In brief Iliotibial band friction syndrome (ITBFS) is an overuse syndrome resulting from friction between the iliotibial band and the lateral femoral epicondyle during flexion and extension of the knee. It is often found in runners. If it is suspected, Ober's test for iliotibial band tightness should be performed. When Ober's test is positive, a lateral sole wedge is prescribed and the patient is started on a series of stretching exercises. These exercises have been shown to alleviate symptoms of ITBFS and prevent their occurrence.
With the rising public interest in physical fitness, physicians are seeing an increasing number of jogging related injuries, including stress fractures. 2 Although previous articles have dealt with the subject of stress fractures in athletes,3-5 none have been specifically concerned with the rare but potentially crippling stress fracture of the femoral neck. Since stress fracture of the femoral neck was first described by Asal in 1936,~ the literature regarding stress fractures in this location, including the most recent report,~ has been focused primarily on its occurrence in young military recruits in basic training.$-'2 This paper presents two cases of femoral neck stress fracture occurring in joggers seen at the Northwestern University Medical School Center for Sports Medicine, and included is a literature review. We hope to increase suspicion for this fracture in athletes presenting with groin pain. ETIOLOGY A stress fracture is a process rather than an occurrence, and is believed to be an example of accelerated bone remodeling. The fracture occurs as the bone is attempting to adapt to changes in form and function.'The relatively nonviolent forces which act to produce this remodeling have been thought to result from the transmission of unusual forces to bone due to fatigue of the surrounding muscles. However, there has been a recent suggestion that rhythmic, repetitive action of muscles on bone produces the forces resulting in a stress fracture. 3,13
SIGNS AND SYMPTOMSThe predominant symptom of a stress fracture of the femoral neck is groin pain. This pain may occur only with weight bearing and be accompanied by an antalgic gait (painful limp),' or it may present as an aching sensation that increases during or shortly after activity and abates with rest.
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