Does altering running gait mechanics in addition to pelvic strengthening and stretching in serious runners decrease IT band friction (syndrome) and pain more than just pelvic strengthening and stretching alone?
Purpose: The purpose of this project is to analyze evidence based research to answer the following PICO question, "Does altering running gait mechanics in addition to pelvic strengthening and stretching in serious runners decrease iliotibial (IT) band friction (syndrome) and pain more than just pelvic strengthening and stretching alone?" Background: IT band syndrome is the second most common running injury, and the most common cause of lateral knee pain. Due to large number of variables that can contribute to this condition a specific cause has yet to be found. The most common theories being looked at are: altered gait mechanics (specifically increased hip adduction and knee internal rotation during the stance phase of running), decreased hip strength (particularly hip abduction), and tight lateral hip musculature. There are many different variables that may contribute to the development of IT band syndrome including: shoe type, running surface, running volume, fatigue, and gender. Due to the number of potential variables that contribute to the development of IT band syndrome, it is difficult to design a robust research study correlating specific variables to the onset of IT band syndrome. Case Description: The patient is a 28 year-old male professional runner who presented to therapy with complaints of lateral right knee pain. His pain began during the end of a 12-mile run 10 days prior to evaluation. Outcomes: A review of the literature shows that studies focus on outcomes of hip strengthening, stretching, and/or running mechanics and how improvement in each aspect alters the patient's functional mobility and pain levels. Research reveals that combining all 3, hip strengthening, stretching of lateral hip musculature, and altering gait mechanics during running (with a wider stride and increased cadence) will most likely result in the biggest improvement of functional mobility and decreased pain levels during running. Discussion: My case presentation involved a patient that had an acute bout of IT band syndrome who discontinued therapy after 4-weeks to pursue other treatment options. There is a need for continued research on the topic, particularly in studies that combine running gait kinematic management with strengthening and stretching. The uncertain ideology of the syndrome makes it difficult to design a study that is able to control all of the potential variables. Also, patients with IT band syndrome will often have muscular tightness, weakness, and gait abnormalities which make it difficult to figure out which of the three was the primary issue, creating the secondary and tertiary impairments. The fact that some studies are finding conflicting information complicates generalizing therapy programs to the general public. At the end of the day, the best strategy is to perform a solid physical therapy evaluation which includes gait analysis to address any gait asymmetries, functional muscle strength test for pelvic control, and range of motion/muscle length testing.
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Gait; Iliotibial Band Syndrome; Running
Nickerson, Todd. "Does altering running gait mechanics in addition to pelvic strengthening and stretching in serious runners decrease IT band friction (syndrome) and pain more than just pelvic strengthening and stretching alone?." (2016). http://digitalrepository.unm.edu/dpt/7
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