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Background: Despite the numerous health benefits of distance running, it is also associated with the development of 'gradual onset running-related injuries' (GORRIs) one of which is Iliotibial Band Syndrome (ITBS). Novel risk factors associated with a history of ITBS (hITBS) have not been described in a large cohort of distance runners. Objective: To identify risk factors associated with hITBS in distance runners. Design: Descriptive cross-sectional study. Setting: 21.1 km and 56 km Two Oceans Marathon races (2012–2015). Participants: 106 743 race entrants completed the online pre-race medical screening questionnaire. A total of 1 314 runners confirmed an accurate hITBS diagnosis. Methods: Selected risk factors associated with hITBS explored included: demographics (race distance, sex, age groups), training/running variables, history of existing chronic diseases (including a composite chronic disease score) and history of any allergy. Prevalence (%) and prevalence ratios (PR; 95% CI) are reported (uni- & multiple regression analyzes). Results: 1.63% entrants reported hITBS in a 12-month period. There was a higher (p < 0.0001) prevalence of hITBS in the longer race distance entrants (56 km), females, younger entrants, fewer years of recreational running (PR = 1.07; p = 0.0009) and faster average running speed (PR = 1.02; p = 0.0066). When adjusted for race distance, sex, age groups, a higher chronic disease composite score (PR = 2.38 times increased risk for every two additional chronic diseases; p < 0.0001) and a history of allergies (PR = 1.9; p < 0.0001) were independent risk factors associated with hITBS. Conclusion: Apart from female sex, younger age, fewer years of running and slower running speed, two novel independent risk factors associated with hITBS in distance runners are an increased number of chronic diseases and a history of allergies. Identifying athletes at higher risk for ITBS can guide healthcare professionals in their prevention and rehabilitation efforts. [ABSTRACT FROM AUTHOR]

Introduction: Iliotibial Band Syndrome (ITBS) is one of the most prevalent overuse injuries among athletes, particularly runners and cyclists. Characterized by lateral knee pain, ITBS often results from repetitive friction of the iliotibial band over the lateral femoral epicondyle, causing inflammation and discomfort. Despite its frequency, the mechanisms, risk factors, and effective interventions for ITBS remain topics of active investigation. Purpose of Work: This systematic review aims to consolidate current research on the etiology, diagnosis, prevention, and treatment of ITBS in athletes. By synthesizing findings from existing studies, this paper seeks to provide evidence-based recommendations for effective management and rehabilitation strategies. State of Knowledge: Research identifies biomechanical abnormalities, overtraining, and inadequate recovery as significant contributors to ITBS. Advances in imaging have improved diagnostic accuracy, while rehabilitation programs emphasizing strengthening and flexibility show promise in recovery. Nonetheless, inconsistencies in studies and intervention outcomes underscore the need for standardized approaches. Material and methods: The research methodology involved conducting a systematic review of the literature, and implementing a screening process to identify pertinent studies. The investigation encompassed a thorough search across scientific databases, such as PubMed and Google Scholar. Summary: ITBS is a complex overuse injury prevalent in athletes, requiring an integrated approach to diagnosis, prevention, and treatment. Current evidence underscores the significance of addressing biomechanical imbalances, training errors, and recovery deficits. While rehabilitation strategies focused on strengthening, flexibility, and neuromuscular control show efficacy, variability in treatment outcomes highlights the need for personalized interventions and further research to optimize prevention and recovery protocols.

Context: Iliotibial band syndrome (ITBS) is a common overuse injury in runners with parallels to our findings of overuse in Greco Roman wrestlers. Despite research indicating coordination and movement-based factors about the hip, no studies were found using functional motor control (FMC) in runners or wrestlers with ITBS. Thus, we compared FMC exercises and therapeutic exercises (TEs) on pain, function, muscle strength, and range of motion (ROM) in national-level Greco Roman wrestlers with ITBS. Design: Controlled laboratory study. Methods: Sixty national-level Greco Roman wrestlers diagnosed with ITBS were randomly assigned to 8 weeks of FMC exercises, TE, and a control group (20 individuals for each group). Pain (visual analog scale), function (triple hop test for distance, single-leg vertical jump test, and agility T test), muscle strength (handheld dynamometer), and ROM (goniometer) were measured at baseline and 8 weeks after intervention as posttest. Results: Although both interventions significantly reduced pain (P < .001, η² = .87), improved function (triple hop test P = .004, η² = .94; single-leg vertical jump P = .002, η² = .93; and T test P < .001, η² = .93) and strength (hip abduction (P < .001, η² = .52), hip external rotation (P = .02, η² = .95), knee flexion (P ≤ .001, η² = .94), and knee extension (P < .001, η² = .91) compared with the control group, FMC showed more significant improvements in comparison with TE. Significant differences (P = .001) were observed between FMC and TE compared with the control group in ROM outcome. However, TE was more effective than FMC in improving ROM hip abduction (P < .001, η² = .93), hip adduction (P = .000, η² = .92), hip internal rotation (P < .001, η² = .92), and hip external rotation (P < .001, η² = .93). Conclusion: FMC exercises were superior to TE in terms of pain, function, and muscle strength, whereas TE was more effective for improving ROM. FMC exercise is suggested as an effective intervention for improvement of the outcomes related to ITBS in national-level Greco Roman wrestlers. [ABSTRACT FROM AUTHOR]

Knochen ist elastisch und verformbar. Kehrt aber ein Knochen nach Trauma, chronischem Zug, Druck oder Torsion nicht in die alte Position zurück, verbleiben Schmerzen im Knochen und in den beteiligten, nicht dehnbaren Faszien, Sehnen, Kapsel- und Bandstrukturen. Nachdem mit dem Strain-Relief-Konzept im vorigen Heft die theoretischen Grundlagen eines neuen manuellen Verfahrens zur Behandlung chronischer Schmerzen im Bewegungsapparat vorgestellt wurden [4] , widmet sich dieser Beitrag der praktischen Anwendung. Am Beispiel der unteren Extremität wird gezeigt, wie man manuell das ossäre Gewebe vom Strain befreien kann und damit erfolgreich Schmerzen mindert oder sogar beseitigt. Bone is elastic and deformable. However, if a bone does not return to its former position after trauma, chronic traction, pressure or torsion, pain will remain in the bone and in the non-stretchable fascia, tendons, capsule and ligament structures involved. Following the introduction of the theoretical basis of a new manual method for the treatment of chronic pain in the musculoskeletal system in the previous issue with the strain relief concept [4] , this article is dedicated to the practical application. Using the lower extremity as an example, it demonstrates how the osseous tissue can manually be freed from the strain, thus successfully reducing or even eliminating pain. [ABSTRACT FROM AUTHOR]

Iliotibial Band (ITB) Syndrome is common among athletes, such as runners and cyclists. There are several theories regarding the etiology of ITB Syndrome, including friction, compression, and chronic inflammation. We report a rare case of ITB Syndrome induced by traditional massage after a history of chronic knee pain. A 63-year-old female visited our Pysical Medicine and Rehabilitation Department with the pain of the lateral side of the right knee for four months after traditional massage. The physical examination showed a positive Ober test and Noble compression test. We performed an ultrasonography on the lateral right knee and found fluid effusion beneath the ITB confirming the diagnosis of ITB Syndrome. A pain intervention was performed with ultrasound-guided aspiration and injection of steroid beneath the ITB. After the procedure and rehabilitation program of cryotherapy and ultrasound therapy, the pain was reduced greatly and there was no need for further management.

Iliotibial band syndrome (ITBS) is an overuse syndrome that commonly causes knee pain and is common in athletics. The prevalence of ITBS in runners ranges from 5%-14%, with a higher prevalence in women (16%-50%) than in men (50%-81%). ITBS can limit Indonesia's athletic performance due to pain on the side of the knee during running, walking and jumping. The aim of this study was to evaluate the physiotherapy management for ITBS cases in Indonesian para-athletics. This research is a descriptive case study involving one client with a participatory observation method. The physiotherapy intervention involved Shock Wave Therapy (SWT) and Static Stretching Exercise. The subject of the study was 22 year old national para athlete with height 182 cm, weight 70 kg, and BMI 21.1 in the ideal category. The patient came to the physiotherapy clinic of NPC Indonesia on 20 August 2023 with complaints of pain in the outer side of the right knee. Physical examination showed normal results except for pain examination using Numeric Rating Scale (NRS), where silent pain 2/10, tenderness 4/10, and motion pain 5/10 were found. The diagnosis of ITBS dextra was confirmed through specific examination. After six physiotherapy sessions with SWT and Static Stretching Exercise, there was a significant decrease in pain and an increase in functional activity in ITBS patients. Patients are advised to undergo physiotherapy regularly, do stretching exercises before and after activities, and compress with warm water if experiencing pain.

Abstract Introduction Description of a new surgical procedure (percutaneous lengthening and arthroscopic release, PLAR) that combines all the possible interventions on the iliotibial band (ITB), and evaluates its outcomes in a group of distance runners diagnosed with ITBS. Methods A prospective observational study was made of distance runners diagnosed with ITBS and operated upon using the PLAR technique between 1 and 2018 and 31 June 2020. The surgical technique is described in detail, and the demographic data and functional outcomes measured by the sports performance scales Activity Rating Scale (ARS) and International Knee Documentation Committee (IKDC) are presented. Results A total of 14 patients were included, with a mean follow-up of 16 months (range 12–42 months). All the patients resumed their previous sporting activity after an average of 4 (range 2.5-6) months, and no complications were recorded. In all cases, statistically significant improvement was evidenced by the ARS and IKDC scales following PLAR (p

Führt eine Dauerbelastung und -beanspruchung oder ein Trauma zur Überschreitung der Elastizitätsgrenze des Knochens, kann es zu einer leichten plastisch-elastischen Verformung der ossären Strukturen kommen. Kehrt der Knochen nicht in seine ursprüngliche neutrale Form zurück, entsteht bzw. verbleibt eine chronische Spannung in der trabekulären Matrix. Das wiederum führt zu einem dauerhaften Zug/Druck auf die beteiligten, nachweislich nicht dehnbaren Faszien-, Kapsel-, Band- und Sehnenstrukturen mit einer zwangsläufigen Aktivierung der darin verwobenen Schmerzrezeptoren. Chronische, mitunter therapieresistente Beschwerden im Knochen selbst und in den mit ihm verankerten Strukturen sind die Folge. In diesem Artikel wird mit dem (Knochen-)Strain Relief ein neues konservatives Behandlungskonzept vorgestellt, mit dessen Hilfe manuell pathologische, nicht sichtbare Knochen„verformungen" in die anatomische Ausgangslage zurückgebogen/-gedreht/-gedrückt werden können, um die permanenten Spannungen, Scherungen oder Zug auf Faszien und Sehnen zu minimieren und damit chronische Schmerzen sehr erfolgreich zu mindern oder sogar zu beseitigen. If a permanent load and stress exceeds the elastic limit of the bone, a slight plastic-elastic deformation of the osseous structures may occur. If the bone does not return to its original neutral shape a chronic tension in the trabecular matrix develops or remains. This in turn leads to permanent traction/pressure on the involved fascia, capsule, ligament and tendon structures, which have been shown to be non-extensible, with inevitable activation of the pain receptors interwoven within them. Chronic, sometimes therapy-resistant complaints in the bone area are the result. This article introduces (Bone) Strain Relief, a new conservative treatment concept that can be used to manually bend/rotate/push pathological, invisible bone "deformities" back into their original anatomical position in order to minimize the permanent tension/shear/pull on fascia and tendons and thus very successfully reduce or even eliminate chronic pain. [ABSTRACT FROM AUTHOR]

Introduction: Description of a new surgical procedure (percutaneous lengthening and arthroscopic release, PLAR) that combines all the possible interventions on the iliotibial band (ITB), and evaluates its outcomes in a group of distance runners diagnosed with ITBS. Methods: A prospective observational study was made of distance runners diagnosed with ITBS and operated upon using the PLAR technique between 1 and 2018 and 31 June 2020. The surgical technique is described in detail, and the demographic data and functional outcomes measured by the sports performance scales Activity Rating Scale (ARS) and International Knee Documentation Committee (IKDC) are presented. Results: A total of 14 patients were included, with a mean follow-up of 16 months (range 12–42 months). All the patients resumed their previous sporting activity after an average of 4 (range 2.5-6) months, and no complications were recorded. In all cases, statistically significant improvement was evidenced by the ARS and IKDC scales following PLAR (p < 0.001), with excellent outcomes in 71% of the cases according to the ARS scale and in 86% according to the IKDC scale (mean difference between preoperative and final follow-up scores of 12.1/16 and 34.2/100 points, respectively). Conclusion: The PLAR technique is effective in allowing a return to previous sports performance levels in a short period of time among patients with ITBS refractory to conservative management, with a high satisfaction rate and the absence of complications. [ABSTRACT FROM AUTHOR]

Background: Delivery workers repeatedly get in and out of trucks and walk or run to deliver packages during work. Iliotibial band syndrome (ITBS) is a well-known non-traumatic overuse injury of the lateral side of the knee caused by frequent knee flexion and extension. Hip muscle strength is among the factors that prevent lower extremity injuries. Although many studies have examined the relationship between ITBS and hip muscle strengths, there was no study comparing hip muscle strength and ratio between delivery workers with and without ITBS. Objects: This study aimed to compare hip muscle strength and hip internal/external rotator and adductor/abductor strength ratios between delivery workers with and without ITBS. Methods: Fourteen delivery workers with ITBS matched inclusion criteria in the present study among 20 participants. Because total sample size was required 28 subjects by G*power program (ver. 3.1.9.4; University of Trier), 14 delivery workers without ITBS were recruited. Hip muscle strengths were measured in a side-lying position using a Smart KEMA pulling sensor (KOREATECH Co. Ltd.). An independent t-test was used to compare hip muscle strengths and hip internal/external rotator and hip adductor/abductor strength ratios between delivery workers with and without ITBS. Results: The adductor/abductor strength ratio was significantly greater in delivery workers without ITBS than in those with ITBS (p < 0.05). The strengths of the hip abductor, hip adductor, hip internal rotator, hip external rotator, and the ratio of internal/external rotator strengths were not significantly different between the delivery workers with and without ITBS (p > 0.05). Conclusion: This study’s findings showed that delivery workers with ITBS had significantly lesser adductor/abductor strength ratio, while the strengths of the hip abductor and adductor muscles did not differ significantly. These results suggest that adductor/abductor strength ratio should be considered when evaluating and treating ITBS in delivery workers.

The iliotibial band corresponds to a longitudinal fibrous sheath located along the lateral region of the thigh and serves as an important structure involved in the movement of the lower limbs. Proximal iliotibial band syndrome is rarely reported in the medical literature, but it is a condition that occurs more frequently in runners, obese and elderly women, and can lead to limited patient movement. Biomechanical studies indicate that a greater relationship between the width of the pelvis and the length of the femur, which occurs in women, causes greater hip adduction, generating an overload on the lateral muscles in order to maintain the balance of the pelvis. We report the case of a 46-year-old woman with pain in the right hip for two years, worsening when walking and climbing stairs, whose ultrasound shows the lesion of the proximal insertion of the iliotibial band, diagnosing the syndrome of the proximal iliotibial band. [ABSTRACT FROM AUTHOR]

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Iliotibial band friction syndrome is an overuse knee injury that is more common in runners. In IT band syndrome, pain, and tenderness are present over the lateral aspect of the knee. It is more common in females because of physiological and anatomical factors. The objective of this research was to determine and compare the effect of proximal to distal postural correction protocol with conventional physiotherapy program for IT band friction syndrome in female amateur runners. This study included 150 female amateur runners with IT band friction syndrome based on inclusion and exclusion criteria. Then the subjects were randomly allocated into group A and group B by simple random sampling method. Group A was given proximal to distal postural correction protocol and for group B conventional physiotherapy exercise program was given. Outcome measures used were a visual analog scale, postural assessment, tenderness assessment by palpation and Ober's test. Pre and post-assessment of the above measures was taken to conform the results. The results showed a statistically significant effect of the proximal to distal postural correction protocol as compared to a conventional exercise program for IT band friction syndrome in female amateur runners. There was a significant reduction in pain (<0.0001) in individuals in group A than the group B. Postural abnormalities in IT band friction syndrome were also significantly (<0.0001) resolved and the Ober's test came as 76% negative out of 100%positive patients. Based on results, it was concluded that the proximal to distal postural correction protocol is effective in female amateur runners. [ABSTRACT FROM AUTHOR]

Iliotibial band syndrome (ITBS) is one of the most common overuse syndromes causing knee pain; it is especially prevalent in runners and also common in cyclists, rowers, and field athletes, with occasional cases occurring in non-athletes too. ITBS symptoms can negatively affect not only knee function, but also mental and physical aspects of health-related quality of life. Although various conservative treatment options have been investigated and discussed, there is still no consensus on a standard of care for ITBS. Moreover, the literature on the etiology and risk factors of ITBS, which could help in selecting appropriate treatment methods, is conflicting and inconclusive. The role of individual treatment modalities such as stretching and releasing techniques has not been extensively studied and remains unclear. In this article, we will critically review the available evidence for the benefits of ITB stretching and "release" methods in the treatment of ITBS. In addition to the direct evidence (clinical studies examining the effects of ITB stretching and other methods that purportedly stretch or "release" the ITB), we present several additional lines of reasoning that discuss the rationale for ITB stretching/releasing in terms of the etiology of ITBS, the mechanical properties and behavior of the ITB, and the risk factors for ITBS development. We conclude that the current literature provides some evidence for the inclusion of stretching or other "release" methods in the early rehabilitation of ITBS. Long-term interventions typically include ITB stretching; however, it remains unclear to what extent stretching within a multimodal treatment actually contributes to resolving the symptoms. At the same time, there is no direct evidence to suggest that stretching and "release" methods have any negative effects. [ABSTRACT FROM AUTHOR]

It is unknown if female runners who have sustained multiple iliotibial band syndrome occurrences run differently compared with runners who developed the injury once or controls. Therefore, the purpose of this study was to determine if differences existed in coordination patterns and coordination variability among female runners with recurrent iliotibial band syndrome, 1 iliotibial band syndrome occurrence, and controls. Overground running trials were collected for 36 female runners (n = 18 controls). Lower extremity coordination patterns were examined during running via a vector coding analysis. Coordination variability was calculated via the ellipse area method. Separate 1-way (group) Kruskal--Wallis tests were performed to compare each coordination pattern and coordination variability. Lower extremity coordination between frontal plane hip--transverse plane hip, frontal plane pelvis--frontal plane thigh, and frontal plane thigh--transverse plane shank was similar among groups and so may not be related to the risk of iliotibial band syndrome. Runners with 1 iliotibial band syndrome occurrence demonstrated greater coordination variability for 2 of 3 couplings compared with both controls and runners with recurrent iliotibial band syndrome. Thus, the number of previous injury episodes may influence coordination variability in female runners with a history of iliotibial band syndrome. [ABSTRACT FROM AUTHOR]

In this dynamic scanning protocol, ultrasound examination of the knee is described using various maneuvers to assess different conditions. Real-time patient examination and scanning videos are used for better simulation of the daily clinical practice. The protocol is prepared by several/international experts in the field of musculoskeletal ultrasound and within the umbrella of European Musculoskeletal Ultrasound Study Group in Physical and Rehabilitation Medicine/Ultrasound Study Group of the International Society of Physical and Rehabilitation Medicine. [ABSTRACT FROM AUTHOR]

Background. Plantar heel pain (PHP) is a degenerative plantar fascia syndrome that causes irritation under the heel and a functional deformity during weight bearing. Myofascial involvement, along with biomechanical changes due to tight fibrous connections, seems to contribute to this condition. As there is a fascial connection between plantar fascia, and iliotibial band, trigger points in the myofascial chain including iliotibial band can interfere with biomechanical modifications and aberrant lower limb functioning. The study aimed at establishing the associating iliotibial band (ITB) trigger points in plantar heel pain patients. Methods. The study included 30 individuals with plantar heel pain of both genders. They were assessed by foot posture index (FPI) for the foot type and manually palpated for trigger points along the Iliotibial band on both the affected and unaffected side. Results. The results revealed 73% prevalence of iliotibial band trigger points in plantar heel pain patients. And there was a significant association was found between trigger points and plantar heel pain (p < 0.001). Conclusions. The current investigation found an association between the existence of iliotibial band trigger points and plantar heel pain. So, addressing the iliotibial band trigger points may help in reducing pain and discomfort in plantar heel pain individuals. [ABSTRACT FROM AUTHOR]

Background: To evaluate the feasibility, inter-reader reliability, and intra-reader reliability for various morphological features reported to be related to iliotibial band friction syndrome (ITBFS) on knee magnetic resonance imaging (MRI). Methods: A total of 145 patients with a clinical diagnosis and knee MRI findings consistent with ITBFS were included in the "study group" and 232 patients without knee pathology on both physical examination and MRI were included in the "control group". Various morphologic features on knee MRI were assessed including the patella shape, patella height, lateral epicondyle anterior-posterior (AP) width, lateral epicondyle height, ITB diameter (ITB-d), and ITB area (ITB-a). Results: Patients in the study group had significantly higher lateral epicondyle height (13.9 mm vs. 12.92 mm, P = 0.003), ITB-d (2.9 mm vs. 2.0 mm, P = 0.022), and ITB-a (38.5 mm² vs. 23.8 mm2, P < 0.001) than the control group. ITB-a showed higher area under the curve index (0.849 with 74.1% sensitivity and 72.4% specificity at a 30.3 mm2 cutoff) than ITB-d (0.710 with 70.8% sensitivity and 61.2% specificity at 2.4 mm cutoff) and lateral epicondyle height (0.776 with 72.4% sensitivity and 67.8% specificity at 13.4 mm cutoff). However, only the interreader agreement for ITB-a (intraclass correlation coefficient = 0.65) was moderate, while the agreements for other morphologic features were good or excellent. Conclusions: Lateral epicondyle height seems to be a reliable and feasible morphologic feature for diagnosis of ITBFS. [ABSTRACT FROM AUTHOR]

Iliotibial band syndrome (ITBS) is a common running related injury. While previous studies have evaluated the relationship between biomechanical variables and ITBS, most have found limited evidence, particularly with measures related to ground reaction force (GRF). The purpose of this study was to use a classification and regression tree (CART) analysis to determine whether the combination of GRF measures would be strongly associated in runners with ITBS. A cross-sectional study was performed at an outpatient center focused on running injuries. A convenience sample of 52 runners with ITBS, assessed between September 2012 and July 2022, were evaluated for eligibility, from which, 30 rearfoot strike runners with ITBS and no secondary running-related injuries were selected. Injured runners were matched to 30 healthy controls from a normative database. Each ran on an instrumented treadmill at a self-selected speed. GRF variables were calculated, including peak GRFs, loading rates, and impulses. CART analysis was performed to identify interactions between GRF data and runners with ITBS. An ROC curve was executed, to determine the accuracy of the model. Posterior GRF impulse (PGRFI), anterior GRF (AGRFI), peak anterior GRF (PAGRF), and vertical stiffness at initial loading (VSIL) all emerged as variables associated with ITBS in the CART analysis. The model was able to correctly identify 25 (83.3%) runners with ITBS and 25 (83.3%) controls. The area under the ROC curve (accuracy) was 0.87 (95% CI, 0.77–0.96; SE, 0.04; p < 0.001). In conclusion, interactions between GRF variables were associated with ITBS in runners. The best classification included interactions between PGRFI, AGRFI, AGRFP, and VSIL, using specific cut-off values. Loading rates were not independently associated with ITBS. [ABSTRACT FROM AUTHOR]

Iliotibial band syndrome is a common overuse injury that is twice as likely to affect female runners compared to male runners. It is unclear if there is a consistent running pattern and strength profile exhibited by female and male runners with iliotibial band syndrome. The purpose of this systematic review and meta-analysis was to determine if any differences existed in lower-extremity kinematics and hip strength between runners who retrospectively, currently, or prospectively had iliotibial band syndrome. Papers included must have reported three-dimensional kinematic running data and/or hip strength data that were statistically analyzed between runners that never developed iliotibial band syndrome and runners with iliotibial band syndrome. Meta-analysis was performed for each kinematic or strength variable reported in at least three studies. Female and male runners were analyzed separately and grouped into three cohorts (retrospective, current, prospective). Seventeen articles were included in this systematic review. Data from 10 cross-sectional studies were included for meta-analysis. Female runners with current iliotibial band syndrome exhibited smaller peak hip internal rotation angles and lower isometric hip abductor strength compared to controls. Although limited biomechanical evidence exists, risk factors for ITBS are different between female and male runners and may vary according to injury status. Specifically, transverse plane hip motion and hip abductor strength weakness may be biomechanical risk factors in female runners with current iliotibial band syndrome only. • It is unknown if iliotibial band syndrome affects female and male runners differently. • Currently injured female runners exhibit smaller peak hip internal rotation angles. • Currently injured female runners exhibit lower hip abductor strength. • More iliotibial band syndrome work must analyze female and male runners separately. [ABSTRACT FROM AUTHOR]

Background: As there has been an increasing incidence of anterior cruciate ligament (ACL) tears in children and adolescents in the past few decades, nonoperative management is seen to result in less favorable clinical outcomes, resulting in meniscal and cartilage damage, and arthritic changes. Despite the risk of iatrogenic physeal injuries with operative approach, several reconstruction options, such as physeal-sparing techniques for skeletally immature patients, are described to restore joint stability. Indications: We bring a combined extra-articular and intra-articular ACL reconstruction technique using autogenous iliotibial band (ITB), which is indicated for prepubescent patients (Tanner stages 1 or 2) with open physes, significant growth potential (≤11 years for girls and ≤12 years for boys) and smaller knees, where an all-epiphyseal ACL reconstruction would lack epiphyseal space Technique Description: The technique consists of a modified MacIntosh intra-articular and extra-articular ITB reconstruction, described by Micheli and further characterized by Kocher. The central portion of the ITB is harvested proximally (at least 15 cm) and left attached to Gerdy's tubercle distally. The harvested graft is brought from over-the-top posteriorly and passed under the intermeniscal ligament anteriorly through an epiphyseal groove on the tibia. Results: The outcomes shown for the Kocher ITB ACL reconstruction technique are favorable at a mean follow-up of 5.3 years: from 44 patients, 41 returned to sports involving cutting or pivoting, and the revision rate was low at 4.5%. Discussion/Conclusion: The awareness of physeal injury related to the operative treatment of ACL tears in the pediatric population has resulted in several physeal-sparing and physeal-respecting techniques of reconstruction. Some of these have shown to reduce the risk of physeal damage, maintaining stability and providing excellent functional outcomes, with low revision rates in long-term follow-up and minimal risk of growth disturbance. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication. Graphical Abstract This is a visual representation of the abstract. [ABSTRACT FROM AUTHOR]

Introduction and objective: The iliotibial band (ITB) is a complex structure located in the lateral part of the thigh and consists of longitudinally arranged fascial connective tissue. The aim of this study is to analyze the current literature regarding etiology, epidemiology, diagnosis, and conservative treatment of iliotibial band syndrome (ITBS). Materials and methods: PubMed database were searched. The criteria for qualifying the article for the review were the following keywords: running, iliotibial band syndrome, knee injuries, conservative treatment, physical therapy modalities. 11 articles from 2017 to 2022 were analyzed. The searches included systematic reviews, meta-analyses, randomized controlled trials, and review articles. Description of the state of knowledge: Iliotibial band syndrome is the most common cause of lateral knee pain in runners and cyclists. It is presumably caused by excessive tension in the iliotibial band. Excessive tension is the result of overuse disorder of the lateral knee. Key symptom of ITBS is sharp or burning pain in the region of the lateral femoral epicondyle.. Pain typically occurs during physical activity, after a reproducible time or distance of running. The diagnosis is achieved through taking clinical history and physical assessment. Summary: Treatment of ITBS is based on therapeutic exercise, manual therapy, neuromuscular re-education, modalities and anti-inflammatory medications. Eliminating modifiable risk factors helps prevent ITBS from recurring.

This paper reviewed the clinical data of 1 patient undergoing five-element cupping therapy for iliotibial band syndrome. Under the concept of Traditional Chinese Medicine syndrome differentiation, the five-element cupping therapy was carried out on Governor Vessel (GV), bladder meridian of Foot-taiyang, Yang-wei meridian and Yang-qiao meridian. The patient’s pain was relieved and walking distance was increased after treatment. (本文回顾1例髂胫束综合症患者行五行能量罐治疗的效果及护理措施。在中医辨证理论指导下, 取督脉、足太阳膀胱经、足少阳胆经、阳维脉、阳跷脉之经络, 运用五行能量罐循经治疗。治疗后患者疼痛明显减轻, 行走距离增加。)

Iliotibial band syndrome (ITBS) is one of the most common overuse syndromes causing knee pain; it is especially prevalent in runners and also common in cyclists, rowers, and field athletes, with occasional cases occurring in non-athletes too. ITBS symptoms can negatively affect not only knee function, but also mental and physical aspects of health-related quality of life. Although various conservative treatment options have been investigated and discussed, there is still no consensus on a standard of care for ITBS. Moreover, the literature on the etiology and risk factors of ITBS, which could help in selecting appropriate treatment methods, is conflicting and inconclusive. The role of individual treatment modalities such as stretching and releasing techniques has not been extensively studied and remains unclear. In this article, we will critically review the available evidence for the benefits of ITB stretching and “release” methods in the treatment of ITBS. In addition to the direct evidence (clinical studies examining the effects of ITB stretching and other methods that purportedly stretch or “release” the ITB), we present several additional lines of reasoning that discuss the rationale for ITB stretching/releasing in terms of the etiology of ITBS, the mechanical properties and behavior of the ITB, and the risk factors for ITBS development. We conclude that the current literature provides some evidence for the inclusion of stretching or other “release” methods in the early rehabilitation of ITBS. Long-term interventions typically include ITB stretching; however, it remains unclear to what extent stretching within a multimodal treatment actually contributes to resolving the symptoms. At the same time, there is no direct evidence to suggest that stretching and “release” methods have any negative effects.

Background: Running overuse injuries (ROIs) occur within a complex, partly injury-specific interplay between training loads and extrinsic and intrinsic risk factors. Biomechanical risk factors (BRFs) are related to the individual running style. While BRFs have been reviewed regarding general ROI risk, no systematic review has addressed BRFs for specific ROIs using a standardized methodology. Objective: To identify and evaluate the evidence for the most relevant BRFs for ROIs determined during running and to suggest future research directions. Design: Systematic review considering prospective and retrospective studies. (PROSPERO_ID: 236,832). Data Sources: PubMed. Connected Papers. The search was performed in February 2021. Eligibility Criteria: English language. Studies on participants whose primary sport is running addressing the risk for the seven most common ROIs and at least one kinematic, kinetic (including pressure measurements), or electromyographic BRF. A BRF needed to be identified in at least one prospective or two independent retrospective studies. BRFs needed to be determined during running. Results: Sixty-six articles fulfilled our eligibility criteria. Levels of evidence for specific ROIs ranged from conflicting to moderate evidence. Running populations and methods applied varied considerably between studies. While some BRFs appeared for several ROIs, most BRFs were specific for a particular ROI. Most BRFs derived from lower-extremity joint kinematics and kinetics were located in the frontal and transverse planes of motion. Further, plantar pressure, vertical ground reaction force loading rate and free moment-related parameters were identified as kinetic BRFs. Conclusion: This study offers a comprehensive overview of BRFs for the most common ROIs, which might serve as a starting point to develop ROI-specific risk profiles of individual runners. We identified limited evidence for most ROI-specific risk factors, highlighting the need for performing further high-quality studies in the future. However, consensus on data collection standards (including the quantification of workload and stress tolerance variables and the reporting of injuries) is warranted. [ABSTRACT FROM AUTHOR]