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The primary objective of this study is to determine if a more specific exercise routine that incorporates a progressive hip stability program will help to rehabilitate the hip and reduce symptoms of iliotibial band syndrome more than conventional hip exercises. Three different exercises interventions will be compared to determine its effectiveness in reducing pain, improving function and returning subjects to running symptom free. Secondary objective for this study is to establish an intervention program for female runners with this injury. There will be three treatment arms and participants will be randomly assigned to one of three groups: Group A- control (stretching), group B (conventional hip exercises and group C (experimental treatment- specific progressive hip exercises).
The gluteus medius muscle is part of a muscle group called the hip abductor muscles. The gluteus medius originates at the dorsal ilium (uppermost, largest bone of the pelvis) below the iliac crest and inserts at the top outside surfaces of the greater trochanter (top of the thigh bone). It is the major abductor of the thigh (moves the leg away from the midline of the body). The anterior fibres rotate the hip internally and the posterior fibres rotate the hip externally. Based on the anatomy and function of this muscle, the gluteus medius plays a major role in the mechanics of running. Research has shown that runners with iliotibial band syndrome have been shown to have weakness in this muscle. Most conventional exercises that have been research have been exercises that focus on only activation of this muscle in an unloaded position (non-weightbearing). Group B of this study will focus on those exercises that have been researched. Group C will be the experimental group in which we will begin with the conventional exercises and progress the exercises from a floor (unloaded) position to a more dynamic functional position (standing). This will be geared towards running specific exercises. We would like to know if there will be a difference in how fast symptoms reduce and strength gains occur and at what rate.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group A | Placebo Comparator | Four iliotibial band stretches; to be completed 3 days per week. |
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| Group B | Active Comparator | Four conventional hip exercises (Hip abductor, gluteus medius strengthening); to be completed 3 days per week. |
|
| Group C | Experimental | Four conventional hip exercises progressed during the 8-weeks, totalling 16 exercises over the 8-week period (Hip abductor, gluteus medius strengthening). Exercises to be completed 3 days per week. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Gluteus medius strengthening | Other | Hip abductor, gluteus medius strengthening |
|
| Measure | Description | Time Frame |
|---|---|---|
| Hip dynamometer strength | Hip dynamometer strengthening will be measured biweekly for the 8-week period | 8-weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Y-balance test | The Y-balance test kit is designed to measure quality of movement and function in three different movement planes. | Measured pre and post 8-week study |
| Single leg mini squat | The single leg mini squat will be used to assess quality of movement. |
| Measure | Description | Time Frame |
|---|---|---|
| Numeric pain scale | This is subjective rating scale 0-10. Participants will rate their pain weekly. | Measured weekly for the duration of the 8-week study |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Dr. Rick Celebrini, PhD, PT | Chief sport officer- Fortius sport & health | Study Chair |
| Dr. Michael Hunt, MSc MPT PhD | Assistant Professor (UBC)- Department of Physical Therapy | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Optimal Performance Clinic | Vancouver | British Columbia | V6E2J3 | Canada |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 3606371 | Result | Agre JC, Magness JL, Hull SZ, Wright KC, Baxter TL, Patterson R, Stradel L. Strength testing with a portable dynamometer: reliability for upper and lower extremities. Arch Phys Med Rehabil. 1987 Jul;68(7):454-8. | |
| 20145781 | Result | Beers A, Ryan M, Kasubuchi Z, Fraser S, Taunton JE. Effects of Multi-modal Physiotherapy, Including Hip Abductor Strengthening, in Patients with Iliotibial Band Friction Syndrome. Physiother Can. 2008 Spring;60(2):180-8. doi: 10.3138/physio.60.2.180. Epub 2008 Oct 10. |
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| ID | Term |
|---|---|
| D058745 | Iliotibial Band Syndrome |
| ID | Term |
|---|---|
| D007718 | Knee Injuries |
| D007869 | Leg Injuries |
| D014947 | Wounds and Injuries |
| D012090 | Cumulative Trauma Disorders |
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| iliotibial band stretches | Other | Iliotibial band stretches |
|
| Measured pre and post 8-week study |
| 15378277 | Result | Birnbaum K, Siebert CH, Pandorf T, Schopphoff E, Prescher A, Niethard FU. Anatomical and biomechanical investigations of the iliotibial tract. Surg Radiol Anat. 2004 Dec;26(6):433-46. doi: 10.1007/s00276-004-0265-8. |
| 15496997 | Result | Devan MR, Pescatello LS, Faghri P, Anderson J. A Prospective Study of Overuse Knee Injuries Among Female Athletes With Muscle Imbalances and Structural Abnormalities. J Athl Train. 2004 Sep;39(3):263-267. |
| 16533314 | Result | Fairclough J, Hayashi K, Toumi H, Lyons K, Bydder G, Phillips N, Best TM, Benjamin M. The functional anatomy of the iliotibial band during flexion and extension of the knee: implications for understanding iliotibial band syndrome. J Anat. 2006 Mar;208(3):309-16. doi: 10.1111/j.1469-7580.2006.00531.x. |
| 10959926 | Result | Fredericson M, Cookingham CL, Chaudhari AM, Dowdell BC, Oestreicher N, Sahrmann SA. Hip abductor weakness in distance runners with iliotibial band syndrome. Clin J Sport Med. 2000 Jul;10(3):169-75. doi: 10.1097/00042752-200007000-00004. |
| D013180 |
| Sprains and Strains |