ITBS

Iliotibial Band Syndrome



Abstract

Iliotibial band syndrome (ITBS) may be defined as friction between Iliotibial Band and knee or hip bone. The friction is so strong that it causes immense pain in the affected area i.e. the knee or hip. It can be in one or both the knees and hips. The iliotibial band (ITB) syndrome affects the iliotibial band, which is formed by fascia from hip flexors, extensors, and abductors. ITB syndrome is a very common knee injury but typically it occurs in runners and cyclists and is possibly the result of overuse coupled with biomechanical factors. The causes of IT band syndrome include long hours of continuous training and mileage coverage of more than the normal capacity of an average runner. It puts a pressure on the knee muscles and causes inflammation. The diagnosis of this syndrome sometimes gets difficult as the medical practitioner may confuse it with symptoms of other closely related disorders. It can be prevented by adopting preventive measures such as Biomechanical Injury Predictors, Shock absorbing insoles and others. The various options of treatment range from Conservative Treatment, Osteopathic Manipulative Treatment, Cortisone injections and Surgical Treatment.

Table of Contents

Introduction1

Diagnosis2

Differential Diagnosis2

Clinical Sings3

Treatment4

Conservative Treatment4

Osteopathic Manipulative Treatment5

Cortisone injections6

Surgical Treatment6

Prevention7

Biomechanical Injury Predictors7

Shock absorbing insoles8

Cause8

Mileage8

Hip abductor weakness8

Management9

Acute Phase9

Sub acute Phase9

Strengthening Phase10

Return-to-running phase10

Conclusion10

References12

Iliotibial Band Syndrome

Introduction

Iliotibial band syndrome (ITBS) may be defined as friction between Iliotibial Band and knee or hip bone. The friction is so strong that it causes immense pain in the affected area i.e. the knee or hip. It can be in one or both the knees and hips.

The iliotibial band (ITB) syndrome affects the iliotibial band, which is formed by fascia from hip flexors, extensors, and abductors. ITB syndrome is a very common knee injury but typically it occurs in runners and cyclists and is possibly the result of overuse coupled with biomechanical factors (Khaund, 2005). Other than excessive running, IT band syndrome can also occur because of weight lifting, court sports and in very rare cases because of pregnancy. In pregnancy it happens when the weight shift causes the tendons to loosen a bit.

Figure 1: Picture of The iliotibial band

Inflammation of the iliotibial band in the distal portion and lateral knee pain are two of the most common symptoms. The patient feels burning or aching sensation at the knee area where you have the iliotibial band. IT band crosses the hip joint and enters the patella, tibia, and biceps femoris tendon. It is a fascia band. When knee is repeatedly flexed and extended, it irritates and inflames the distal iliotibial band while diffusing lateral knee pain. The pain can also move up to the thigh extending to the hip (Hergenroeder, 2011). Possible causes identified for ITBS include excessive running mileage, continuous running on uneven terrain, varus alignment of the knee or worn shoes. Moreover, it can be caused by abnormal shortening of the iliotobial tract. These are only some of the most common causes of ITBS.

Diagnosis

The diagnosis involves the examiner to check the iliotibial band ...