Iliotibial band syndrome - AbsoluteAstronomy.com

Iliotibial band syndrome (ITBS or ITBFS, for iliotibial band friction syndrome) is a common injury

Injury

-By cause:*Traumatic injury, a body wound or shock produced by sudden physical injury, as from violence or accident*Other injuries from external physical causes, such as radiation injury, burn injury or frostbite*Injury from infection...

to the thigh

Thigh

In humans the thigh is the area between the pelvis and the knee. Anatomically, it is part of the lower limb.The single bone in the thigh is called the femur...

, generally associated with running

Running

Running is a means of terrestrial locomotion allowing humans and other animals to move rapidly on foot. It is simply defined in athletics terms as a gait in which at regular points during the running cycle both feet are off the ground...

, cycling

Cycling

Cycling, also called bicycling or biking, is the use of bicycles for transport, recreation, or for sport. Persons engaged in cycling are cyclists or bicyclists...

, hiking

Hiking

Hiking is an outdoor activity which consists of walking in natural environments, often in mountainous or other scenic terrain. People often hike on hiking trails. It is such a popular activity that there are numerous hiking organizations worldwide. The health benefits of different types of hiking...

or weight-lifting (especially squats

Squat (exercise)

In strength training, the squat is a compound, full body exercise that trains primarily the muscles of the thighs, hips and buttocks, quads , hamstrings, as well as strengthening the bones, ligaments and insertion of the tendons throughout the lower body...

Definition

ITBS is one of the leading causes of lateral knee pain

Knee pain

Knee pain is a common complaint for many people. There are several factors that can cause knee pain. Awareness and knowledge of knee pain causes lead to faster diagnosis and treatment. Knee pain can be related to knee joint or around the knee.-Knee joint:...

in runners. The iliotibial band

Iliotibial tract

The iliotibial tract or iliotibial band is a longitudinal fibrous reinforcement of the fascia lata. It is attached to the anterolateral iliac tubercle portion of the external lip of the iliac crest and to the lateral condyle of the tibia...

is a superficial thickening of tissue

Tissue (biology)

Tissue is a cellular organizational level intermediate between cells and a complete organism. A tissue is an ensemble of cells, not necessarily identical, but from the same origin, that together carry out a specific function. These are called tissues because of their identical functioning...

on the outside of the thigh, extending from the outside of the pelvis, over the hip

Hip (anatomy)

In vertebrate anatomy, hip refer to either an anatomical region or a joint.The hip region is located lateral to the gluteal region , inferior to the iliac crest, and overlying the greater trochanter of the femur, or "thigh bone"...

and knee, and inserting just below the knee. The band is crucial to stabilizing the knee during running, moving from behind the femur

Femur

The femur , or thigh bone, is the most proximal bone of the leg in tetrapod vertebrates capable of walking or jumping, such as most land mammals, birds, many reptiles such as lizards, and amphibians such as frogs. In vertebrates with four legs such as dogs and horses, the femur is found only in...

to the front while walking. The continual rubbing of the band over the lateral femoral epicondyle

Lateral epicondyle of the femur

The lateral epicondyle of the femur, smaller and less prominent than the medial epicondyle, gives attachment to the fibular collateral ligament of the knee-joint. Directly below it is a small depression from which a smooth well-marked groove curves obliquely upward and backward to the posterior...

, combined with the repeated flexion

Flexion

In anatomy, flexion is a position that is made possible by the joint angle decreasing. The skeletal and muscular systems work together to move the joint into a "flexed" position. For example the elbow is flexed when the hand is brought closer to the shoulder...

and extension of the knee during running may cause the area to become inflamed.

Symptoms

ITBS symptoms range from a stinging sensation just above the knee joint

Joint

A joint is the location at which two or more bones make contact. They are constructed to allow movement and provide mechanical support, and are classified structurally and functionally.-Classification:...

(on the outside of the knee or along the entire length of the iliotibial band

Iliotibial tract

) to swelling or thickening of the tissue at the point where the band moves over the femur. The pain may not occur immediately during activity, but may intensify over time, especially as the foot

Foot

The foot is an anatomical structure found in many vertebrates. It is the terminal portion of a limb which bears weight and allows locomotion. In many animals with feet, the foot is a separate organ at the terminal part of the leg made up of one or more segments or bones, generally including claws...

strikes the ground. Pain might persist after activity. Pain may also be present below the knee, where the ITB actually attaches to the tibia

Tibia

The tibia , shinbone, or shankbone is the larger and stronger of the two bones in the leg below the knee in vertebrates , and connects the knee with the ankle bones....

.

ITBS can also occur where the IT band connects to the hip, though this is less likely as a sports injury. It commonly occurs during pregnancy

Pregnancy

Pregnancy refers to the fertilization and development of one or more offspring, known as a fetus or embryo, in a woman's uterus. In a pregnancy, there can be multiple gestations, as in the case of twins or triplets...

, as the connective tissues loosen and the woman gains weight—each process adding more pressure. ITBS at the hip also commonly affects the elderly. ITBS at the hip is studied less; few treatments are generally known, This may also happen when a child's or teenager's hip grows faster than the band, and it creates tightness over the hip and knee, therefore creating a popping and snapping over the hip or knee.

Sports activities to avoid while symptomatic

Soccer
Running
Running
Running is a means of terrestrial locomotion allowing humans and other animals to move rapidly on foot. It is simply defined in athletics terms as a gait in which at regular points during the running cycle both feet are off the ground...
Stair climbing
Stair climbing
Stair climbing is the climbing of a flight of stairs. It is often described as a "low-impact" exercise, often for people who have recently started trying to get in shape.A common exhortation in health pop culture is "Take the stairs, not the elevator"....

or mountaineering
Mountaineering
Mountaineering or mountain climbing is the sport, hobby or profession of hiking, skiing, and climbing mountains. While mountaineering began as attempts to reach the highest point of unclimbed mountains it has branched into specialisations that address different aspects of the mountain and consists...
Deadlift
Deadlift
The deadlift is a weight training exercise where a loaded barbell is lifted off the ground from a stabilized, bent over position. It is one of the three canonical powerlifting exercises, along with the squat and bench press.-Overview:...

s or squats
Squat (exercise)
In strength training, the squat is a compound, full body exercise that trains primarily the muscles of the thighs, hips and buttocks, quads , hamstrings, as well as strengthening the bones, ligaments and insertion of the tendons throughout the lower body...
Court sports, such as tennis
Tennis
Tennis is a sport usually played between two players or between two teams of two players each . Each player uses a racket that is strung to strike a hollow rubber ball covered with felt over a net into the opponent's court. Tennis is an Olympic sport and is played at all levels of society at all...

, basketball
Basketball
Basketball is a team sport in which two teams of five players try to score points by throwing or "shooting" a ball through the top of a basketball hoop while following a set of rules...

, or similar
Martial arts
Martial arts
Martial arts are extensive systems of codified practices and traditions of combat, practiced for a variety of reasons, including self-defense, competition, physical health and fitness, as well as mental and spiritual development....

, such as karate
Karate
is a martial art developed in the Ryukyu Islands in what is now Okinawa, Japan. It was developed from indigenous fighting methods called and Chinese kenpō. Karate is a striking art using punching, kicking, knee and elbow strikes, and open-handed techniques such as knife-hands. Grappling, locks,...

(especially where being bare foot emphasizes any symptoms being caused by leg/foot abnormalities)
Bowling
Bowling
Bowling Bowling Bowling (1375–1425; late Middle English bowle, variant of boule Bowling (1375–1425; late Middle English bowle, variant of boule...
Skating
Wrestling
Wrestling
Wrestling is a form of grappling type techniques such as clinch fighting, throws and takedowns, joint locks, pins and other grappling holds. A wrestling bout is a physical competition, between two competitors or sparring partners, who attempt to gain and maintain a superior position...
Cycling
Cycling
Cycling, also called bicycling or biking, is the use of bicycles for transport, recreation, or for sport. Persons engaged in cycling are cyclists or bicyclists...
Dancing
Parkour
Parkour
Parkour is a method of movement focused on moving around obstacles with speed and efficiency. Originally developed in France, the main purpose of the discipline is to teach participants how to move through their environment by vaulting, rolling, running, climbing and jumping...
Rowing
Rowing (sport)
Rowing is a sport in which athletes race against each other on rivers, on lakes or on the ocean, depending upon the type of race and the discipline. The boats are propelled by the reaction forces on the oar blades as they are pushed against the water...
Softball
Softball
Softball is a bat-and-ball sport played between two teams of 10 to 14 players. It is a direct descendant of baseball although there are some key differences: softballs are larger than baseballs, and the pitches are thrown underhand rather than overhand...
Gymnastics
Gymnastics
Gymnastics is a sport involving performance of exercises requiring physical strength, flexibility, agility, coordination, and balance. Internationally, all of the gymnastic sports are governed by the Fédération Internationale de Gymnastique with each country having its own national governing body...
Kitesurfing
Kitesurfing
Kitesurfing or Kiteboarding is an adventure surface water sport that has been described as combining wakeboarding, windsurfing, surfing, paragliding, and gymnastics into one extreme sport. Kitesurfing harnesses the power of the wind to propel a rider across the water on a small surfboard or a...

Causes

ITBS can result from one or more of the following training habits, anatomical abnormalities, or muscular imbalances:

Training habits:

Always Running on a banked surface (such as the shoulder of a road or an indoor track) bends the downhill leg slightly inward and causes extreme stretching of the band against the femur
Inadequate warm-up or cool-down
Excessive up-hill and down-hill running
In cycling, having the feet "toed-in" to an excessive angle
Running up and down stairs
Hiking long distances
Rowing

Abnormalities in leg/feet anatomy:

High
Pes cavus
High arch is a human foot type in which the sole of the foot is distinctly hollow when bearing weight. That is, there is a fixed plantar flexion of the foot...

or low arches
Flat feet
Flat feet is a formal reference to a medical condition in which the arch of the foot collapses, with the entire sole of the foot coming into complete or near-complete contact with the ground...
Supination
Supination
Supination is a position of either the forearm or foot; in the forearm when the palm faces anteriorly, or faces up . Supination in the foot occurs when a person appears "bow-legged" with their weight supported primarily on the anterior of their feet.The hand is supine in the anatomical position...

of the foot
Excessive lower leg rotation due to over-pronation
The force at the knee when the foot strikes
Uneven leg length
Bowlegs or tightness about the iliotibial band.
- Excessive wear on the outside heel
  Heel
  In human anatomy, the heel is the prominence at the posterior end of the foot. It is based on the projection of one bone, the calcaneus or heel bone, behind the articulation of the bones of the lower leg.- Human anatomy :...
  
  edge of a running shoe (compared to the inside) is one common indicator of bowleggedness for runners.

Muscle imbalance:

Weak hip abductor muscles
Weak/non-firing multifidus muscle
Multifidus muscle
The multifidus muscle consists of a number of fleshy and tendinous fasciculi, which fill up the groove on either side of the spinous processes of the vertebrae, from the sacrum to the axis...

Treatment

While ITBS pain can be acute, the iliotibial band can be rested, iced, compressed and elevated (RICE

RICE (medicine)

RICE is a treatment method for soft tissue injury which is an acronym for Rest, Ice, Compression and Elevation. When used appropriately, recovery duration is usually shortened and discomfort minimized....

) to reduce pain and inflammation

Inflammation

Inflammation is part of the complex biological response of vascular tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. Inflammation is a protective attempt by the organism to remove the injurious stimuli and to initiate the healing process...

, followed by stretching. Using a foam roller to loosen the iliotibial band can help prevent and treat ITBS although the treatment itself can be very painful to some. Also, an ultra sound machine can be used around the area to relax it, followed by a machine that utilizes electrode stimulation to the area to further relax it. This can result in more comfort and/or a wider range of motion. Consulting with a doctor or referring to a registered physiotherapist, athletic therapist, or a massage therapist would be the best solutions. Custom foot orthotics may treat this condition by controlling the amount of inversion (medial rotation) of the foot and thus reducing rotation of the leg and knee (which creates friction of the iliotibial band against the outside of the knee).

A very effective way of off-loading the ITB and restoring VMO control/normal medial glide of the patella, is via "McConnell's Taping", or taping pulling the knee medially (inward). Tape from the bottom half of the patella, to under the knee over the patella tendon. When this is done firmly, they should notice it feels 'stronger' or 'less painful.'

Other treatments available for this injury use a compression wrap to mobilize the ITB where the tendon meets the knee. This is called an 'IT band compression wrap.'

In severe cases where a conservative approach has failed, surgery can be a good option.

External links

Iliotibial Band Syndrome at drpribut.com

The source of this article is wikipedia, the free encyclopedia. The text of this article is licensed under the GFDL.