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Iliotibial band contracture/ IT band friction syndrome

  • What is the Iliotibial band contracture /IT band friction syndrome
    • IT band contracture : IT band thickening and tight, usually combine with TFL and/or Gluteus maximus tightness
    • IT band friction syndrome : It is inflammation and pain where the iliotibial band crosses the lateral femoral condyle
  • Cause
    • acitivities or occupations that place the knee and hip in flexion
      • exmaples ; cylcling, horseback riding, prolonged sitting
    • postural imbalances : hyperlordosis
    • prolonged wheelchair use or bedrest
  • Symptoms
    • Pain ; gradual at onset and worse with activity(by knee flexion and extension ). along the lateral thigh and into the lateral aspect of the knee. The pain of IT band friction syndrome is directly over the lateral femoral condyle and is worse on activity.
    • shortening of the iliotibial band
    • thickening, adhesion and possible fibrositic nodules on IT band
    • inflammatino is possible over the lateral femoral condyle
    • anterior pelvic tilt
    • valgus or hyperextension of the affected knee
    • secondary trochanteric bursitis can develop
  • Muscles’s change
    • Tight muscles
      • TFL
      • Gluteus maximus
      • Quadriceps
      • Sartorius
      • Iliopsoas
      • QL
    • Weak muscles
      • Adductors
      • Lateral rotators except piriformis
  • SOAP
    1. Subject information : health history
      • Occupation
      • Activity : ex) long time cycling or running
      • Pregnacny
    2. Objective information
      1. Observation
        1. Postural Assessment : knee hypertension, hyperlordosis, pes planus
        2. Palpation
          1. Tenderness on the distal third of IT band and at the greater trochanter
          2. IT band friction syndrome : heat, swelling and tenderness on the lateral femoral condyle
        3. Testing
          1. ROM : Reduced ROM of hip adduction, Knee extension is always painfyl with IT band friction syndrome
          2. Special test
            1. Ober’s test : To check shortness of tensor fascia lata or IT band
            2. Noble’s test : To check IT band friction syndrome
    3. Treatment Plan
      1. Hydrotherapy
        1. Deep moist heat for pre treatment application
        2. Cold : when inflammation exist
      2. For shortend and tight muscles : TFL, Gluteus maximus, Quadriceps, Sartorius, Iliopsoas
        1. Heat
        2. Massage techniques
          1. Deep fascial work : Tensor fascia lata and IT band (lateral thigh)
          2. Trigger points release : TFL, Gluteus maximus, Vastus lateralis
          3. Friction on distal of IT band when inflammation has subsided
        3. Joint play
        4. Passive stretch
          1. TFL, Gluteus maximus, Quadriceps, Sartorius, Iliopsoas
      3. For loosen and weak muscles : Adductors, Lateral rotators except piriformis
        1. Cold
        2. Stimulating massage techniques
        3. Tapotement
      4. Remedial exercise
        1. Self Stretch : TFL, Gluteus maximus, Quadriceps, Sartorius, Iliopsoas
        2. Strengthen weak muslces : Adductors, Lateral rotators except piriformis
        3. Tips of daily acitity
          1. Avoid maintaining one position for prolonged periods
          2. Chair and seats should have adsquate lumbar support
          3. When sitting, client’s femurs should be horizontal to the ground to maintains normarl lordosis.
          4. client make an effort to maintain an increased posterior pelvic tilt
          5. Avoid sleeping with the hips in flexion
    4. Example of the IT band syndrome treatment
      • Trigger point : Vastus lateralis
      • Friction : distal part of IT band
      • G3 anterior glide : tibiofemoral joint
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Pelvis and Thigh Trail Guide - Test for Massage Therapist
3 years ago

[…] IT band syndrome […]

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