Iliotibial band syndrome
The runner's knee or Ilio - tibial band syndrome ( ITBS ) or Tractussyndrom is a widespread pain syndrome that occurs from overuse of the musculoskeletal system, especially in runners.
Anatomy
The iliotibial band is a Faszienstreifen, that is a broadly expansive chord-like skin to the muscles that support the muscles on the outside of the thigh and the iliac crest moves down and is anchored at the head of the tibia.
The pain occurs when the iliotibial band at the Gelenksvorwölbung of the thigh ( epicondyle ) - similar to a rope along a cliff edge - rubs. Especially in long distance runners, this friction lead to congestion and irritation of the periosteum and of the bursa. The pain syndrome itself is known to many long-distance runners and cyclists. ITBS is the most common cause of pain in the outer side of the knee ..
While the runner's knee is identical to the Ilio - tibial band syndrome in the German-speaking world ( chondromalacia patellae ) and the Iliotibial band syndrome is distinguished in the Anglo-American space between the Runner's Knee.
Causes
Ultimate cause of the pain syndrome is a permanent load on the musculoskeletal system, as is common in long- distance running or cycling. Benefiting it is ( bow legs ) by varus leg axis. Furthermore, a weakness of the pelvic stabilizers promote the occurrence of ITBS. The non-loaded hip drops and there is an excessive train on tract. An over - supination of the foot during running, different leg lengths and a shortened inflexible muscles, especially on the outer side of the thigh, are more anatomical factors that may favor a runner's knee. Too frequent workouts on outward sloping streets, a faster training to build and too many fast workouts, however, are methodological causes of runners knee.
Symptoms
The stabbing pain on runner's knee can be so strong that they make walking impossible and even normal walking is greatly hindered. Frequently observed the pain at first only when running and then even while walking. The pain emanating from the epicondyles are usually projected in the knee or the outside of the shin bone. The reason for this is that the iliotibial band moves to the head of the tibia. The pain projection in the direction tibial means that the cause is often misdiagnosed.
Diagnosis
The disease can range from a relatively simple doctor, be diagnosed without imaging (x-ray or magnetic resonance imaging ). Here, the area is where the iliotibial band slides over the femur, easy to feel.
In less clear cases ITBS is distinguished from knee injury with similar symptoms. Among other tendonitis and meniscal damage and arthritis can cause similar symptoms on the outer knee joint in this area, for example.
Therapies
In the acute onset of pain, cryotherapy ( " ice packs " ), anti-inflammatory ointments or plasters and a break from training is very helpful. Stretching exercises for the tract and strengthening exercises of the pelvic stabilizers as well as the abdominal and back muscles have a preventive effect. Good walking shoes, warm-up and stretching exercises before a longer exposure can also prevent the occurrence of the pain syndrome. After three to six weeks, the injury is usually healed.
Too early or too strong onset of re- loading of the knee can lead to a so-called " injury cycle" ( cycle injury ) can occur. In bowlegged customized inserts are very helpful. The frequently encountered in running shoes restraints on the inner edge shall be removed.
Is physiotherapy treatment is unsuccessful, a cortisone injection is administered frequently.
Surgery
As a last resort, when all treatment measures listed above have failed, there is still the possibility of surgical intervention. Here, the tract is lengthened by a Z-shaped incision, thereby offloading.