IlioTibial Band Syndrome (ITBS)
The iliotibial tract is a thick band of fascia that runs on the lateral side of the thigh from the iliac crest and inserts at the knee.
It is composed of dense fibrous connective tissue that appears from the m. tensor fasciae latae and m. gluteus maximus.
It descends along the lateral aspect of the thigh, and inserts onto the lateral tibial plateau at a projection known as Gerdy’s tubercle.
iliotibial band does not have any boney attachments as it courses between the Gerdy tubercle and the lateral femoral epicondyle. This allows it to move anteriorly and posteriorly with knee flexion and extension.
Causes
Long distance running is a common cause of ITBS,
Sudden increases in activity levels can also lead to ITBS.
Repeated tissue compression leading to irritation
Friction between the posterior edge of the iliotibial band and the underlying lateral femoral epicondyle
Muscle weakness of the hip abductors
Chronic inflammation of the ITB bursa.
Symptoms
Burning pain at the level of (or just underneath) the lateral femoral epicondyle.
The main symptom of ITBS is a sharp pain on the outer aspect of the knee, especially as the heel strikes the floor, which may also radiate into the outer thigh or calf.
Pain worsens on running or coming down stairs.
Audible snapping sensation the knee bends.
Swelling on the outer aspect of the knee.
Clinical diagnosis
Physical Therapy management
period of active rest or substantially decreasing the intensity of the aggravating activities
cryotherapy or heat to reduce pain and swelling, if any.
Taping and stretching to relieve pain and stiffness
Ultrasound therapy at a frequency range of 0.75 to 3 MHz (depending on the depth of the soft tissue to be treated)
Muscle stimulation
Iontophoresis or phonophoresis
RSWT is believed to stimulate healing of soft tissue and to inhibit nociceptors.
Myofascial treatment can be effective in reducing the pain in acute phase, when pain and inflammation in the insertion is felt. The trigger points in Biceps femoris, vastus lateralis, gluteus maximus, and tensor fascia latae muscles will be addressed by a myofascial treatment.
The use of a foam roller on the tight muscles could also be beneficial to create deep transversal friction and stretching of the muscles.
Exercises to strengthen the abductor muscles :
1-Hip Bridge with Resistance Band
2-Side Lying Hip Abduction
3- Lateral Band Walk
4-Side Plank
5-single-leg step down
6-single-leg wall squat
7-single-leg dead lift
So why delay? Your Physical therapist is the right person who can walk you through a successful phase of recovery from pain in the lateral aspect of your knee. We at Valley Healing Hands, Brownsville, Texas provide the best physical therapy for ITBS or lateral knee pain and we are more than willing to see you recover and get back to your sport.
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