What am I missing ? (recurring ITBFS)

[Bikerphys]

Dear all,

Thanks for all your valuable advice, much appreciated.

Just to update you, my pt. is in the process of recovery !

Had 2 weeks complete rest; during which he was treated by sstm and tp release to biceps femoris and TFL/ITB.
thickening to distal biceps fem/ ITB treated with cross friction massage, (boy did he squeal ! :evil )

stretching and ice application daily, u/s following manual treatment.

Also introduced glut strengthening exs and lumbar spine flexibility exs.

resumed light training with no adverse effects, but rx continued as above. After this a structured increase in training load & intensity has been followed with no recurrence !

pt. feels he has turned a corner and is more positive in his approach.

One thing of note is the return of slight popliteal swelling, but is pain free and can be reduced with effleurage... anyone have any theories on the nature of this ?

Thanks again to all who have offered advice.

[zisuer]

Happy to hear your pt getting better. Usually, if the problem is muscle weakness, it will take coupld weeks to get them better. And there is a new article reported that more than 60% ITBFS pt have lateral knee pain because the bursa underneath the band inflammed, while not the band itself ( a small study though).

[Sports_Rx]

Happy to hear your pt getting better. Usually, if the problem is muscle weakness, it will take coupld weeks to get them better. And there is a new article reported that more than 60% ITBFS pt have lateral knee pain because the bursa underneath the band inflammed, while not the band itself ( a small study though).

Interesting. Can you post a link for the study please? Some recent stuff I'd read was saying the opposite, and questioning whether a bursa was in fact even present under the band. All the anatomy stuff I've looked at shows a juicy fat bursa but it's good to read challenges to the norm

[zisuer]

Yes, it is controversal whether the bursa exists, 90 % stduies reported negative results. But this study reported positive results, it is small study though, but it is new. Here is the paper: Hariri S, Savidge E, Reinold MM, Zachazewski J, Gill TJ. Treatment of recalcitrant iliotibial band friction syndeome with open iliotibial band bursectomy. Am J Sport Med 2009