Presentation
Abstract A 51-year-old male cyclist presented with a mass over the lateral portion of his knee. MR scans showed a cystic collection deep to the iliotibial band (ITB). [ncbi.nlm.nih.gov]
Initially pain may only be present when running. As the syndrome progresses, pain may be felt when not running. Solutions : If caused by excessive pronation, consider a stability or motion control shoe/insert. [fleetfeet.com]
Entire Body System
- Pain
Pain may not occur immediately during activity, but may intensify over time. Pain is most commonly felt when the foot strikes the ground, and pain might persist after activity. [en.wikipedia.org]
There was a 12.5% improvement in running time, and the pain score while running improved by 50% postintervention; these improvements were maintained at 1-mo follow-up. [ncbi.nlm.nih.gov]
For instance, stopping running before the time or distance when you normally get the pain. If your pain is more severe though, you should stop altogether. You can keep active by doing exercise which doesn’t bring on pain, such as swimming. [bupa.co.uk]
- Inflammation
[…] of extensor carpi ulnaris muscle tendon Inflammation of extensor indicis muscle tendon Inflammation of extensor pollicis longus muscle tendon Inflammation of flexor carpi radialis muscle tendon Inflammation of flexor carpi ulnaris muscle tendon Intermuscular [icd9data.com]
Symptoms of Iliotibial Band Syndrome The above-mentioned inflammation is the most notable symptoms of iliotibial band syndrome. [rothmanortho.com]
Treatment for iliotibial band syndrome The initial treatment for iliotibial band (ITB) syndrome aims to reduce your pain and the inflammation causing it. You can do this with rest, ice and medicines to reduce pain and inflammation. [bupa.co.uk]
Image 2 image Repetitive irritation can lead to chronic inflammation, especially beneath the posterior fibers of the ITB, which are thought to be tighter against the lateral femoral epicondyle than the anterior fibers. [online.epocrates.com]
Treatment [ edit ] While ITBS pain can be acute, the iliotibial band can be rested, iced, compressed and elevated ( RICE ) to reduce pain and inflammation, followed by stretching. [2] Physical therapy can offer relief if symptoms arise. [en.wikipedia.org]
- Weakness
Runners predisposed to this injury are typically in a phase of overtraining and often have underlying weakness of the hip abductor muscle. [16] [18] [19] The runner may describe a rapid progression in weekly mileage. [16] Intrinsic factors that contribute [online.epocrates.com]
Muscle imbalance Weak hip abductor muscles Weak/non-firing multifidus muscle Uneven left-right stretching of the band, which could be caused by habits such as sitting cross-legged Anatomical mechanism [ edit ] Iliotibial band syndrome is one of the leading [en.wikipedia.org]
Sports medicine physicians recommend modifying your exercise regimen, begin a strengthening program to address weak gluteal or core muscles, and consider a video running gate analysis. [saltlakeregional.org]
Hip abductor weakness is not the cause for iliotibial band syndrome. Int J Sports Med. 2008 Jul. 29(7):579-83. [Medline]. Louw M, Deary C. [emedicine.com]
Causes of the excessive friction include: Structural abnormalities, such as a short, tight IT band Problems related to the foot, ankle, or hip Opposing muscle imbalances, such as the quadriceps stronger than hamstrings or weak gluteal muscles A prominent [winchesterhospital.org]
- Swelling
This swelling and inflammation is typically located around the outside of the knee, causing many athletes to mistake this condition for a knee injury. [rothmanortho.com]
When it becomes inflamed, pain and swelling often occur as a result. If left untreated, IT band syndrome can lead to scarring in the bursa, the small fluid-filled sacs that cushion the knee. [saltlakeregional.org]
Your GP may recommend that you have a corticosteroid injection into the inflamed area if you have severe pain or swelling. [bupa.co.uk]
[…] with running, cycling, hiking or weight-lifting (especially squats ) [2]. [ citation needed ] Signs and symptoms [ edit ] ITBS symptoms range from a stinging sensation just above the knee and outside of the knee (lateral side of the knee) joint, to swelling [en.wikipedia.org]
Ice—Ice therapy may help relieve swelling. Heat therapy may be advised when normal activities are reintroduced. An orthotic device may be advised to help control rotation of the foot and stabilize the knee. [winchesterhospital.org]
- Severe Pain
Your GP may recommend that you have a corticosteroid injection into the inflamed area if you have severe pain or swelling. [bupa.co.uk]
Musculoskeletal
- Knee Pain
Other symptoms that may indicate the presence of this condition include: Pain on the lateral side of the knee; pain will typically worsen during running activity Pain when the knee is bent at a 45-degree angle Stinging or pins-and-needles sensations along [rothmanortho.com]
Overuse and inflexibility can shorten the ITB, causing hip and knee pain. Many runners attempt to counteract this with the ITB stretch shown here. But because it stresses the leg and back muscles, this stretch has the opposite effect. [runnersworld.com]
Epidemiology Frequency United States ITBS is the most common cause of lateral knee pain in runners. [emedicine.com]
She reported a 9/10 stabbing pain on a visual analog scale (VAS) in the left lateral knee at mile two while running. [ncbi.nlm.nih.gov]
- Muscle Weakness
Runners predisposed to this injury are typically in a phase of overtraining and often have underlying weakness of the hip abductor muscle. [16] [18] [19] The runner may describe a rapid progression in weekly mileage. [16] Intrinsic factors that contribute [online.epocrates.com]
Muscle imbalance Weak hip abductor muscles Weak/non-firing multifidus muscle Uneven left-right stretching of the band, which could be caused by habits such as sitting cross-legged Anatomical mechanism [ edit ] Iliotibial band syndrome is one of the leading [en.wikipedia.org]
Hip Muscle Weakness and Overuse Injuries in Recreational Runners. Clinical Journal of Sport Medicine, 15(1), 14. Noehren, B., Scholz, J., & Davis, I. (2011). [amtraining.es]
The role of hip muscle weakness in lower extremity athletic injuries. Int Sports Med J 2007; 8(4): 179–92. Google Scholar 83. Pecci M. Knee pain in the recreational athlete. Fam Pract Recertification 2007; 29(11): 45–50. Google Scholar 84. [doi.org]
weakness, specifically in the hip abductors, has also been suggested as a potential contributing factor in ITBS. [ncbi.nlm.nih.gov]
- Osteoporosis
For patient education resources, see the Osteoporosis Center. Also, see patient education articles Knee Pain, Knee Injury, Tendinitis, and Running. [emedicine.com]
Neurologic
- Irritability
The ITB and surrounding muscles tighten against this pressure, irritating these areas. Our " active-isolated " method (below) allows you to lengthen the ITB without causing additional harm. [runnersworld.com]
Image 2 image Repetitive irritation can lead to chronic inflammation, especially beneath the posterior fibers of the ITB, which are thought to be tighter against the lateral femoral epicondyle than the anterior fibers. [online.epocrates.com]
Background Iliotibial band syndrome (ITBS) is the result of inflammation and irritation of the distal portion of the iliotibial tendon as it rubs against the lateral femoral condyle, or less commonly, the greater tuberosity. [emedicine.com]
To reduce inflammation and pain, a corticosteroid may be injected into the irritated bursa. For those patients who do not improve with more conservative treatment approaches, orthopedic surgery must be used to release the IT band. [saltlakeregional.org]
This excessive rubbing can irritate the ITB and/or the tissue underneath. [winchesterhospital.org]
- Sciatica
Back strain and sciatica. JAMA 1935; 104: 1580–1. Google Scholar 119. Greenland S. Quality scores are useless and potentially misleading. Am J Epidemiol 1994; 140: 300–2. Google Scholar 120. Whiting P, Harbord R, Kleijnen J. [doi.org]
Treatment
[…] the conservative treatment of ITBFS. [ncbi.nlm.nih.gov]
There are numerous Sports Medicine treatments for this conditions; the recommended treatment for your particular case will depend upon the degree of irritation and inflammation that your ligament is experiencing. [rothmanortho.com]
While the articles were inconsistent regarding the treatment of ITBS, hip/knee coordination and running style appear to be key factors in the treatment of ITBS. [doi.org]
Surgery Surgery is not usually used as a treatment for iliotibial band (ITB) syndrome. Your doctor will only offer you surgery in very rare cases, where other treatments have failed. [bupa.co.uk]
Treatment Talk with your doctor about the best treatment plan for you. Recovery time ranges depending on the grade of your injury. Treatment steps may include: Supportive Care The IT band will need time to heal. [winchesterhospital.org]
Etiology
Etiology Excessive friction of the distal iliotibial band (ITB) sliding over the lateral femoral epicondyle occurs as the knee flexes during deceleration into stance-phase running. [5] This is termed the impingement zone at approximately 30 degrees of [online.epocrates.com]
[…] was supplemented with the concept of the ITB impingement zone, occurring at around 30° of knee flexion, which was also the most common knee position during foot strike. 11 Fairclough et al. 12 refuted this friction model and proposed an etiology based [ncbi.nlm.nih.gov]
Etiologic factors associated with selected running injuries. Medicine and Science in Sports and Exercise, 20(5), 501-505. Naclerio, F., Barriopedro, M. I., & Rodríguez, G. (2010). [amtraining.es]
Etiology of iliotibial band friction syndrome in distance runners. Med Sci Sports Exerc. 1995 Jul. 27(7):951-60. [Medline]. Holmes JC, Pruitt AL, Whalen NJ. Iliotibial band syndrome in cyclists. Am J Sports Med. 1993 May-Jun. 21(3):419-24. [emedicine.com]
Etiology of iliotibial band friction syndrome in distance runners. Med Sci Sports Exerc 1995; 27(7): 951–60. PubMed Google Scholar 20. Taunton JE, Clement DB, Smart GW, et al. Non-surgical management of overuse knee injuries in runners. [doi.org]
Epidemiology
Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration Ann Intern Med 2007; 147(8): W–163. Google Scholar 125. Muhle C, Ahn JM, Yeh L, et al. [doi.org]
Epidemiology Frequency United States Iliotibial band syndrome (ITBS) is most common in athletes who participate in long-distance running. Studies have indicated a 4.3-7.5% occurrence rate for ITBS in long-distance runners. [emedicine.com]
Anuruddh M: Epidemiology and Aetiology of Marathon Running Injuries. Sports Medicine, 5–437. Fredericson, M., & Weir, A. (2006). [amtraining.es]
Pathophysiology
Pathophysiology Anatomically, the iliotibial band (ITB) is a continuation of the tendinous portion of the tensor fascia lata muscle with significant contributions from the gluteus maximus. [6] [22] [23] Image 1 image Distally, the ITB spans out and has [online.epocrates.com]
Pathophysiology The iliotibial band (ITB) is a dense fibrous band of tissue that originates from the anterior superior iliac spine region and extends down the lateral portion of the thigh to the knee. [emedicine.com]
Prevention
Can ITBS Be Prevented? Although no sports injury is entirely preventable, you can take steps to reduce your chances of developing ITBS. [saltlakeregional.org]
The ITB is prevented from rolling over the epicondyle by its femoral anchorage and because it is a part of the fascia lata. [ncbi.nlm.nih.gov]
With that in mind, awareness is a key element of preventative health. [rothmanortho.com]
Therefore, the study designs should be improved to prevent selection bias and to increase the generalizability of findings. [doi.org]
Your physiotherapist may also give you some advice on how to try to prevent the problem coming back. They may advise you about changing your footwear to correct problems with your foot movement or look at your running gait on a treadmill. [bupa.co.uk]