II. Epidemiology
- See also Running Injury
- Second most common knee problem in runners
- Accounts for 12% of Running injuries
III. Risk factors
IV. Pathophysiology
- Microtrauma injury to iliotibial band
- Irritation of distal iliotibial band
- Excess friction, impingement at lateral femoral condyle (esp. with knee flexed to 20 to 30 degrees)
- Usually due to repetitive flexion and extension
V. Symptoms
- Initial characteristics
- Non-focal, diffuse lateral knee ache
- Later characteristics
- Provocative: Repetitive knee flexion and extension
VI. Signs
- Provocative Tests
- See Noble's Test
- See Ober's Test
- Tenderness at 2 cm above (proximal to) lateral joint line
- Tenderness at lateral epicondyle of femur
- Pain on standing with knee flexed to 30 degrees
-
Muscle Strength (weakness risk IT Band Syndrome)
- Knee extensors and flexors
- Hip abductors
VII. Differential Diagnosis
- Plica Injury
- Popliteus Tendonitis
- Medial meniscus or lateral Meniscus Injury
VIII. Management: Initial reduction in acute inflammation
- Acute measures
- Phonophoresis or Iontophoresis
- Iliotibial Band coticosteroid Injection
- Rarely indicated
- Consider for ambulatory pain longer than 3 days
- Inject maximally Tender Point over femoral condyle
IX. Management: After acute inflammation resolves
-
Stretching (Described for affected right leg)
- Stand with right leg crossed behind left
- Lean forward and to left, with arms stretched out
- Gluteus medius strengthening (for affected right leg)
- Start after Stretching is no longer painful
- Standing position
- Right foot on raised platform (2-3 inches up)
- Left foot on floor
- Keep right knee locked in full extension
- Motion to repeat
- Slowly lower left foot to floor
- Raise left foot to Pelvis level
- Feel this in the right gluteus medius
- Modify Running training regimen
- Run on flat, non-banked surfaces
- Vary pace
- Gradually increase distance if no pain
- Stop Running for persistent pain
- Modify Bicycle fit
- Consider adjusting saddle height, pedal system
-
Orthotics
- Adjust shoe for excessive lateral wear
- Surgical release of posterior 2 cm of IT Band
- Indicated if refractory to conservative measures
- Relieves pressure point over lateral epicondyle
X. Course
- Resolves within 6 weeks on consistent rehab program
Images: Related links to external sites (from Bing)
Related Studies
Definition (MSH) | An overuse injury causing lateral knee pain that results from repetitive friction of the iliotibial band over the lateral femoral epicondyle. |
Concepts | Disease or Syndrome (T047) |
MSH | D058745 |
ICD10 | M76.3 |
SnomedCT | 423849004, 202864001, 393604008 |
Italian | Sindrome della fascia ileotibiale, Sindrome da frizione della fascia ileotibiale, ITB, Sindrome della bandelletta ileotibiale |
Dutch | iliotibiale band-frictiesyndroom, iliotibiale band; syndroom, syndroom; iliotibiale band, Iliotibiale-bandsyndroom, iliotibiale band-syndroom |
French | Syndrome de la bandelette ilio-tibiale, Syndrome de la bandelette iliotibiale, Syndrome de la bandelette de Maissiat, Syndrome de l'essuie-glace, Ressaut de la bandelette de Maissiat |
German | Iliotibial Band Friction Syndrome, Tractus-iliotibialis-Syndrom, Iliotibial-Band-Syndrom, Iliotibial Band Syndrome |
Portuguese | Síndrome de fricção de banda ilotibial, Síndrome da Banda Iliotibial, Síndroma da banda iliotibial |
Spanish | Síndrome de fricción de la banda iliotibial, síndrome de fricción de la bandeleta iliotibial (trastorno), síndrome de fricción de la bandeleta iliotibial, Síndrome de la Banda Iliotibial, Síndrome de la banda iliotibial |
Japanese | 腸脛靱帯摩擦症候群, 腸脛靱帯症候群, チョウケイジンタイマサツショウコウグン, チョウケイジンタイショウコウグン |
English | Iliotibial band friction syndrome (disorder), Iliotibial band friction syndrome, Iliotibial band syndrome, iliotibial band friction syndrome, iliotibial band friction syndrome (diagnosis), Syndrome, Iliotibial Band, Iliotibial Band Syndrome [Disease/Finding], Iliotibial Band Syndrome, Iliotibial band syndrome (disorder), iliotibial band; syndrome, syndrome; iliotibial band |
Czech | Syndrom lupavé kyčle, Coxa saltans, syndrom iliotibiálního pruhu |
Korean | 엉덩정강뼈 환 증후군 |
Russian | ILIOTIBIAL'NOGO TRAKTA TRENIIA SINDROM, ПОДВЗДОШНО-БОЛЬШЕБЕРЦОВОГО ТРАКТА СИНДРОМ, ИЛИОТИБИАЛЬНОГО ТРАКТА ТРЕНИЯ СИНДРОМ, PODVZDOSHNO-BOL'SHEBERTSOVOGO TRAKTA SINDROM |
Hungarian | Iliotibialis szalag dörzsölés szindróma, Iliotibialis szalag szindróma |
Polish | Zespół tarcia pasma biodrowo-piszczelowego, Zespół pasma biodrowo-piszczelowego, Zespół ITB |
Norwegian | Iliotibialbåndsyndrom, Løperkne, Tractus iliotibialis-syndrom |