Iliotibial band syndrome rehabilitation in female runners: a pilot randomized study

Janine Mckay,Rocco Aicale,Nicola Maffulli,Jack Taunton

doi:10.1186/s13018-020-01713-7

Abstract

BackgroundIliotibial band syndrome (ITBS) carries marked morbidity in runners. Its management is not standardized and lacks evidence base. We evaluated the effectiveness of three different exercises programs in reducing ITBS symptoms.MethodsPatients were divided into three equal treatment groups: ITB stretching (group A), conventional exercise (group B), and experimental hip strengthening exercise (group C). Numeric pain rating scale (NPRS; every week), lower extremity functional scale (LEFS; every 2 weeks), dynamometer (DN; weeks 0, 2, 4, 6, 8), single-limb mini squat (SLMS; week 0, 8), and Y-balance test™ (YBT), between and within group’s differences were evaluated using ANOVA model.ResultsTwenty-four female runners (age 19–45 years) were included into one of three groups (A, B, and C). Statistical significance (p < 0.05) within group C was observed for composite YBT and DN for injured and non-injured leg, the YBT (injured leg for the posterior medial), LEFS, NPRS, and the SLMS. Statistical significance (p < 0.05) was found between group A and group C. The stretching group exhibited statistically significant (p < 0.05) YBT anterior reach for the injured/non-injured leg and the LEFS.ConclusionThere were no statistical differences between the three groups. The subjects who underwent experimental hip strengthening exercises consistently showed improvements in outcome measures, and never scored less than the other two groups.Trial registrationClinicalTrials.gov identifier (NCT number): NCT0229615

Highlights

Iliotibial band syndrome (ITBS) carries marked morbidity in runners
The present study aimed to evaluate the relationship between hip strengthening and each of the following: pain associated with ITBS, Y-balance testTM (YBT) outcome, single-limb mini squat (SLMS) as a functional outcome, and lower extremity functional scale (LEFS), a self-reported questionnaire
The study results showed that neither 8 weeks of stretching of hip nor core strengthening significantly influenced the YBTTM, DN muscle testing, LEFS, NPS, and SLMS indices, which may be attributed to the small sample size and short rehabilitation periods

Summary

Introduction

Iliotibial band syndrome (ITBS) carries marked morbidity in runners. Iliotibial band syndrome (ITBS) is one of the most common injuries among runners [1], with two different competing anatomic theories for ITBS, namely, compression and enthesopathy versus friction and impingement [2]. Treatment of ITBS may be undertaken using conservative or surgical methods, with surgery indicated in refractory cases. Non-surgical methods or conservative management are preferred and may include a combination of rest, activity modification, pain management, stretching, and strengthening. The conservative therapies used for the treatment of runners presenting with pain include the use of non-steroidal antiinflammatory drugs (NSAIDs), corticosteroids, deep friction massages, phonophoresis, ice packs, ultrasound, and stretching. Several studies have reported the effects of conservative therapies in reducing pain, current management options of ITBS have not been clearly established. No randomized study to date has assessed the effects of individual conservative therapies [2, 12,13,14,15,16]

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