THE MANAGEMENT OF ILIOTIBIAL BAND SYNDROME WITH A MULTIFACETED APPROACH: A DOUBLE CASE REPORT.

BACKGROUND AND PURPOSE: Iliotibial Band Syndrome (ITBS) has commonly been thought of as an overuse injury in runners. The exact etiology of ITBS is not well understood and there is no consensus on how to properly manage it. The purpose of this case series is to present a comprehensive model that utilizes a review of the current literature and the concept of regional interdependence as a foundation for the treatment of ITBS in runners.

CASE DESCRIPTIONS: The first subject was a 36-year old female, referred from an orthopedic physician with the diagnosis of left iliotibial band friction syndrome. She reported a 9/10 stabbing pain on a visual analog scale (VAS) in the left lateral knee at mile two while running. The second subject was a 41-year old female with a referral to physical therapy from an orthopedic surgeon for left iliotibial band tendinitis. She reported the symptoms beginning one month prior to her presentation to therapy, and that she would get an 8/10 stabbing pain on a VAS in the left lateral knee at mile three while running. Both subjects complained of the onset of lateral knee pain at a consistent mileage that forced them to stop running. Neither of them initially reported pain in adjoining regions, but did recall some low back stiffness from time to time when questioned further. The concept of regional interdependence, as well as neuromuscular re-education, and strengthening interventions in conjunction with addressing the contributing factors of training errors, shoe wear, running surface, and program design were utilized.

OUTCOMES: At a six-month follow-up, subject one had successfully completed a half marathon without knee pain. At a nine-month follow-up, subject two was able to run five miles, twice weekly and 10 miles once weekly without pain or symptoms.

DISCUSSION: These case reports demonstrate the successful management of ITBS in two subjects using a multifaceted approach based on the current literature and the concept of regional interdependence.