- An overuse injury characterized by pain on the outside part of the knee
- Pain can be experienced during activity or at rest with the knee bent
- Common in runners but also seen in hikers and cyclists
- Some debate over ‘friction’ and exact pathology
- Likely some inflammation/irritation of connective tissue on the outside of the knee
- ITB attached to gluteus max and tensor fascia latae (TFL), runs along the length of the femur and attaches to the lateral condyle of the tibia
- Contributes to lateral knee stability
- *Very unlikely to be able to stretch it*
- May behave like a tendon in storing and releasing energy
- Potential most vulnerable range is 30-40 degrees of knee flexion when ITB may cross lateral femoral condyle
Unmodifiable Intrinsic Risk Factors
- Gender – although yet to be proven it is thought females have a higher likelihood of developing ITBS due to anatomical differences
- Genu varum (Bow leggedness)
- May overlap with anterior knee pain/patella femoral pain syndrome
Modifiable Intrinsic Risk Factors (*Best evaluated by a Physiotherapist*)
- Reduced control of hip adduction/internal rotation
- Reduced glute med strength
- Biomechanical abnormalities – foot alignment/pronation
- Weight (Increased BMI)
- Muscle imbalance and inflexibility
- Leg length discrepancy (LLD)
- A true LLD can be modified with appropriate foot lift orthotic
- A functional LLD can be modified with better muscular control and/or orthotics if necessary
Extrinsic Risk Factors (*Best evaluated by an MPT Physiotherapist*)
- Change in loading
- Return to running or activity after a break
- Training errors
- Change in training type (i.e. increased downhills for runners and hikers)
- Increase in training volume/intensity too quickly
- Change in training duration
- Increase in training frequency
- Change in weekly distance
- Running style
- Narrow step width
- Slower cadence
- Footwear – if not supportive enough to prevent over pronation
Treatment…To Be Continued.
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Brindle, R. A. (2018). Physiological and Biomechanical Factors Contributing to the Hip Adduction Angle in Female Runners (Doctoral dissertation, Drexel University).
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