Abstract

BackgroundShortening of the iliotibial band (ITB) has been considered to be associated with low back pain (LBP). It is theorized that ITB tightness in individuals with LBP is a compensatory mechanism following hip abductor muscle weakness. However, no study has clinically examined this theory. The purpose of this study was to investigate the muscle imbalance of hip abductor muscle weakness and ITB tightness in subjects with LBP.MethodsA total of 300 subjects with and without LBP between the ages of 20 and 60 participated in this cross-sectional study. Subjects were categorized in three groups: LBP with ITB tightness (n = 100), LBP without ITB tightness (n = 100) and no LBP (n = 100). Hip abductor muscle strength was measured in all subjects.ResultsAnalysis of Covariance (ANCOVA) with the body mass index (BMI) as the covariate revealed significant difference in hip abductor strength between three groups (P < 0.001). Post hoc analysis showed no significant difference in hip abductor muscle strength between the LBP subjects with and without ITB tightness (P = 0.59). However, subjects with no LBP had significantly stronger hip abductor muscle strength compared to subjects with LBP with ITB tightness (P < 0.001) and those with LBP without ITB tightness (P < 0.001).ConclusionThe relationship between ITB tightness and hip abductor weakness in patients with LBP is not supported as assumed in theory. More clinical studies are needed to assess the theory of muscle imbalance of hip abductor weakness and ITB tightness in LBP.

Highlights

  • Shortening of the iliotibial band (ITB) has been considered to be associated with low back pain (LBP)

  • No study has clinically examined the theory of muscle imbalance of hip abductor weakness and ITB tightness in patients with LBP

  • The purpose of this study was to evaluate the muscle imbalance of hip abductor weakness and ITB tightness in LBP by investigating the relationship between tightness of ITB and hip abductor muscle strength in subjects with LBP

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Summary

Introduction

Shortening of the iliotibial band (ITB) has been considered to be associated with low back pain (LBP). It is theorized that ITB tightness in individuals with LBP is a compensatory mechanism following hip abductor muscle weakness. The purpose of this study was to investigate the muscle imbalance of hip abductor muscle weakness and ITB tightness in subjects with LBP. The exact cause of ITB shortness in persons with LBP has not yet been determined. The ITB is a continuation of the tendinous portion of the tensor fascia lata (TFL) muscle with some contributions from the gluteal muscles. TFL/ITB is a synergist of gluteus medius muscle in hip abduction [6]. Hip abductor muscles play a significant role in control of rotational alignment of the limb and maintaining pelvic lateral stability in single leg stance [1,6,7]. Gottschalk et al [8] believe that the primary function of hip abductors is to stabilize the

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