condition of the week - ilio-tibial band syndrome

Ilio-Tibial Band Syndrome Prevention and RehabilitationPrevention and Rehabilitation

Mark J Pitcher DC, MScchiropractor, exercise physiologist

www.markjpitcher.com www.vailhealth.com

Ilio-tibial band

A tract of thickened fascia that arises • Anteriorly off the tensor fascia lata

Tensor fascia lata

Ilio-tibial band

A tract of thickened fascia that arises • Anteriorly off the tensor fascia lata• In the middle off the iliac crest •

Iliac crest

Ilio-tibial tract

Ilio-tibial band

A tract of thickened fascia that arises • Anteriorly off the tensor fascia lata• In the middle off the iliac crest • Blends posteriorly with the glutes

Iliac crest

Ilio-tibial tract

Gluteus Maximus

Ilio-tibial band

A tract of thickened fascia that inserts

• distally at Gerdy’s tubercle

Ilio-tibial band

It’s important to remember that the fascia around the thigh is continuous and is just thickened into the ilio-tibial band (IT band) at the lateral aspect of the thigh.

Ilio-tibial band Syndrome

Pain is usually located at the distal aspect of the tract, just above the joint line of the knee

Ilio-tibial band Syndrome

Muscle imbalance of weak glutes coupled with overactive tensor fascia lata and adductor musculature creates a fascial pull

that draws the ilio-tibial band anteriorly.

This creates increased friction over the lateral femoral condyle and

ultimately inflammation

and pain.

ITB Treatment:

Success of treatment depends on severity and ability to modify current activity.

RICE: Rest, Ice,

Compression,

Elevation

Addressing Mechanical Deficits Sacroiliac joint dysfunction Pronation Talo-calcaneal dysfunction Internal rotation at the tibia

Myofascial soft tissue work

ARTGraston

Foam Roller

ITB Treatment:

Success of treatment depends on severity and ability to modify current activity.

Iontophoresis using electrical stimulation todeliver steroid into the tissue

Local steroid

injection

Surgical Release considered a last resort only if all conservative methods fail.

Dry Needling

ITB Treatment:

Success of treatment depends on severity and ability to modify current activity.

Foam RollingGlutesITB

Adductors

Stretching Gluteus medius

Tensor fascia lata

ExerciseGluteus Maximus

Gluteus Medius

GlutesGlutes

Self Care:Self Care: Foam RollingFoam Rolling

Glutes Glutes GlutesGlutes

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Glutes Glutes GlutesGlutes

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Piriformis and Piriformis and external hip rotatorsexternal hip rotators

(part of the glutes)(part of the glutes)

Piriformis and external hip rotators Piriformis and external hip rotators

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Glutes/PiriformisGlutes/PiriformisPiriformis and external hip rotators Piriformis and external hip rotators

22

AdductorsAdductors(groin / inside of leg)(groin / inside of leg)

AdductorsAdductors

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CalvesCalvesAdductorsAdductors

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Ilio-tibial band Ilio-tibial band

(outside of leg)(outside of leg)

Very tender in most athletes, especially runners

IT bandIT band

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IT bandIT band

22

Self Care:Self Care: Sample ExercisesSample Exercises

What exercises are appropriate depends on What exercises are appropriate depends on the particular needs of the patient. the particular needs of the patient.

The following are examples of some The following are examples of some exercises we prescribe in the office. exercises we prescribe in the office.

Hip HikeHip Hikeglute mediusglute medius

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SL Glute BridgeSL Glute Bridgeglute max strengthglute max strengthhip flexor stretch hip flexor stretch

Crab WalkCrab Walk

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TFL stretchesTFL stretches

Mark J Pitcher DC, MScchiropractor, exercise physiologist

www.markjpitcher.com www.vailhealth.com