Info Iliotibial Ring Syndrome
Tensor fasciae latae muscle
Origin: Spina iliaca anterior superior
Insertion: iliotibial band
Actions: Hip > ABD, FLEX, INT ROT
Gluteus maximus muscle
Origin: Dorsal surface of the sacrum as well as facies glutea of the ilium
Insertion: Upper fibers > iliotibial band, lower fibers > tuberositas glutea of the femur
Actions: Hip > EXT, EXT ROT, upper fibers > ABD, lower fibers > ADD
Iliotibial band insertion: lateral tubercle of the tibia (tuberculum of Gerdy, after French surgeon Pierre Nicolas Gerdy [1797–1856]).
Iliotibial band syndrome is a mutual overuse syndrome peculiarly inwards long distance athletes. There are a lot of factors that tin motion this syndrome, both biomechanical as well as training, but the exact motion is non completely understood.
When an athlete is running his human foot touches the soil nigh 3000 times per mile. After running for 10 times he has touched the soil 30000 times. The forcefulness required to elevator his trunk weight spell running is nigh three times this weight. So, if someone weight seventy kg he volition require to exert forcefulness to elevator 210 kg. This agency that his leg joints as well as muscles are loaded alongside extreme forces during exercise.
Biomechanics
The iliotibial band (ITB) provides the articulatio genus alongside stability. When the articulatio genus is inwards flexion over xxx degrees, the ITB is moving dorsally behind the lateral epicondyle of the femur. When the articulatio genus is extended, the ITB is moving ventrally inwards frond of the lateral epicondyle of the femur. This motion irritates the ITB as well as the bursa that lies nether the insertion of it as well as attaching on the periosteum of the lateral epicondyle of the femur (Running News, Margaritis, 2008).
Research has shown that the articulation capsule of the articulatio genus is folding at the shout for of attachment of the ITB as well as it is this construction that is inflamed inwards the ITB syndrome as well as non the ITB itself (Running News, Margaritis, 2008).
Causes
The ITB syndrome is an overuse syndrome which appears when the body's natural healing machinery arrive at non receive got enought fourth dimension to heal the micro-damages at the point. However, in that place are a lot of hazard factors that tin increment the chances of it to appear. Here are about major causes (Running News, Margaritis, 2008):
1. Uneven leg lenght > causes variations inwards the constituent as well as order of the hip abductors as well as the pelvis os increasing tension on the ITB
2. Genu varum > increases tension on the ITB
3. Foot overpronation > causes tibial internal rotation as well as hip adduction increasing tension on the ITB
4. Week hip abductors > causes increased hip adduction as well as internal rotation increasing tension on the ITB
5. Myofascial limitations > tight hip flexors and/or extensors as well as rotators increment tension on the ITB
Assessment
The hurting is located at the lateral side of the knee, but it may also look inwards the hip. Pain increases alongside running, hip as well as articulatio genus active flexion, hip active or passive adduction. Palpating the portion tin also reproduce the symptoms.
Special tests to reproduce the symptom:
Ober test > positive if the hip remains abducted.
Thomas test > positive if the articulatio genus off the bed is non flexed to a greater extent than than seventy degrees or hip cannot live on adducted to a greater extent than than xv degrees.
During assessment, the iliopsoas, the rectus femoris, the gastrocnemius as well as the soleus muscles should live on also assessed for tightness or weakness.
How to protect yourself against the ITB syndrome
- Avoid running on difficult surfaces
- Avoid running inwards descending surfaces
- Avoid extreme increases inwards your preparation session
- Have proper running shoes as well as purchase novel ones every 300-400 miles of training
- Stretch your legs during as well as after your training
- Increase knee, hip as well as pelvis musculus strength
Physical therapy for ITB syndrome
Acute stage - inflammation (2-5 days):
- cut inflammation putting H2O ice at the portion for 10-15 minutes, two times per day
- avoid movements that reproduce the symptoms as well as accept about rest
- add together calorie-free stretching of the ITB to avoid contractures during the healing process
Later stage - proliferation (up to six weeks):
- facilitate fibers' normal alignemnt as well as forestall abnormal activation to decease habitual
- increment blood time period to the portion through passive activation, static stretching, gentle isometric activation alongside rattling minimum or no loading as well as opened upward chain exercises, massage, as well as electrotherapy
- strengthen the hip abductors as well as external rotators, the quadriceps as well as the cuff muscles
- stretch the ITB as well as the hip adductors, extensors as well as internal rotators
Remodelling stage (up to 1 year):
- rebuild all locomotive properties as well as position the patient dorsum to his/her daily life every bit functionally every bit possible
- usage passive, active as well as isometric activation
- piece of occupation alongside coordination, proprioception as well as functional activation
- suggested methods: ballistic stretching, PNF, dynamic stretching, weights inwards shut chain
- strengthen the hip abductors as well as external rotators, the quadriceps as well as the cuff muscles
- stretch the ITB as well as the hip adductors, extensors as well as internal rotators
References:
References:
- Brody TL, Carrie MH. Therapeutic Exercise: Moving Toward, Function. tertiary ed. Philadelphia: Wolters Kluwer, Lippincott Williams & Wilkins; 2011.
- Running News. The iliotibial band syndrome. Anastasios Margaritis. c2008 [cited 2008 Nov 28]. URL: http://www.runningnews.gr/item.php?id=4930.
- Schuenke M, Schutle E, Schumacher U. Thieme Atlas of Anatomy: General Anatomy of the Musculoskeletal System. New York: Thieme Medical Publishers, Inc.; 2006.
Always see your personal GP, Orthopedic Dr. or PT earlier trying anything yourself that may worsen the situation.