves surgical intervention Stage three involves surgical intervention for refractory cases. for refractory cases.
PreventionPrevention
GaitGait– The stride should be as much inline with the direction The stride should be as much inline with the direction
of travel as possible, especially in longer distance of travel as possible, especially in longer distance workouts. Avoid uneven terrain.workouts. Avoid uneven terrain.
Avoid rapid rampup of training mileageAvoid rapid rampup of training mileage– The intermediate runs between long runs are The intermediate runs between long runs are
importantimportant
Proper footwear Proper footwear – Reduces lateral strain on the kneeReduces lateral strain on the knee
Stretch after warmupStretch after warmup
StrechesStreches
The Figure 4 StretchThe Figure 4 Stretch– While StandingWhile Standing– Take the affected leg Take the affected leg
and place your foot and place your foot above the knee of the above the knee of the other legother leg
– Hold onto something Hold onto something for balancefor balance
– Slowly ‘sit’ bending Slowly ‘sit’ bending your unaffected legyour unaffected leg
The Side IT BandThe Side IT Band StretchStretch
StretchesStretches
http://crossroadsmedicalmission.org/education/ortho/patello-femoral.html
Using a foam roller, lie on your side with lateral hip on the foam roller. Roll back and forth to loosen up muscles on outside of the hip.
http://www.therapeuticassociates.com/events/lower-quadrant-stretching-exercises/