Rehabilitation protocol of „runner’s knee” (Iliotibial Band Syndrome - ITBS) – a case study

Abstract

AbstractIntroduction:„Runner’s knee”, in other words Iliotibial Band Syndrome (ITBS) is the second, after PFPS, in terms of incidence frequency overuse injury amongst runners - 8.5 %. It is the most common cause of lateral knee pain. It mainly occurs in middle aged athletes, in the second decade of life. Cyclists, skiers, weight lifters, soccer and tennis players are next groups, where this clinical entity occurs. ITBS is typical overuse injury which results from cyclic friction (or compression) of iliotibial band on lateral epicondyle of femur. Training errors are main risk factors. Biomechanical disorders leading to this entity are: weakness of gluteus medius, lack of functional hip mobility, weakness of knee flexors and extensors, shortness of hip adductors, limited hip internal rotation. Improper saddle height, frame size or incorrect pedal position can cause ITBS among cyclists.Case study:Professional cyclist was referred to Rehabilitation Centre, complaining about severe pain located at lateral side of the right knee, lasting from 4 months. The pain was described as burning, sharp, increasing during biking, finally disabling him to continue sports activity. After biomechanical analysis we introduced functional re-education training correcting disbalances, the causes of injury. The role of tri-planar, eccentric exercises rotating the pelvis is underlined. After 7 weeks of aggressive, functional rehabilitation resumed sports activity without pain and functional limitations.Conclusions:An early diagnosis of ITBS allows for shorter rehabilitation time. It’s necessary to precisely determine biomechanical disorders leading to ITBS. 7-week rehabilitation, with functional, three dimensional exercises is effective mean of ITBS treatment. We recommend to continue this kind of exercises for 6-12 months to prevent injury recurrence