Iliotibial band syndrome
The iliotibial band is a long strip of fibrous tissue connecting the hip to the knee. Before reaching its attachment point on the tibia, this strip passes over the lateral condyle of the femur. At this place, it can happen that it "rubs" excessively on it, causing irritation of the area.
1) A LITTLE ANATOMY:
The iliotibial band is a long strip of fibrous tissue connecting the hip to the knee. More specifically, it starts from the tensor fascia lata (TFL) muscle and ends at the level of the tibia (Gerdi’s tubercle).
2) What are the lesional mechanisms?
Before reaching its attachment point on the tibia, this strip passes over the lateral condyle of the femur. At this place, it can happen that it “rubs” excessively on it, causing irritation of the area.
This usually occurs during knee flexion movements (friction at +/- 30 degrees of flexion). It is therefore at this angle that the irritation between the BIT and the lateral condyle of the femur is at its maximum.
The causes of triggering this irritation are therefore regularly the same:
Sudden change in training volume or intensity
Unsuitable equipment (worn shoes, etc.)
Poor motor control and muscle weakness
Bad technique in the sporting gesture
3) WHAT ARE THE SYMPTOMS?
This type of injury can appear gradually or following a specific event. The intensity of the problem will produce more or less severe symptoms. Among these are:
A precise and localized pain a few centimeters above the external face of the knee, accentuated with running and reduced at rest
Muscle tension, which can be felt in the thigh or even up to the hip
In more severe cases, this pain may be constant and present even at rest.
4) IS IT SERIOUS?
The BIT syndrome is a pathology frequently encountered in athletes, especially runners. It’s usually relatively easy to get rid of with early treatment.
However, it can become problematic and more difficult to treat when the irritation has been present for longer, and when the intensity is high.
5) IS SURGERY AN OPTION?
The surgical procedure remains exceptional and will only be considered in the event of repeated failures of conservative treatments or in the event of complications linked to the absence or poor initial treatment.
6) CAN I CONTINUE TRAINING? WHAT REFLEXES SHOULD I TAKE?
This pathology needs to be taken seriously from the start in order to avoid complications and aggravations.
At the onset of the first symptoms, a temporary cessation of activities that cause pain is recommended. These activities can be replaced by others, which unload the area and do not recreate the pain.
Finally, refrain from applying ice and taking anti-inflammatories, as these methods generally interfere with the healing of the strip.
Then, it is the importance of the symptoms and the improvement of the situation that will determine the duration of the relative cessation of the activity. The best option should be discussed with your doctor.
7) HOW DOES THE REHABILITATION TAKE PLACE?
The physiotherapy sessions start by paying attention to the painful symptomatology of the subject. Respecting this, work will focus on:
The work of joint mobility and tissue flexibility
Gradual restoration of the affected lower limb
Global and specific muscle strengthening (strength, neuromuscular control, stability, etc.)
Re-athletics and getting back into sport (with technical work if necessary)
8) WILL I RETURN TO MY PRE-INJURY LEVEL?
This pathology, although having a favorable prognosis, needs to be taken seriously from the start.
However, provided you follow the instructions and recommendations provided by your surgeon and your therapist, you will return to a normal sports activity.
9) WHAT CAN I DO TO SPEED UP THE PROCESS?
You are the main actor of your rehabilitation!
In order to speed up the healing process, be sure to follow the recommendations of the health professionals with whom you work.
Laziness or, on the contrary, overzealousness, will be your enemies.
Conversely, discipline, rigor, perseverance as well as a positive and voluntary state of mind will help you get back in top shape as soon as possible!