Medline ® Abstracts for References 4-6
of 'Iliotibial band syndrome'
Iliotibial band friction syndrome--a systematic review.
Ellis R, Hing W, Reid D
Man Ther. 2007 Aug;12(3):200-8. Epub 2007 Jan 8.
Iliotibial band friction syndrome (ITBFS) is a common injury of the lateral aspect of the knee particularly in runners, cyclists and endurance sports. A number of authors suggest that ITBFS responds well to conservative treatment, however, much of this opinion appears anecdotal and not supported by evidence within the literature. The purpose of this paper is to provide a systematic review of the literature pertaining to the conservative treatment of ITBFS. A search to identify clinical papers referring to the iliotibial band (ITB) and ITBFS was conducted in a number of electronic databases using the keyword: iliotibial. The titles and abstracts of these papers were reviewed to identify papers specifically detailing conservative treatments of ITBFS. The PEDro Scale, a systematic tool used to critique randomized controlled trials (RCTs), was employed to investigate both the therapeutic effect of conservative treatment of ITBFS and also to critique the methodological quality of available RCTs examining the conservative treatment of ITBFS. With respect to the management of ITBFS, four RCTs were identified. The interventions examined included the use of non-steroidal anti-inflammatory drugs (NSAIDs), deep friction massage, phonophoresis versus immobilization and corticosteroid injection. This review highlights both the paucity in quantity and quality of research regarding the conservative treatment of ITBFS. There seems limited evidence to suggest that the conservative treatments that have been studied offer any significant benefit in the management of ITBFS. Future research will need to re-examine those conservative therapies, which have already been examined, along with others, and will need to be of sufficient quality to enable accurate clinical judgements to be made regarding their use.
Health Rehabilitation Research Centre, Division of Rehabilitation and Occupation Studies, Faculty of Health&Environmental Sciences, AUT University, Auckland, New Zealand.
The nature and response to therapy of 196 consecutive injuries seen at a runners' clinic.
Pinshaw R, Atlas V, Noakes TD
S Afr Med J. 1984;65(8):291.
We studied a series of 196 running injuries to determine the nature of the common injuries, the type of runners with the different injuries, specific factors causing the most common injuries, and the response of these injuries to correction of the biomechanical abnormalities believed to cause them. The four commonest injuries were 'runner's knee' (peripatellar pain syndrome) (22%), 'shin splints' (posterior tibial stress syndrome) (18%), the iliotibial band friction syndrome (12%), and chronic muscle injuries (11%). Within 8 weeks of following the biomechanically based treatment regimen, between 62% and 77% of the runners with the commonest injuries were completely pain-free and running almost the same training distance as before injury. Only 13% of runners were not helped at all, but most of these had not adhered to the prescribed treatment. The response of the iliotibial band syndrome to treatment was less predictable, however, and some runners who followed the advice faithfully were not helped. These data therefore confirm the importance of biomechanical factors in running injuries and indicate that practitioners involved in the care of injured runners need to know not only how to diagnose the conditions accurately but also which running shoes are appropriate for the different running injuries, how to detect subtle lower limb structural abnormalities, in particular foot abnormalities and leg-length inequalities, and when to prescribe in-shoe orthoses.
A retrospective case-control analysis of 2002 running injuries.
Taunton JE, Ryan MB, Clement DB, McKenzie DC, Lloyd-Smith DR, Zumbo BD
Br J Sports Med. 2002;36(2):95.
OBJECTIVE: To provide an extensive and up to date database for specific running related injuries, across the sexes, as seen at a primary care sports medicine facility, and to assess the relative risk for individual injuries based on investigation of selected risk factors.
METHODS: Patient data were recorded by doctors at the Allan McGavin Sports Medicine Centre over a two year period. They included assessment of anthropometric, training, and biomechanical information. A model was constructed (with odds ratios and their 95% confidence intervals) of possible contributing factors using a dependent variable of runners with a specific injury and comparing them with a control group of runners who experienced a different injury. Variables included in the model were: height, weight, body mass index, age, activity history, weekly activity, history of injury, and calibre of runner.
RESULTS: Most of the study group were women (54%). Some injuries occurred with a significantly higher frequency in one sex. Being less than 34 years old was reported as a risk factor across the sexes for patellofemoral pain syndrome, and in men for iliotibial band friction syndrome, patellar tendinopathy, and tibial stress syndrome. Being active for less than 8.5 years was positively associated with injury in both sexes for tibial stress syndrome; and women with a body mass index less than 21 kg/m(2) were at a significantly higher risk for tibial stress fractures and spinal injuries. Patellofemoral pain syndrome was the most common injury, followed by iliotibial band friction syndrome, plantar fasciitis, meniscal injuries of the knee, and tibial stress syndrome.
CONCLUSIONS: Although various risk factors were shown to be positively associated with a risk for, or protection from, specific injuries, future research should include a non-injured control group and a more precise measure of weekly running distance and running experience to validate these results.
Allan McGavin Sports Medicine Centre, Department of Family Practice and School of Human Kinetics, University of British Columbia, Vancouver, BC, Canada. firstname.lastname@example.org