Iliotibial Band Friction Syndrome
 Custom Search Iliotibial Band Friction Syndrome is an overuse problem that results from inflammation and irritation of the distal portion of the iliotibial tendon as it rubs against the lateral femoral condyle. What Is Iliotibial Band Friction Syndrome ? The iliotibial band is a non elastic collagen cord stretching from the pelvis to below the knee.At the top it is attached to the iliac crest where it blends with gluteus maximus and TFL. As the tract descends the lateral side of thigh its fibres attach to the linea aspera of the femur.The superficial fibres continue downwards to attach to the lateral femoral condyle, lateral patellar retinaculum and anterolateral aspect of the tibial condyle. In standing, the itb lies posterior to hip axis and anterior to knee axis and therefore help to maintain hip and knee extension, reducing the muscle work required to sustain an upright stance. As the knee flexes to 30 degree, the itb passes posterior to knee joint axis and in doing so it glides over the lateral femoral condyle. When the tendon passes the knee (lateral femoral condyle) there is a bursa sac between the bone and the tendon.This tendon moves over a bony bump at the outer knee as it passes in front and behind it.The bursa functions like a water balloon to reduce friction.In IT Band Friction Syndrome, overuse causes excessive friction at this bump, resulting pain and inflammation of the bursa (bursitis),tendon (tendinitis)or both. What Causes Iliotibial Band Friction Syndrome? IT Band Friction Syndrome is caused by excessive friction of the iliotibial band and the underlying bursa due to repetitive knee bending activities.This is an overuse injury, although direct trauma to the outer knee may cause the bursa to get inflamed. Factors that contribute to the development of Iliotibial Band Friction Syndrome- 1-cavus feet. SIGNS AND SYMPTOMS 1-Pain,tenderness,swelling,warmth and redness at the iliotibial band about 2 cm above the joint line and may travel up or down the thigh or leg. 2-Initially pain at the beginning of an exercise that lessens once warmed up, eventually pain through out the activity.It may cause the athlete to stop in the middle of training or competition. 3-Pain that worse with running downhill or stairs. 4-Possibly crepitation when the tendon or bursa is moved or touched. 5-Pain is often exacerbated by repetitive flexion-extension movements. LINDENBERG classified itb friction syndrome into 4 grades- a)Pain comes after running but does not restrict distance or speed. b)Pain comes on during running but does not restrict distance or speed. c)Pain comes on during running and restricts distance or speed. d)Pain so severe that it prevents running.
SPECIAL TESTS 1-Thomas test-The Affected side abducts.It indicates tight ITB.Known as 'J' sign. 2-Obers test-Greater stretch is placed on ITB when the knee is extended. 3-Noble's test- Physiotherapy Management Of Iliotibial Band Friction Syndrome 1-The initial inflammation responds to anti-inflammatory medications and rest from flexion-extension activity of the knee. 2-Avoid downhill running and stairs.Use soft running shoes. 3-Icing for initial inflammation. 4-ultrasonic therapy to reduce inflammation. 5-LASER therapy 6-TENS for pain relief.Massage to prevent adherent scar. 7-When limited range of motion is identified it band stretch is given. 8-Strengthening exercises in open and closed kinematic chain. 9-Gait re-education. 10-Use lateral wedge in the shoes,for patients with it band tightness. 11-If the patient does not respond then steroid injection can be given.Surgery to remove the inflamed bursa or inflamed iliotibial band is considered usually after at least 6-12 months of conservative treatment. Return from Iliotibial Band Friction Syndrome to home page Return from Iliotibial Band Friction Syndrome to sports physical therapy |