Iliotibial Band Syndrome Of The Knee - Everything You Need To Know - Dr. Nabil Ebraheim
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- Опубликовано: 26 авг 2024
- Dr. Ebraheim's animated educational video describes iliotibial band syndrome of the knee.
Inflammation and thickening of the iliotibial band result from excessive friction as the iliotibial band slides over the lateral femoral condyle. The iliotibial band is a thick band of fascia that extends along the lateral thigh from the iliac crest to the knee. It inserts into the Gerdy’s tubercle of the tibia.
The iliotibial band is a continuation of the tensor fascia lata muscle. The tensor fascia lata muscle arises from the outer surface of the anterior iliac crest, between the tubercle of the iliac spine and inserts into the iliotibial tract. The gluteus maximus also inserts into the iliotibial band.
Function of the iliotibial band
The IT band extends, abducts and laterally rotates the hip. The IT band also contributes to lateral knee stabilization. The IT band is repeatedly shifted forward and backward across the lateral femoral condyle.
Impingement usually occurs around 30 degrees of knee flexion. There may be swelling, tenderness and crepitus over the lateral femoral condyle. The condition of ITBS around the knee most commonly occurs in runners, cyclists and other athletes undergoing exercise with repetitive knee flexion and extension. The IT band inserts into Gerdy’s tubercle. The pain is proximal to the Gerdy’s tubercle. The pain may be reproduced by doing single leg squat.
Predisposing factors
•Foot and knee malalignment (foot pronation &varus knee)
•Prominent lateral condyle.
•Tight IT band
•Leg length discrepancy
•Weak abductors of the hip
•Poor shoe wear
•Training errors.
Provocative examinations
The Ober's test is a clinical examination test used to access tightness of the iliotibial band.
Ober’s test
•the patient should lay on the side with the affected leg up.
•the examiner will slowly abduct the leg with the knee in flexion and the hip in full extension.
•When the IT band is tight, adduction of the leg will be limited as the leg will not touch the other knee and the test is considered positive.
Noble test
•The noble test is performed by the examiner placing the knee into flexion and putting the thumb over the iliotibial band prior to its insertion into the Gerdy’s tubercle of the lateral tibia.
•With the pressure placed onto the IT band, then extend the leg.
•If pain is felt at the lateral femoral condyle with extension of the leg, then this is a positive Noble test.
Imaging
•X-rays may not be helpful.
•MRI may show edema in the area of the ITB.
Treatment
Nonoperative
•Rest and ice
•Physical therapy is very important: stretching, proprioception and improvement in neuromuscular coordination.
•Training modification
•Better shoe wear
•Consider injection (may be helpful)
Majority of patient will get better in about 4-8 weeks.
Surgery: (last resort)
•Surgical excision of the scarred, inflamed part of the iliotibial band.
•Excision of a cyst or a bursa
•z-plasty is rarely done.
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This is the best video between hundreds of IT band videos everywhere!
FINALLY I understand how the IT band works
exactly what i was looking for , well explained!
Thanks Doc. Helpful information
Thank you. The most comprehensive and clear video on the topic
This is the BEST IT BAND VIDEO!!!! Very clearly explained and shown in excellent animation…thank you!
I’m going thru this ..this was the most help I got ..even my dr or my Physical therapist didn’t tell me all this
What an excellent video! I finally understood the muscle groups, saw where they are located, and can devise a plan to fix my very stiff IT band muscle. The predisposing factors are interesting. Any leg shortens if the Psoas and Piriformis are not stretched regularly and you sit too much, or exercise too hard. I have found that some light weights + swimming + stretching + supplements (MSM, Glucosamine, Zinc 50 mg, Vit C powder, CoEnzyme Q10, Fish Oil) daily will alleviate any issues and keep body working with suppleness. You have to stretch 4-6 times a day as often as possible. Just like cats and dogs do.
Thank you doc!! Very much appreciated!!
@Zeus1955 NO!!!! Stay away from this doctor! 100% wrong path. They do not understand the body and carve it up needlessly. The body works as a whole. The only reason you needed a knee replacement is because you never stretched your hips or legs. Live and learn. You need to stretch. Pain is no gain. Rubber bands don't break till they get brittle, right? Ditto for the body. Swim, stretch!! Let everything heal with very gentle movements and DO NOT SIT for long periods at work - yet another horrible habit leading to crippled muscles.
Use DMSO GEL 99% (Amazon) directly on the band and sprinkle MSM crystals on it (Source Naturals MSM on Amazon). Use a wooden icecream stick or flat clean knife to spread the gel, do not use your hands. Skin should be clean. Anything on skin will be taken into bloodstream by DMSO (a form of sulfur mineral that goes thru the skin barrier in seconds). You can use a bit of an ibuprofen capsule powder directly on IT band as well, but not a tablet.
Swim!!! Do some weights to strengthen pelvic, glutes, inner thigh muscle (very important), calf, hamstring (leg curls). Do not stress the knees or use the quads too much in these workouts. Light workouts to get the blood flowing and tighten opposing muscles like the inner thigh (adductor?). Use a rolling pin with oil to 'iron out' IT band. Use a tennis ball and do stretches (see Bob and Brad channel for IT Band Syndrome stretches). Take Ibruprofen with restraint. Take a number of natural anti-inflammatories:
Amazon Source Naturals or NOW brand MSM Crystals - 1/2 tsp in juice 2 x day
Trader Joe's - Vit C powder 1/4 tsp in water 2 or more times a day. Removes waste from cells making them heal faster.
Costco - Glucosamine/Chondroitin/MSM 750 mg tablet 2 x day
Costco - Co Enzyme Q10 - 300 mg capsule 1-2 x day (antioxidant, brings oxygen to cells for rapid healing)
Zinc - 50 mg 1 x day before bedtime (wound healing, immune system, and enables sleep)
Vit D3 - 5000 IU 1 x day before bedtime (pre-hormone, bones, heart, anti aging, depression, and essential for everyone!)
Source Naturals Mega One without Iron Multi Vit/Mineral 1 x day at noon (no coffee). Take daily at noon. Do not buy bad vitamins at Costco or GNC!
Costco or Trader Joes - Fish Oil (not Salmon!) 1 x day. Keep in fridge. Helps nerve healing, connective tissue, eyes, heart, organs. Can use 2 if you want.
Amazon - DMSO 99% gel - white jar blue lettering type. Use directly on IT band or wound or sprain for rapid healing. SKIN MUST BE CLEAN!!! APPLY WITH CLEAN KNIFE OR ICE CREAM STICK. LET DRY. Do not use anything on skin for 4 hrs afterwards, no balm, nothing. This is highly effective. Slight garlic odor which goes away soon. Its sulfur mineral. Not on broken skin.
Eat RAW FOODS like salads, sushi, cooked seaweed. Non fat no sugar yoghurt with probiotics (mix with fresh grated ginger, salt, cumin powder, or cilantro for a Lassi or yoghurt drink - yum!. These foods will reduce inflammation and promote healing.
Avoid sugar, starch, grains, overly cooked food, wheat, gluten, keep dairy to a minimum. These create inflammation and slow down healing.
This should fix your problem rapidly. Good luck.
@Zeus1955 You are most welcome. I think we were both born the same year. Remember that anything that does not work in your body is your fault. The right food, supplements, workouts, and early and adequate sleep fixes everything. Truly everything. I've tested this concept on broken rescued animals from boa constrictors to dogs, and it works. Real food is the key to health. Animals seldom get sick if they have access to good nutrition. The body is such a perfect machine but we give better care to our cars and neglect ourselves.
@@lass-inangeles7564 Awesome information!!!
@@lass-inangeles7564 "Remember that anything that does not work in your body is your fault" lmao this is hilarious you were doing so well
You have wonderful educational videos on youtube. Thanks so much!
Best teacher ever ♥️♥️
Thank you so much, Dr.! Your videos have been such a gift to be able to visualize so many concepts. Truly a blessing!
Thank you Dr. Ebraheim, very short and very nice, so informative.
Great video, thank you Dr. Nabil
This video is very straight forward and easy to understand.
Thank you, yes it is very helpful.
I have found exercices that take away the tension in my IT Band take the knee pain away almost immediately.
Thank you Dr, I’ve been dealing with this for couple of month and the physio and doctor I saw couldn’t figure it out. Thanks again
So now in sever pain for some time, can you please tell me if and how you treated it?
Been going to doctors for months with no answers.... This seems most on point with my pain.. I've been in bed since 8/2020... 😣 Any information concerning yote successful treatment would be an encouragement...
@@unknownos600
No good news to tell you from my experience, turned out I had some sort of lymphoma... Been through radiology. And steroids, and near my 3round of Chemo... My advise is go get checked out, an orthopedic Dr spotted my problems and I was fast tracked thru the system
@@livingintongues and did you heal from it ?
ابدعت يا دكتور نبيل ومنتهى البساطه 👏🏻👏🏻
I went to many orthopedic doctors...ihad x-rays on my knee...and MRI on my spine and lower back.... everything was clear. Watching this now, I'm positive that's what i have. The pain is excruciating 😭
Go to a physical therapist who also runs and lifts, I'm sure someone of this knowledge and a goodtraining background will be able to help you. I've had scans in the past and nothing shows up much, 2 years on and my pain is down 95%
It takes the correct training and guidance and understanding and the results will follow, have faith 👌
Same here
suffering this ryt know .. it really hurts
Thank you. All your videos are helpful
Glad you like them!
This video explains my issue with my right knee. I went for an MRI because I felt my tendon snapping on the Lateral Femoral Condyle after a leg workout. My doctors told me that I have a mild patellar tendinitis but no tear.
Loved your explanation, sir.
Excellently done, Doc! Thank you!
This was a terrific video. It will help me tremendously in my job! THANK YOU, Dr. Ebraheim.
great work doctor thank you very much
Thanks Doctor,for your contribution !🙏
Thank you this gave me a insight on my problem!
I have it myself. This was an excellent video of all the information one needs. Finally I have a timeframe for how long it takes to get well. After that physiotherapy heavy duty job I will switch to doing the exercises 3 times a week instead of every day and preferably twice a day.
Is it resolved now?
@@johnweak3198 yes it is.
Great video! I suffer from this when walking down hill. After about 100 metres Im in agony.
Did u ever find a cure? Dealing w this rt now and it was never a problem in the past..
@@PureExistence1 Hi did you find a cure? I'm trying for months.
@@konradg4069 you know what? It just went away eventually! I stopped hiking for about 3 months and when i resumed hiking again, it hasnt come back...strange...now i git issues with a tight psoas muscle thats causing snapping hip syndrome and a severe decrease in flexibility in the right inner thigh...
Assalam, jazakallah khair. from Ahmedabad, Gujarat, India.
Thank you so much very informative
Thank you so much iv been suffering for so long and now i know what is wrong with me. I had almost given up hope iv been suffering for a year now and it has gotten so debilitating i can barely walk!
I've had similar pain for a year as well now and I think it's this. What have you done to fix it?
Thanks... the best explanation by far
Best one yet! Thank you
Also check for and eliminate any adhesions between the IT and vastus lateralis. I have found many times that the IT is only adhered and some myofascial work relieves this condition.
Thank You Doctor! Very helpful!
thanks for the video. شکرا
Very informative. Thank you!
Thank you for the video, very informative, i believe this is what i have, my IFL is also very tender
Great video i was searching for a long time. Cheers
Thank you Doc!
Nice discussion, thanks.
Great video! Thank you.
I was able to recover in 3 months. During my injury I can’t even run 1 kilometer and now with stretching and strengthening training, I can now run 5kilometers pain free.
what kind of training do you do?
mantid the training depends on the root cause but first you need to rest your knee, be patient because it takes time to heal, on my end, I was dumb to rest it in a short period(a week) then try running again in hills so the pain got even worst. The ortho advices me to rest for 2 months, then after 2 months I went to a physical therapist for a rehab, they advice me to work on my lower body muscles, hips and legs muscles then reduce weight to lessen the pressure on my knee. After 2 weeks of muscle strengthening and stretching, I tried running 800m, 2 rounds oval and I was so happy I was able to finished because when I injured my knee, I can’t even finished a round in oval400m. After another 2 weeks, I pick up the pace then go for 3km, then after another week I went for 5km. Remember to avoid running in hills, run 3 to 4 times a week only while recovering, give it a month or 2 before you go back to your normal running. All and all it took me 4 months to fully recover and run 10 to 15km w/o any worries.
I hope this helps cos I know how frustrating this injury is.
Thanks for the info! I really need to strengthen my legs, etc. Most of my IT band issues are from not working the surrounding muscles as much. I started biking a lot and run and walked a lot less, so I'm thinking that is the root cause. When I jump straight into squats and leg workouts, the side of my knee gets hit hard, with butt soreness, which is symptoms of IT band issues.
ford I’m suffering from this pain as well thank you very much for your advice. I am also overweight so that is also not helping with the issue. I’m going to try to rest it for a bit then work out my surrounding muscles.
Excelent video. Thanks!
So informative
Thank you very much, well-done.
I think I have this. I don’t run but workout a lot and I think it came from doing leg squats..sometimes now when I work legs in the gym, it feels like it’s strained and almost like my knee makes a snapping sound and wants to buckle
Very well explained.. shukran ya prince
Thank you....Very helpful.
thank you it is very informative
Best video on itbs on you tube ,thanks.
Very informative.
Excellent!!! Thank You!!
Very informative thank you !!!!!
Exactly what I’m going through right now. I work for Amazon and my right work shoes’ heel started to prematurely deteriorate leading to poor support, over I’m guessing 2 months. Now my knee pops all the time and the band rubs the outside of my knee something fierce.
Thank you ..very good informations
I fell on my knee a month ago. Landed on the inner-top of the tibia and got a bone bruise. I noticed last week that my kneecap (patella) is about 1/8th inch lower than the good knee. I'm wondering if that's causing the IT band to catch because it triggers my peroneal nerve on the outside bottom-half of the leg, and the sensation extends down to the top-right of the foot.
My chiropractor adjusted the bottom-half of the leg because the foot was extended slightly outward, and that helped a lot! The IT band catching went down a lot the day of that adjustment but returned the next day and remains. Aleve and Extra Strength Tylenol help keep the sensation down but hopefully physical therapy will resolve it. I'm 5 weeks into the injury. I heard it can take 4 to 8 weeks for IT band syndrome to resolve but my situation might vary differently from "runner's knee" because of the type of injury I had.
Thanks for nice helpful video
احلى دكتور نبيل ٫بطل الله يحفظك
Ameen ☪️
Thanks a million! :)
Great video
Tq so much sir
Great explanation
Could this cause shin pain too?i have pain in the hip joint area and sometimes outer font of the knee usually relieved after a loud pop and the worst part is shin pain just in the middle area of the shin muscle but it’s not the muscle. Something behind the muscle maybe.
I’m suffering from this right now and the pain is horrible, I’m putting ice and massaging it and it’s getting better. I got back to running from a thigh injury and I know my running form was bad but I continue and then this happened :/
Did you get better ?
ما شاء الله يا دكتور. شغل حلو
So the IT band does connect to below the knee onto the tibia... I've heard plenty people say "no it doesn't". Can the function of the lower leg muscles "tibialis anterior etc" have an effect on IT Band syndrome? As the sight of pain is near the head of the fibular?
Asalamu alaikum dear Doctor shukran for explaining so much! I’ve had to go to the hospital twice within the month of December. Alhamdo lillah now I know what I’m dealing with. in sha Allah this will be gone in a few months. The doctor had to give me Morphine when I was in the hospital last Sunday. I’m not doing enough stretching 🙆♀️. ma sha Allah I’m working all the time!! I actually had to leave my job because I’m in so much pain and then throw in the pain killers with Tylenol or Motrin Jazak Allah Khair 💜🥳💪🙃😓😱
Thank you for your help
Thank you Doc. Allah ya 5alik
GET MASSAGE GUN - Couldn't run past 1km for 2 years without getting sharp pain (2 physios and mri scan) bought massage gun recently, 1st run after using it, I got to 3km (didn't want to push it) 2nd run back to 5km, I do the normal stretches for the IT but the gun completely loosened the leg up.
Imma try this
Helpful. Shall i know which type of braces should be used to overcome it.
Thanks,
My pain is in the inner side of the knee not outer😟
Then it's not ur it band
That maybe runners knee which is much worse
Often, the Inner thigh muscle and outer thigh muscle - Adductors and Abductors are not in balance (developed evenly or stretched out evenly). Do some weight machine workouts for these two, and stretch them both out as well. This will re-balance them.
Very helpful as I have it band syndrome all docs said the same; suffer an live with it
Horrible "advice". Try to find other actual doctors.
Thank you sir
Excelente!
Thnq so much sir
I don't really have pain. The area is just very weak.
I think this is my issue. I’ve been getting it recently. Only go 2-3 miles then the side of my knee is sore 2-3 days. But I wonder if barefoot running could eventually help? Maybe I have weaker muscles in other places
Bare foot run on cocrete and hard surfaces only. Make sure you run fast like if you are trying to catch a gazzel, like in the ancient times. Also don't use toilet paper or soap because that's unnatural. Do not take any of these new age crazy medicines, just chew on some grass and you will be good in a couple years.
Tyler Durden I know what you’re saying but concrete is also unnatural. Have to run on rocks
Yah it’s helpful
thank u
I have it now! Pain on outside of right knee. Worst then TKR on other knee.
I like his accents
Philippino?
In a above knee amputation basically were you just do a knee disarticulation what is done with the IT band? Is it just reattached at the side of the femur bone? I'm having a lot of problem right now with my stone and I'm having problems finding the right guy to take care of the problem and diagnosis. Please sir if you have any suggestions or any advice it would be greatly appreciated thank you
Is it possible to tear your it band because I feel like I did
Especially disorders
I'm suffering this one after running downhill
Can hileotibial band hurt at hip level only? Thank you.
Sir do tutorial on SIJ also.
I am a bilateral amputee. Ak on left and hip disarticulation on right. My stump on left is killing me right at the outside end of my femur bone. It's sharp burning almost tearing feeling. I have contractures also. Can this band be constracting on me? You can hardly touch the outside end of my stump. And I feel so tight halfwAy up my femur bone. When I lay flat my stump stays like I'm sitting. I was hit by train at 9 months old. I'mvery45 now. Car train wreck. So my leg was completely degloved both sides right was worst. Left was saved above knee but is covered by only a layer or 2 of grafting. I don't know if I need surgery or therapy. But it's so painful sir. Any advice would be appreciated....I live in Illinois around Peoria or I would see you. You seem very good at what you do....
I understand this is inflamation.... Does it have anything to do with the food you eat.?
❤❤❤❤❤
here is the foremost question on this "syndrome" for all who think they are "qualified" to treat it...what happens to the body when you go PAST this condition (itband syndrome)??? Any takers out there in youtube land? Look to reading Ida Rolf's book (Rolfing) to truly understand my question. Thanks
Hi
Not a runner....but why i having it?
I want to be an orthopedic surgeon so bad!
Dammit i have all this
thekey wala banda
👍