Biomechanics of Iliotibial Band Friction Syndrome in Runners

Orchard, John; Fricker, Peter; Abud, Anna T.; Mason, Bruce R.

doi:10.1177/036354659602400321

Cited by 163 publications

(122 citation statements)

References 23 publications

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“…This finding provides further evidence that knee flexion, by itself, does not play a significant role in the aetiology of ITBS as has been historically believed. 1,21,23 However, the increased peak knee internal rotation angle in the ITBS group measured in the current study is likely an important factor in the development of ITBS. A number of authors have suggested that, due to its insertion on the tibia, increased knee rotation increases torsional loads to the tissues of the knee joint such as the iliotibial band.…”

Section: Data Collection and Analysismentioning

confidence: 54%

“…21,26 Anecdotally, this syndrome has been associated with repetitive flexion and extension on a loaded knee, in combination with a tight iliotibial band. 1,16,[21][22][23] Orchard et al 23 suggested that frictional forces between the iliotibial band and the lateral femoral condyle are greatest at 20° to 30° of knee flexion, which occur during the first half of the stance phase of running. However, despite this well-accepted sagittal-plane theory, 1,21,23 no differences have been found in the few biomechanical investi-…”

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confidence: 99%

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Competitive Female Runners With a History of Iliotibial Band Syndrome Demonstrate Atypical Hip and Knee Kinematics

Ferber¹,

Noehren²,

Hamill³

et al. 2010

Journal of Orthopaedic & Sports Physical Therapy

212

169

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Study Design: Cross-sectional experimental laboratory study. Objective: To examine differences in running mechanics between runners who had previously sustained iliotibial band syndrome (ITBS) and runners with no knee-related running injuries. Background: ITBS is the second leading cause of knee pain in runners and the most common cause of lateral knee pain. Despite its prevalence, few biomechanical studies have been conducted to better understand its aetiology. Because the iliotibial band has both femoral and tibial attachments, it is possible that atypical hip and foot mechanics could result in the development of ITBS. Methods: The running mechanics of 35 females who had previously sustained ITBS were compared to 35 healthy age-matched and running distance-matched healthy females. Comparisons of hip, knee, and ankle 3-dimensional kinematics and internal moments during the stance phase of running gait were measured. Results: The ITBS group exhibited significantly greater peak rearfoot invertor moment, peak knee internal rotation angle, and peak hip adduction angle compared to controls. No significant differences in peak rearfoot eversion angle, peak knee flexion angle, peak knee external rotator moment, or peak hip abductor moments were observed between groups. Conclusion: Females with a previous history of ITBS demonstrate a kinematic profile that is suggestive of increased stress on the iliotibial band. These results were generally similar to those reported for a prospective study conducted within the same laboratory environment. J Orthop Sports Phys Ther 2010;40(2):52–58. doi:10.2519/jospt.2010.3028

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Section: Data Collection and Analysismentioning

confidence: 54%

mentioning

confidence: 99%

Competitive Female Runners With a History of Iliotibial Band Syndrome Demonstrate Atypical Hip and Knee Kinematics

Ferber¹,

Noehren²,

Hamill³

et al. 2010

Journal of Orthopaedic & Sports Physical Therapy

212

169

View full text Add to dashboard Cite

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“…4,5,10,11 This friction-based understanding 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 on fascia lata compression through cyclic tension changes within the ITB during gait.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic Treatment of Iliotibial Band Syndrome

Cowden

Barber

2014

Arthroscopy Techniques

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Lateral knee pain in athletes is commonly seen in the sports medicine clinic, and the diagnosis of iliotibial band (ITB) syndrome is frequently made. Although conservative management including rest from activity, equipment modification, oral nonsteroidal anti-inflammatory drug use, and physical therapy is the mainstay of treatment initially, refractory cases do exist. Multiple surgical techniques have been described including an arthroscopic technique. Arthroscopic release of the ITB attachment to the lateral femoral epicondyle and resection of the lateral synovial recess for recalcitrant ITB syndrome comprise a valid option that can have a good outcome. This option avoids the complications associated with open surgery and allows for a complete arthroscopic knee examination. Division or lengthening of the ITB band itself is not a necessary step in this technique. R enne 1 first described iliotibial band (ITB) syndrome in 1975 in the US Marine Corps recruit population. Since that time, the syndrome has been identified in multiple endurance athletes including runners (1.6% to 12% incidence) and cyclists (15% to 24% incidence), as well as multiple other sports. The most common complaint is lateral knee pain, 2 and patients with ITB syndrome have been shown to have different running kinematics than those without the problem. 3 Anatomically, the ITB, or iliotibial tract, constitutes a lateral thickening of the fascia lata of the thigh. It is formed from a coalescence of fascial elements from the tensor fascia lata as well as the gluteus maximus and minimus at the level of the greater trochanter. Moving distally, the ITB has attachments to the intermuscular septum and supracondylar tubercle. It then passes over the lateral femoral condyle, crossing the knee joint and inserting on Gerdy's tubercle at the anterolateral proximal tibia. Proximal to the lateral femoral condyle, a layer of fat separates the ITB from underlying structures, but at the condyle, the band is more intimately involved with underlying layers of tissue. An arthroscopic technique is desirable for many reasons including the inherent capacity to examine and address any associated intra-articular pathology during the same session. It is also inherently less invasive than the open options. Assuming the inflammation in the tissue connecting the ITB band to the lateral femoral epicondyle is the culprit of ITB pain, this tissue can be removed with an arthroscopic shaver.9 Michels et al. 9described such a technique in a series of 36 patients successfully treated for ITB syndrome and followed up for at least 18 months. This case report illustrates our use of this arthroscopic approach. Clinical PresentationA 41-year-old white man described chronic lateral left knee pain for at least 10 years. He was a marathon runner and ran the Boston Marathon in the previous 5 years. Despite several nonoperative therapies, his pain continued to worsen. In the previous 6 months, these nonoperative therapies included physical therapy, NSAIDs, a steroid injection, an...

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“…Researchers have investigated healthy and IT band injured runners for anatomical and lower extremity running kinematics differences in clinical and research settings (Anderson, 1991;Grady, O'Connor, & Bender, 1986;McNicol, Taunton, & Clement, 1981;Messier & Pittala, 1988;Messier, et al, 1995;Noble C., 1980;Orava, 1978;Orchard, Fricker, Abud, & Mason, 1996;Renne, 1975;Sutker, Barber, Jackson, & Pagliano, 1985). Anatomical factors included knee, forefoot and rearfoot alignments, Q-angle, IT band tightness, and size of the lateral femoral epicondyle.…”

Section: Introductionmentioning

confidence: 99%

“…Anatomical factors included knee, forefoot and rearfoot alignments, Q-angle, IT band tightness, and size of the lateral femoral epicondyle. (Anderson, 1991;Grady et al, 1986;McNicol et al, 1981;Messier & Pittala, 1988;Messier et al, 1995;Noble C., 1980;Orava, 1978;Orchard et al, 1996;Renne, 1975;Sutker et al, 1985). Studies involving the leg length discrepancy (LLD) measurement have opposing views of its contribution to IT Band pain: (a) the LLD did not contribute to a person's IT band pain, and (b) 6 of 52 IT band cases experienced pain in the longer leg (Grady et al, 1986;Lindenberg et al, 1984;McNicol et al, 1981).…”

Section: Introductionmentioning

confidence: 99%

Examining Biomechanical and Anthropometrical Factors as Contributors to Iliotibial Band Friction Syndrome

Bauer¹,

Duke²

2011

Sport Science Review

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Examining Biomechanical and Anthropometrical Factors as Contributors to Iliotibial Band Friction Syndrome This study was conducted in an attempt to determine if the biomechanical parameters thought to predict iliotibial band injury could accurately differentiate between iliotibial band (IT band) injured and healthy runners. 20 injured and 20 healthy runners were tested. Injured subjects were randomly assigned into groups of ten (INJ-1 or INJ-2). Ten healthy runners acted as controls (CON) and ten healthy (EXP) subjects trained for 1 week with a 1.27 cm felt heal pad in the shoe of their longer leg. All subjects completed a runner's questionnaire, and 13 lower extremity anatomical measurements, four clinical lower extremity assessments, and 2D kinematics from the sagittal and frontal planes during treadmill running were recorded. Comparison of kinematic values between INJ-1 vs. CON and INJ-2 vs. EXP indicated the INJ-1 group had a greater knee flexion angle than the CON group. No other direct comparisons revealed statistically significant differences between groups, nor did a discriminant function based on nine anatomical measurements or analysis of the running questionnaire responses. It was not possible to clearly distinguish between the healthy and injured runners of this study based on the biomechanical factors most commonly thought to predispose individuals to iliotibial band injury.

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Biomechanics of Iliotibial Band Friction Syndrome in Runners

Cited by 163 publications

References 23 publications

Competitive Female Runners With a History of Iliotibial Band Syndrome Demonstrate Atypical Hip and Knee Kinematics

Competitive Female Runners With a History of Iliotibial Band Syndrome Demonstrate Atypical Hip and Knee Kinematics

Arthroscopic Treatment of Iliotibial Band Syndrome

Examining Biomechanical and Anthropometrical Factors as Contributors to Iliotibial Band Friction Syndrome

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