Iliotibial band syndrome (ITBS):
3 Conflicting Causes:
1. Friction of ITB over epicondyle
2. Compression of Fat Pad and Pacinian Corpuscle
Proximally, provides an insertion for the TFL and gluteus maximus.
Distal attachments include:
Lateral patellar retinaculum
During weight bearing:
Greater peak hip adduction and knee internal rotation
Lower tibial internal rotation
Femoral external rotation.
Abnormal mechanics at the foot and the tibia and strain rate may play a role.
Leg-length discrepancies have been reported as a factor in developing ITBS also.
💪🏼 MUSCLE PERFORMANCE
TFL may dominate the weaker gluteus medius posterior and gluteus maximus, resulting in Trendelenburg pattern.
Which could result in:
Poor control of the hip and femur during stance Excessive hip adduction
Knee Valgus or Varus
Repetitions at 30° of knee flexion in a closed-chain and weight-bearing position.
Rapid increases in mileage/hill training
Tenderness localized at lateral epicondyle
No symptoms indicating lateral joint line, popliteal tendon, or intra-articular disorders.
Flexibility of lateral hip musculature .
Compression over the lateral epicondyle at 30° knee flexion; elicits pain reproduction.
Trunk and lower-extremity strength
Excessive femur internal rotation
Ipsilateral hip adduction
Contralateral hip drop during a step-down test or Trendelenburg test
Lateral hip stretch
Side-lying hip abduction and pelvic drops
Progressive closed chain exercises
Bilateral closed chain exercises:
Relatively low vigor and used early to promote technique in squats
Higher vigor intended for strengthening the gluteal muscles.
Read the full article for more info!
Baker, Souza, and Fredericson, 2011. Iliotibial Band Syndrome: Soft Tissue and Biomechanical Factors in Evaluation and Treatment. PMR. 3(6), 550–561.