Sex Differences in Iliotibial Band Strain under Different Knee Alignments

Abstract

Background: Increased strain of the iliotibial band (ITB) is a plausible contributing factor for the development of iliotibial band syndrome (ITBS). Although several studies have found relationships between the strain of the ITB and kinematic factors during running, the associations of the ITB strain with knee alignment and sex, which are considered intrinsic factors, are not well understood.Objective: To clarify the sex differences in the ITB strain between genu varum and normal knee alignments in different postures. Design: Observational cross-sectional study. Setting: Laboratory research within a university. Participants: Forty-four healthy recreational athletes (21 men and 23 women) volunteered for this study and were divided into four groups by sex and knee alignment: men with genu varum alignment, men with normal knee alignment, women with genu varum alignment, and women with normal knee alignment. Methods: An ultrasound real-time elastography (RTE) unit was used for distal ITB strain measurements in weight bearing and for different non-weight-bearing: neutral, knee flexion, hip adduction, and hip adduction with knee flexion. Gender information and the intercondylar distance data were collected to divide the participants into two groups. Main Outcome Measurements: Main Outcome was the ITB strain (strain ratio) measured by the RTE. Results: There were no significant differences in neutral and hip adduction postures among the four groups. However, during weightbearing, the women's genu varum group (6.91 AE 1.69; Mean AE SD) exhibited greater strain than both the men's normal group (3.50 AE 1.04, P = .005) and the women's normal group (4.42 AE 1.42, P = .048). In addition, there were significant positive correlations between the intercondylar distance and the ITB strain during weight-bearing (r = 0.315, P = .037). Conclusions: The women's genu varum group exhibited a higher ITB strain during weight-bearing, which may be related to the high incidence of ITBS in women athletes. Furthermore, the changes in alignment and muscle activities during weight-bearing could influence the strain of the ITB.

Distinct displacement of the superficial and deep fascial layers of the iliotibial band during a weight shift task in runners: An exploratory study

“…Findings of this study should be interpreted in light of some limitations. First, the majority of participants were females, and differences in morphological and biomechanical features may have a different impact on displacement and mechanical properties of the ITB (Fain et al, 2019; Hannigan et al, 2018; Kim et al, 2020). This limits the potential to extrapolate findings into a broader population.…”

Intraobserver Assessment of Shear Wave Elastography in Tensor Fasciae Latae and Gluteus Maximus Muscle: The Importance of the Hip Abductor Muscles in Runners Knee Compared to Healthy Controls

“…Increased muscle stiffness in runners might lead to false negative SWE values as compared to healthy volunteers. Moreover, another very recent study showed that women with genu varum alignment exhibit higher ITB strain during weight-bearing, which could be related to a higher incidence of ITBS in women [37]. This was unknown to us prior to this study's subject selection and therefore not evaluated and should be addressed in further studies.…”

A quantitative MRI investigation of the association between iliotibial band syndrome and patellofemoral malalignment

“…The etiology of ITBS involves both intrinsic and extrinsic factors (6,7), and the risk factors for ITBS include past history, static and dynamic alignment in the lower extremities, and gender (8). Previous studies have identified that excessive motion of the hip and knee in the frontal and transverse planes are important factors in the development of ITBS (6,9,10).…”