Pathophysiology and classification of iliotibial friction injuries

As a result of the frequent endurance sports that are being practiced nowadays, many techniques have been introduced to this field with favorable outcomes regarding to the management approaches of the different injuries. However, no previous investigations have adequately discussed the pathophysiology of iliotibial band friction syndrome (ITBS) based on recent evidence from the current studies in the literature. In the present investigation, we have discussed the pathophysiology and related classification of iliotibial band friction injuries based on the current studies in the literature. The current evidence about the pathophysiology of the condition is still controversial, although epidemiological investigations indicate that ITBS is becoming a more prevalent condition among runners and other endurance athletes. Furthermore, many factors can attribute to the development of the condition and have been reported to take essential roles in the pathophysiology of the disease. Some of these factors include gender, iliotibial band tightness, rearfoot eversion and weak hip abductors. Further investigations are still needed to completely understand the pathophysiology of the disease to help clinicians aim to achieve better interventions to enhance the outcome of practicing endurance and excessive exercises.

Iliotibial Band Pathology: Synthesizing the Available Evidence for Clinical Progress

The current paradigm of practice concerning insidious lateral knee pain involving the iliotibial band in repetitive knee flexion activities has been presented as iliotibial band friction syndrome since 1974. Renne's original model for ITB pain was based on a limited or incorrect understanding of the relevant anatomy, biomechanics, and tissue science, which gradually led to a plethora of frustrating and ineffective interventional strategies. Mounting evidence from arthroscopic, cadaveric and biomechanical studies, as well as from diagnostic imaging and histology reports helps deconstruct this long-held paradigm for ITB related pathology and treatment. Using an archeological approach to gather relevant evidence, this clinical update synthesizes the available data in order to present an updated, more informed model for understanding and treating insidious onset related ITB related pathology. The result is a new, more informed paradigm called Iliotibial Band Impingement Syndrome.

Measurement of iliotibial band diameter in iliotibial band friction syndrome and comparison with an asymptomatic population

Background Iliotibial band friction syndrome (ITBFS) is an overuse injury of the lateral aspect of the knee. This syndrome classically affects the active young population. Purpose To determine the diameter of the ITB using magnetic resonance imaging (MRI) in patients clinically diagnosed with ITBFS, compare the results with asymptomatic patients, and assess the inter-observer agreement between a senior and a junior radiologist with different levels of experience in musculoskeletal imaging. Material and Methods From April 2014 to October 2019, 78 knee MRI scans of 78 patients were included in the study group who were referred from the orthopedic clinic with a clinical diagnosis of ITBFS. In the control group, there were 114 knee MRI scans of 114 patients who had knee MRI for various reasons and had no radiological abnormality on the performed knee MRI. The ITB diameters, cut-off values, and interclass correlation coefficient (ICC) were calculated. Results Mean thickness of the ITB was higher in the study group compared to the control group in measurements done by both the senior and junior radiologists and this was statistically significant ( P < 0.001). Cut-off values of the diameters of the ITB were calculated as 2.385 for the senior radiologist and 2.420 for the junior radiologist. ICC of 0.80 was determined, which showed excellent agreement among interpreters. Conclusion ITB thickness in the study group was significantly higher than in the control group. There was also excellent agreement among the two observers. Measurement of ITB thickness on axial plane knee MRI is one of the reliable criteria for ITBFS.

Analysis of Running-Related Injuries: The Vienna Study

Background: This study aimed to provide an extensive and up-to-date analysis of running-related injuries (RRI) and analyze a broad range of contributing factors for a large heterogeneous and non-selected running population from Central Europe. Methods: Anthropometric, training, footwear, anatomic malalignment, and injury data from 196 injured runners were assessed case-controlled and retrospectively. Univariate and multivariate regression models were developed to identify associated factors for specific injury locations and diagnoses. Results: The majority of patients were female (56%). Three most frequently observed malalignments included varus knee alignment, pelvic obliquity, and patellar squinting. The most common injuries were the patellofemoral pain syndrome (PFPS), the iliotibial band friction syndrome (ITBFS), patellar tendinopathy, spinal overload, and ankle instability. A number of contributing factors were identified. Previous injury history was a contributing factor for knee injuries and ITBFS. Lower training load was reported with a higher incidence of PFPS, while a higher training load was positively associated with injuries of the lower leg. Runners with a higher body mass index (BMI) were at a significantly higher risk for lower back injuries. Conclusions: Running-related injuries are multifactorial associated with a combination of variables including personal data, training load, anatomic malalignments, and injury history. They can furthermore result from a lack of experience/training as well as from overuse. Suffering a specific RRI of high risk could be defined based on individual predispositions and help to induce appropriate training balance.