The Iliotibial band syndrome (ITB) is commonly called "runner's knee" and is an inflammatory process in the iliotibial area which is the last section

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2 The Iliotibial band syndrome (ITB) is commonly called "runner's knee" and is an inflammatory process in the iliotibial area which is the last section of the femoral fascia (or fascia lata). The problem occurs at the distal side of the knee, where the band fits on the side of the tuberosity of the tibia.

3 In fact, rather than borne by the band, the inflammatory process is related to the innervated and vascularized tissue that separates the ilio-tibial band from the femoral epicondyle. It affects mainly the runners, though cyclists and sports in general are included.

4 ANATOMY The iliotibial band is the common tendon of two muscles: the gluteus maximus tensor fascia lata (TFL). It fits on the outer face of the tibia, just below the femoral articulation - tibial (Gerdy's tubercle). In its course passes over a bony protuberance, the lateral femoral epicondyle (LFE), which is separated, in order to facilitate the sliding, by a bursa scroll.

5 ANATOMY The iliotibial band, which moves from behind toward the front of the femur during physical activity, is essential for the stabilization of the pelvis and the knee joint during the monopodalic stance phase in running and in gear.

6 ANATOMY At this point there may be a mechanical friction that generates a chronic inflammatory painful state in the fibrous tissue and in the bursa, that is exacerbated in the movements of flexion and extension of the knee.

7 ANATOMY The ilio-tibial bendelletta is in front of the tuberosity of the LFC when the knee is extended; begins to flow in the direction of the condyle back when it starts bending motion, is perfectly superimposed on the condyle when the decline reaches 30 and goes further back with increasing knee flexion.

8 Any movement that causes to the leg a side internal bend or and internal rotation, stretches the ITB against the femur. Excessive pronation (feet rotate too far inward on impact) tightens the iliotibial muscle, as well as not enough stretching, running shoes are not suitable or worn, excessive hill running (especially downhill), circular racing circuits and overload training.

9 Ø varus knee Ø varus tibial Ø prominence of the lateral femoral epicondyle Ø the limb-length discrepancy Ø tending to foot pronation

10 Ø running on a sloping or uneven surface Ø excessive mileage Ø abrupt change in excess of excessive training loads circuits with alternating ups and downs Ø training for explosive strength particularly intense Ø overweight athletic.

11 The main symptom is lateral knee pain especially acute in the first 30 of flexion. Sometimes there is also a swelling in the inset of bendelletta.

12 At first the pain manifests itself deaf after a few minutes, then seems to fade with the passage of km, but eventually increases again up to affect the dynamics of the race at the end of the session. With every passing day, if the picture does not improve, pain induces reduce km and the speed of the race.

13 It s substantially clinic. Usually the pain is in the side of the knee and increases with a pressure with a knee flexion on the lateral condyle of the femur. Radiographic examination is negative, the ultrasound examination can help confirm the diagnosis and quantify inflammation while the MRI may be useful for differential diagnosis with other diseases of the knee.

14 The first treatment that can provide relief is cryotherapy: Apply the ice pack locally for min. immediately after the race but also during the day. Reduce your training load and intensity, however, in any case avoided running down the paths and circular tracks.

15 In the event that the problem is not resolved, normally the orthopedic specialist advise of NSAIDs (nonsteroidal antiinflammatory drugs) and muscle relaxants in addition to the suspension of the race.

16 Stretching of the ITB, maintain 30 seconds and then slowly relax. Repeat on both legs two or three times a day. AUTO- TREATMENT

17 Myofascial release of the iliotibial band with the help of tools such as the foam roller AUTO- TREATMENT

18 Ø Swimming Ø Bike in low gear. Ø Avoid any exercise that brings power to the ITB, especially to prevent the movement up and down the stairs.

19 Ø Ø Ø Ø Ø Ø Ø Reduction of predisposing factors and favoring the onset of the syndrome of ITB: evaluation and correction of postural defects evaluation of the biomechanics of the sporting gesture stretching the ITB, quadriceps, and gluteal dell'hamstring medium, small and large reinforcement of muscle deficit use of appropriate footwear gradual increase in the program of 'training avoid the rush downhill and on uneven terrain.