Iliotibial band tightness and internal rotation of the tibia in the stance phase of running associated with patella instability.

Abstract

Management of patellar instability is still a clinical challenge, especially in pediatric and adolescent athletes. The purpose of the study was to check the association between the positive apprehension test (which is a sign of patellar instability) and positive Ober's test [which is a sign of a tight iliotibial band (ITB)] and the lower degree of internal rotation of the tibia in young athletes determined by inertial sensors. The participants of this observational case-control study were 56 young athletes aged 10-15. The moving patellar apprehension test for lateral patellar instability and Ober's test for assessing the flexibility of the ITB were performed on all participants. There were 32 sides with positive apprehension tests (cases) and 80 with negative apprehension tests (controls). The degree of internal rotation of the tibia was determined with an inertial sensor. Internal rotation of the tibia in the stance phase of running was lower in the case group than in the control group. Logistic regression analysis showed that the degree of internal rotation of the tibia in the stance phase of running was a good predictor of patellar instability. Our study illustrates that wearable devices can be valuable in determining possible initial patellar instability. Using inertial sensors, a strong association between patellar instability, ITB tightness, and lower internal rotation of the tibia in the stance phase of running was determined. The significance of this study might be the possibility of preventing damage or dislocations of the patella by improving the elasticity of the ITB, which is particularly relevant since patellar instability is common among adolescents.