Abstract
Iliotibial band syndrome (ITBS) is a common clinical presentation in runners. There are several hypotheses to explain this condition including faulty control of the hip joint in the frontal plane during the stance phase of running. It is postulated that improving activity in the gluteus medius muscle may assist in produc-ing more appropriate stabilization and therefore reduce the stress on the Iliotibial band (ITB). This single case study provides an interesting clinical scenario where a single-subject with ITBS was measured for hip kinematics during running, before and after a trial period of classic gluteus medius exercises. The biomechanical data show an initial (pre-intervention) increase in adduction position during the stance phase of running on the affected side (in contrast to the unaffected side). This was measured using a Moven motion analysis suit. After the trial intervention period, the relative position of the affected hip had reduced in adduction at both heel strike and at 30° knee flexion. This study provides support for the theory that hip control in the frontal plane may be a contributing factor in ITBS. Clinicians are encouraged to monitor hip control as well as ITBS symptoms when they utilise this gluteus medius protocol. Further research to establish whether change in pelvic control results in decrease in ITBS symptoms is warranted.
Highlights
Iliotibial band syndrome (ITBS) is the second leading cause of knee pain and the primary cause of lateral knee pain in runners (Noehren et al 2007)
The main objective of this study was to investigate the biomechanical effect of gluteus medius training during the stance phase of running in a patient with ITBS
This confirmed that the participant in this study presented with a similar clinical presentation to those described in the biomechanical study of Noehren et al (2007)
Summary
Iliotibial band syndrome (ITBS) is the second leading cause of knee pain and the primary cause of lateral knee pain in runners (Noehren et al 2007). Due to the increased aware ness of aerobic exercise to maintain a healthy lifestyle, jogging and running have become more popular. This is mirrored by an increase in acute and chronic running injuries (Dugan and Bhat 2005). In long-distance running, repetitive flexion and extension of the knee joint leads to excessive rubbing of the distal iliotibial band across the lateral femo ral condyle (Grau et al 2008). The pain usually increases over the duration of the run due to cumulative effects of the repetitive knee flexion/ extension movements and leads to an inflammatory process (Franco et al 1997, Fredericson and Wolf 2006, Khaund and Flynn 2005). ITBS in runners is a significant problem, as the intensity of the pain can lead to attrition from run ning (Miller et al 2007)
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