• The Korean Journal of Pain
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• v.26 no.4
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• pp.387-391
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• 2013

A 64-year-old woman visited our pain clinic with the pain of right lateral side of thigh for one year. Her pain always started from knee and was radiated to buttock area when symptom was severe. She showed significant tenderness at knee lateral side and local tightness at lateral thigh. Magnetic resonance image of the knee was performed and we could identify high signal intensity of iliotibial band through coronal and axial view. In spite of medication and physical stretching exercise of iliotibial band for one month, she did not show any improvement of pain. To alleviate her symptom, ultrasound guided local corticosteroid injection targeting beneath the iliotibial band was performed. After the procedure, the reduction of pain was significant and there was no need for further management.

• Journal of International Academy of Physical Therapy Research
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• v.10 no.4
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• pp.1879-1888
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• 2019

Background: The treatment of pain in the iliotibial band friction syndrome has been difficult to determine, according to studies to date. However, recent studies have suggested that flexibility in the subacute stage of pain in the iliotibial band friction syndrome may help reduce pain. Objective: To investigate the immediate effect on pressure pain threshold and flexibility of the tensor fascia latae and iliotibial band by applying static and dynamic myofascial release foam rolling and self-stretching to adults with shortening iliotibial band. Design: Randomized controlled trial Methods: In this study, 50 subjects who were selected in advance as a randomized controlled trial were randomly allocated using a R Studio program. The included subjects were randomly allocated to three intervention groups. The static self-myofascial release 18 people, dynamic self-myofascial release group 16 people separated the self-stretching group 16 people and conducted a homogeneity check in advance. Before the start of the experiment, after of the experiment, 5 minutes after the end of the experiment, the pressure pain threshold and flexibility change for each part were measured. Results: The results of this study showed that the static self-myofascial release showed a significant difference in the pressure pain threshold in the tensor fascia latae and middle, lower part of the iliotibial band, compared with the other intervention groups (p<.05). In change of flexibility, the static self-myofascial release was significantly different than the other intervention groups (p<.05). Conclusion: The result of this study suggest that static self-myofascial release using foam roller may help to improve the pain and flexibility of the iliotibial band and to apply it as a more discerning intervention.

• The Korean Journal of Pain
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• v.34 no.3
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• pp.369-370
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• 2021

• The Korean Journal of Pain
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• v.36 no.2
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• pp.208-215
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• 2023

Background: To evaluate the feasibility, inter-reader reliability, and intra-reader reliability for various morphological features reported to be related to iliotibial band friction syndrome (ITBFS) on knee magnetic resonance imaging (MRI). Methods: A total of 145 patients with a clinical diagnosis and knee MRI findings consistent with ITBFS were included in the "study group" and 232 patients without knee pathology on both physical examination and MRI were included in the "control group". Various morphologic features on knee MRI were assessed including the patella shape, patella height, lateral epicondyle anterior-posterior (AP) width, lateral epicondyle height, ITB diameter (ITB-d), and ITB area (ITB-a). Results: Patients in the study group had significantly higher lateral epicondyle height (13.9 mm vs. 12.92 mm, P = 0.003), ITB-d (2.9 mm vs. 2.0 mm, P = 0.022), and ITB-a (38.5 mm² vs. 23.8 mm², P < 0.001) than the control group. ITB-a showed higher area under the curve index (0.849 with 74.1% sensitivity and 72.4% specificity at a 30.3 mm² cutoff) than ITB-d (0.710 with 70.8% sensitivity and 61.2% specificity at 2.4 mm cutoff) and lateral epicondyle height (0.776 with 72.4% sensitivity and 67.8% specificity at 13.4 mm cutoff). However, only the inter-reader agreement for ITB-a (intraclass correlation coefficient = 0.65) was moderate, while the agreements for other morphologic features were good or excellent. Conclusions: Lateral epicondyle height seems to be a reliable and feasible morphologic feature for diagnosis of ITBFS.

• The Korean Journal of Pain
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• v.34 no.2
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• pp.229-233
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• 2021

Background: Iliotibial band friction syndrome (ITBFS) is a common disorder of the lateral knee. Previous research has reported that the iliotibial band (ITB) thickness (ITBT) is correlated with ITBFS, and ITBT has been considered to be a key morphologic parameter of ITBFS. However, the thickness is different from inflammatory hypertrophy. Thus, we made the ITB cross-sectional area (ITBCSA) a new morphological parameter to assess ITBFS. Methods: Forty-three patients with ITBFS group and from 43 normal group who underwent T1W magnetic resonance imaging were enrolled. The ITBCSA was measured as the cross-sectional area of the ITB that was most hypertrophied in the magnetic resonance axial images. The ITBT was measured as the thickest site of ITB. Results: The mean ITBCSA was 25.24 ± 6.59 ㎟ in the normal group and 38.75 ± 9.11 ㎟ in the ITBFS group. The mean ITBT was 1.94 ± 0.41 mm in the normal group and 2.62 ± 0.46 mm in the ITBFS group. Patients in ITBFS group had significantly higher ITBCSA (P < 0.001) and ITBT (P < 0.001) than the normal group. A receiver operator characteristic curve analysis demonstrated that the best cut-off value of the ITBT was 2.29 mm, with 76.7% sensitivity, 79.1% specificity, and area under the curve (AUC) 0.88. The optimal cut-off score of the ITBCSA was 30.66 ㎟, with 79.1% sensitivity, 79.1% specificity, and AUC 0.87. Conclusions: ITBCSA is a new and sensitive morphological parameter for diagnosing ITBFS, and may even be more accurate than ITBT.

• Journal of Korean Orthopaedic Sports Medicine
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• v.5 no.2
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• pp.147-154
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• 2006

Purpose: To analyze the effectiveness of the treatment with the stretching exercise in the patients with iliotibial band (ITB) friction syndrome. Materials and Methods: 22 patients with ITB friction syndrome were treated with the stretching exercise of the ITB. The criterion for determining the good result is more than 75% recovery according to the classification of success of treatment. We analyzed the differences of the duration of treatment at which the good result it achieved according to sincerity of the stretching exercise. The sincerity of the exercise is defined at performing more than 50% of the exercise that we prescribed. Results: Of 22 patients, there were good results in 19 cases (87%) within 8 weeks after the treatment. Except for 3 cases who did not achieved good results, the average duration of the treatment is 28.1 days. In patients with good results there was no statistical significance for the relationship between the duration of symptoms before diagnosis (average 25.6 days) and the duration of the treatment (average 28.1 days). In comparison with the group who performed the exercise sincerely and the group who did not, the average duration of the treatment if 23 days and 32.7 days respectively and there was significant difference between the two groups. Conclusion: The stretching exercise in ITB friction syndrome was helpful in reducing the duration of treatment.

• Journal of Korean Orthopaedic Sports Medicine
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• v.7 no.2
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• pp.75-83
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• 2008

과사용 증후군은 정상적인 조직에 최대하 부하(submaximal stress)가 지속되어 발생하는 것이다. 이와 같은 현상은 연부조직의 접합부(junction)에서 주로 일어나며 힘의 전달이 집중되는 곳, 조직의 역학적 성질이 변화되는 곳, 그리고 성장시 빨리 변화하는 성질이 있는 곳에 주로 생긴다. 근육의 불균형이 과사용 증후군의 가장 많은 원인이다. 과거의 부상 이후 부적절한 재활치료 및 각형성 또는 회전 부정정렬(angular and rotational malalignment) 등이 과사용 증후군의 원인이 될 수 있다. 스포츠 훈련 방법의 실수로도 과사용 증후군이 생길 수 있다. 전방 슬관절 동통시 감별해야 할 질환들은 jumper's knee, 슬개건염 혹은 대퇴 사두건염, Osgood-Schlatter 병, Sinding-Larsen-Johansson 병, 슬개골 연골 연화증, 슬개골 전(prepatellar) 혹은 슬개골 하(infrapatellar) 점액낭염, Hoffa's fat pad의 염증, 그리고 특발성 전방 슬관절 동통 증후군(idiopathic anterior knee pain syndrome)등이 있다. 후방 슬관절 통증의 원인 질환으로는 만성 슬와근 염좌, 슬괵건 점액낭염, 경골 골간단의 피로 골절 등이 포함되며 외측 슬관절 통증의 원인으로는 장경대 충돌 증후군(iliotibial band friction syndrome)등이 있을 수 있다. 이외 과사용 증후군과 관련된 슬관절 통증의 원인으로 다분 슬개골(multipartite patella), 내측 경골 스트레스 증후군(medial tibial stress syndrome), 박리성 골연골염, 반월상 연골의 퇴행성 변화 등이 있을 수 있다. 과사용 증후군의 진단 및 치료의 일반적인 접근법은 다섯가지 단계의 프로그램으로 요약될 수 있다. 첫째, 원인 요소를 확인하고, 둘째, 요소를 변경시키고, 셋째, 통증을 조절하고, 넷째, 능동적 재활을 시키고, 그리고 다섯째, 유지시키는 것이다.

• Physical Therapy Korea
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• v.19 no.4
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• pp.24-31
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• 2012

The aim of this study was to investigate the effectiveness of self-stretching exercises for iliotibial band (ITB) (Side-lying; right hip and knee were flexed to support the pelvis while left hip was extended and adducted, Standing A; side-bending of the trunk on standing with crossed leg, Standing B; same as Standing A, except the hands were clasped overhead and shifted right side, and Standing C; same as Standing B, except moving the arms diagonally downward) to help determine the most effective self-stretching method to stretch ITB. Twenty-one healthy subjects who do not have ITB shortness from Yonsei University (14 men and 7 women) between the ages of 18 to 28 years voluntarily participated. Ultrasound was performed to measure the thickness of the ITB between the long axis of the ITB and the level parallel to the lateral femoral epicondyle during four self-stretching exercises. All data were found to approximate a normal distribution. We used a one-way repeated-measures analysis of variance (ANOVA) to compare the thickness of the ITB among all self-stretching exercises. The level of significance was set at ${\alpha}$=.05. The ANOVA was followed by Bonferroni's correction. The overall mean of ITB thickness was $1.14{\pm}.4$ mm (${\pm}$ standard deviation) in resting status. The change in the ITB thickness in percentages between the tested position of each self-stretching exercises and resting status was significant (p<.05) (Side-lying $26.62{\pm}10.18%$ with 95% confidence interval [CI]=21.99~31.25%; Standing A $29.46{\pm}16.19%$ with 95% CI=22.09~36.84%; Standing B $44.06{\pm}14.82%$ with 95% CI=37.31~50.81%; Standing C $53.76{\pm}12.1%$ with 95% CI=48.25~59.29%). Results indicated significant differences among four self-stretching exercises except Side-lying versus Standing A (p<.01). Based on these findings, the Standing C self-stretching exercise was the most effective in stretching the ITB thickness among four types of ITB self-stretching exercises. Additionally, the Side-lying self-stretching exercise using gravity to stretch the ITB is recommended as a low-load (low-intensity), long-duration stretch.

• Journal of Acupuncture Research
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• v.17 no.4
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• pp.88-99
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• 2000

Objectives : This study was performed to evaluate the clinical effect of acupuncture on microtraumatic injuries of the knee joint. Methods : Among the outpatients with knee joint pain who visited to Department of Acupuncture & Moxibustion, National Medical Center from February 2000 to September 2000, we selected 15 cases that showed normal finding in both X-ray and neurological examination, and that were categorized into microtraumatic injuries by the physical examination based on the Cyriax's orthopedic medicine. During acupuncture therapy, the patients were ordered to move involved side actively. The effect was assessed through questionnaires of CNRS(Cincinnati Knee Rating System). Results : We investigated 11 female and 4 male patients. The most common distribution of age was 30's(40%). The most commom duration of symtoms was from 3 to 5 months(40%). The most common microtraumatic injury was pes anserinus bursitis(33.3%), and followed by iliotibial band friction syndrome(20%), and patellar tendinitis(20%). In the CNRS, the mean number of before treatment was 60.6 and after was 66.5. 10 cases among the 15 patients were improved(66.6%). Conclusions : These results suggest that the acupuncture therapy combined with active movements of involved side was effective treatment modality on microtraumatic injuries of the knee joint.