• Physical Therapy Korea
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• v.26 no.1
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• pp.75-83
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• 2019

Background: A tight iliotibial band (ITB) may lead to lateral patellar maltracking, compression, and tilt, and dominant vatus lateralis (VL) muscle activation relative to vastus medialis oblique (VMO) can laterally displace the patella, which leads to anterior knee pain. Therefore, an effective management technique is needed to stabilize the patella in individuals with tight ITB. Increased stability during the modified Thomas test has the potential to decrease compensatory motion and thus to selectively stretch the ITB. Objects: The purpose of this study was to determine the effects of ITB stretching in the modified Thomas test position on ITB flexibility, patellar translation, and muscle activities of the VMO and VL during quadreceps-setting (QS) exercise in individuals with tight ITB. Methods: Twenty-one subjects with tight ITB were recruited. Digital inclinometer was used to measure the hip adduction angle during the modified Ober test. Universal goniometer was used to measure the hip abduction angle during the modified Thomas test. Ultrasonography was used to measure the patella-condylar distance. Electromyography was performed to collect data of muscle activities. Paired t-test was used to determine the statistical significance between pretest and posttest. Results: The range of hip adduction in modified Ober test increased (p=.04) and the range of hip abduction in the modified Thomas test decreased after ITB stretching (p<.01). There was no difference between lateral patellar translation (p=.18). VMO muscle activity significantly increased after ITB stretching during QS (p<.01). VL muscle activity had no difference after stretching. Conclusion: The ITB stretching in the modified Thomas test position can be suggested as a management method for improving ITB flexibility and VMO muscle activity in individuals with tight ITB.

• 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.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.

• Physical Therapy Korea
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• v.19 no.4
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• pp.61-69
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• 2012

The purpose of this study was to identify the effects of tensor fasciae latae-iliotibial band (TFL-ITB) self-stretching exercise on the lumbopelvic movement patterns during active prone hip lateral rotation (HLR) in subjects with lumbar extension rotation syndrome accompanying TFL-ITB shortness. Eleven subjects (9 male and 2 female) were recruited for the two-week study. A three dimensional ultrasonic motion analysis system was used to measure the lumbopelvic movement patterns. The TFL-ITB length was measured using the modified Ober's test and was expressed as the hip horizontal adduction angle. The subjects were instructed how to perform TFL-ITB self-stretching exercise program at home. A paired t-test was performed to determine the significant difference in the angle of lumbopelvic rotation, movement onset time of lumbopelvic rotation, TFL-ITB length, and LBP intensity before and after the two-week period of performing the TFL-ITB self-stretching exercise. The results showed that after the intervention, the lumbopelvic rotation angle decreased significantly (p<.05), the movement onset time reduced significantly (p<.05), and LBP intensity decreased slightly but not significantly (p=.07). The hip horizontal adduction angle increased significantly (p<.05) after the intervention. These findings indicate that TFL-ITB stretching exercise increased TFL-ITB length, decreased lumbopelvic rotation angle, and delayed the movement onset time of lumbopelvic rotation after two-weeks. In conclusion, the TFL-ITB self-stretching exercise performed over a period of two weeks may be an effective approach for patients with lumbar extension rotation syndrome accompanying TFL-ITB shortness.

• 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.

• Physical Therapy Korea
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• v.31 no.1
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• pp.79-88
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• 2024

Background: The abdominal drawing-in maneuver (ADIM), a method of lumbar stabilization training, is an effective neuromuscular intervention for lumbar instability associated with low back pain (LBP). Objects: The purpose of this study was to compare the effect of a 2-week period of the ADIM and tensor fasciae latae-iliotibial band (TFL-ITB) self-stretching on lumbopelvic rotation angle, lumbopelvic rotation movement onset, TFL-ITB length, and pain intensity during active prone hip lateral rotation. Methods: Twenty-two subjects with lumbar extension rotation syndrome accompanying shortened TFL-ITB (16 males and 6 females) were recruited for this study. The subjects were instructed how to perform ADIM training or ADIM training plus TFL-ITB self-stretching program at home for a 2-week period. A 3-dimensional ultrasonic motion analysis system was used to measure the lumbopelvic rotation angle and lumbopelvic rotation movement onset. An independent t-test was used to determine between-group differences for each outcome measure (lumbopelvic rotation angle, lumbopelvic rotation movement onset, TFL-ITB length, and pain intensity). Results: The results showed that ADIM training plus TFL-ITB self-stretching decreased the lumbopelvic rotation angle, delayed the lumbopelvic rotation movement onset, and elongated the TFL-ITB significantly more than did ADIM training alone. Pain intensity was lower in the ADIM training plus TFL-ITB self-stretching group than the ADIM training alone group; however, the difference was not significant. Conclusion: ADIM training plus TFL-ITB self-stretching performed for a 2-week period at home may be an effective treatment for modifying lumbopelvic motion and reducing LBP.

• 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.