Conservative care options for Iliotibial band syndrome: REST and activity avoidance
Conservative care options for Iliotibial band syndrome: PRICE
Conservative care options for Iliotibial band syndrome: Anti-inflammatories and pain medications
Conservative care options for Iliotibial band syndrome: Foam rollers, stretching
Conservative care options for Iliotibial band syndrome: Physical therapy and exercise, massage
A March 2022 paper (1) discusses conservative care treatments for ITBS: “Iliotibial band syndrome (ITBS) is presumably caused by excessive tension in the iliotibial band (ITB) leading to compression and inflammation of tissues lying beneath it. Usually managed conservatively, there is a lack of scientific evidence supporting the treatment recommendations, and high symptom recurrence rates cast doubt on their causal effectiveness. . . The potential pathogenic factors are presented on the basis of a simple biomechanical model showing the forces acting on the lateral aspect of the knee. . . .ITBS may be promoted by anatomical predisposition, joint malalignments, aberrant activation of inserting muscles as well as excessive ITB stiffness. Hip abductor strengthening may correct excessive hip adduction but also increase ITB strain. Intermittent stretching interventions are unlikely to change the ITB’s length or mechanical properties. Running retraining is a promising yet understudied intervention.”
A September 2020 paper (3) tested the hypothesis that Iliotibial Band Syndrome (ITBS) is caused by excessive iliotibial band (ITB) tension, promoted by hip abductor and external rotator weakness. Then patients were evaluated to see if 6 weeks of physiotherapy on ITB stiffness helped them. To see if the physical therapy helped these patients, the researchers used Ultrasound shear wave elastography (to demonstrate stiffness or elasticity in the tendon and the muscles). Participants: 14 recreational runners with ITBS and 14 healthy controls of both sexes.
Results: “No statistical differences in ITB tension between legs as well as between patients suffering from ITBS and healthy controls were detected. Results showed significant strength deficits in hip abduction, adduction as well as external and internal rotation. Following six weeks of physiotherapy, hip muscle strength (all directions but abduction), pain and lower extremity function were significantly improved. ITB stiffness, however, was found to be increased compared to baseline measurements. . . Shear wave elastography data suggest that ITB tension is not increased in the affected legs of runners with ITBS compared to the healthy leg or a physical active control group, respectively. Current approaches to the conservative management of ITBS appear ineffective in lowering ITB tone. ”
Conservative care options for Iliotibial band syndrome: Posture training
Conservative care options for Iliotibial band syndrome: Cortisone injections
Surgery for Iliotibial band syndrome: Bursectomy and IT Band release
A paper from August 2022 (2) writes: “Multiple surgical techniques have been described to treat refractory ITBS, such as a posterior triangular resection of the iliotibial band, elliptical resection, transverse sectioning of the posterior half, multiple punctures of the band, or the mesh technique, isolated bursectomy, digastric release from Gerdy’s tubercle, and the Z-plasty lengthening technique. Despite the broad range of surgical procedures, the Z-plasty lengthening and bursectomy technique appears as an attractive procedure that combines the treatment of 2 of the most accepted pathophysiologic mechanisms. On the one hand, it lengthens the ITB, decreasing the friction between the band and the lateral epicondyle. On the other hand, removing the inflammatory tissue, especially the bursae, reduces pain and inflammation. Due to its broader approach, this merging surgical technique should be a more appropriate method to treat refractory ITBS.”
Bursectomy and IT Band release outcomes and complications
Regenerative medicine injections for Iliotibial band syndrome:
Regenerative medicine injections for Iliotibial band syndrome: Stem cell therapy
Regenerative medicine injections for Iliotibial band syndrome: Donated cell therapy
Regenerative medicine injections for Iliotibial band syndrome: Platelet Rich Plasma therapy
Regenerative medicine injections for Iliotibial band syndrome: Prolotherapy
1 Friede MC, Innerhofer G, Fink C, Alegre LM, Csapo R. Conservative treatment of iliotibial band syndrome in runners: Are we targeting the right goals?. Physical Therapy in Sport. 2021 Dec 27.
2 Vaisman A, Guiloff R, Andreani D. Knee Iliotibial Band Z-Plasty Lengthening and Bursectomy Technique. Arthroscopy techniques. 2022 Aug 1;11(8):e1381-5.
3 Friede MC, Klauser A, Fink C, Csapo R. Stiffness of the iliotibial band and associated muscles in runner’s knee: assessing the effects of physiotherapy through ultrasound shear wave elastography. Physical Therapy in Sport. 2020 Sep 1;45:126-34.