after suffering an annoying "ache" to the outside of his right knee that occurred after a "long" I consulted a doctor I tried and trusted information on the internet to try to better understand the cause and possible remedies.
Obviously there is nothing more wrong than seek treatment rely on the web or experienced friends improvised. So, I repeat, I first heard a doctor and once you understand what it was, I tried to learn more by doing a search on the net and, as usual, I found lots of information, some of them conflicting.
The medical diagnosis was: bandelletta iliotibial syndrome.
At this point there is a very important clarification.
This post and, more generally, this is my other blog may contain information on medical topics, healing, or related to therapeutic practice with (pseudo-science, medicine, etc..): there is no guarantee that the information is accurate, correct, accurate or not contravene the law. Moreover, even if the information were from a general point of view right, it may not refer to the symptoms exhibited by the reader. Again, different people showing the same symptoms often require different treatment, because of the complexity of some clinical cases.
The information provided on my blog is general in nature and informative purposes only and may not under any circumstances replace the advice of a doctor (or a legally authorized person to the profession) or, in specific cases, other health professionals (dentists, nurses, pharmacists, veterinarians, physical therapists, etc.)..
In no case, therefore, be held responsible for the results or consequences of any use or attempted use of any of the information published.
Nothing on my blog can be interpreted as an attempt to offer a medical opinion or otherwise engage in the practice of medicine.
The information contained herein are for illustrative purposes only: not and does not come from prescription or medical advice.
That said, here is a summary of information that I found about this syndrome.
1) What
The bandelletta ileo-tibial syndrome is an overload syndrome that affects the final part of a muscle on the side of the thigh, the tensor fascia lata, which ends with a sort of bandelletta positioned laterally to the knee (see figure). In susceptible individuals, which represent a situation of tibia vara, or legs, brackets, or which tends to foot pronation (ie that gives too much support in phase with the ground), you may experience an excessive friction between this tendon underlying bone (lateral femoral condyle), resulting in inflammation.
is commonly called "runner's knee." It is, in fact, an inflammation of the lateral area of \u200b\u200bthe knee (the ilio-tibial tract of fascia lata). Anatomically, we describe the fascia lata as the lining of the lateral thigh muscles and his ilio-tibial tract is what goes on the side of the external femoral condyle on the fibula es'inserisce
initially manifested by a lateral knee pain, which sometimes do not pay attention because it is not too intense. Each successive training sessions, however, the pain worsens, making it impossible at some point in the race. The runners are athletes who are most affected, but the syndrome bandelletta ilio-tibial interesting practitioners of other disciplines such as, for example, football, cycling, basketball or volleyball. Among the injuries that hit the knee of the rider is still the most frequent, it is for the primacy of the patellar tendon inflammation, followed by the patellofemoral syndrome (inflammation of the patellofemoral joint from "excessive consumption") and inflammation flexor tendons (leg goose or hamstring).
2) What are the causes of the syndrome
bandelletta ilio-tibial can be considered essentially an overload syndrome whose causes can be traced back to competition factors predisposing conditions and type of sport.
Predisposing factors are generally of an anatomical, among them the varus knee (ie the so-called "legs in parentheses), the varus of the tibia, the prominent lateral femoral epicondylitis, the asymmetry of the lower limbs and foot tending to pronation, the principal terms of such athletes, combined with the above factors, due to repeated microtrauma which eventually trigger the inflammatory process, are running on sloping or uneven, excessive mileage, an abrupt change in excess of loads workout or the choice of circuits that are too long alternation of ascents and descents, or even training for explosive strength particularly intense, or the incorrect execution of a single session (both quantity and quality). Another predisposing factor, often poorly considered, it is overweight. As a
overload syndrome may occur in susceptible individuals mentioned above in all situations of excess load, regardless of the level of training.
Precisely because of its anatomical shape, the bandelletta undergoes a series of micro-trauma during the race, which may cause the onset of the syndrome of the knee of the rider. The injuries are due to rubbing of the femoral condyle bandelletta when his tail moves before any extension of the knee (the maximum stress occurs at about 30 ° of knee flexion).
3) What are the symptoms
The pathology shows a generally constant pain, but not acute, the lateral aspect of knee pain is accentuated when the bandelletta passes over the lateral femoral condyle, which is when the knee form an arc of about 30 degrees in flexion. The soreness usually develops after a certain period of time from the start and tends to decrease with the rest.
The symptoms occurs in a very subtle: at first it appears so dull after a few minutes, then seems to have diminished with the passage of km, but eventually increases again up to affect the dynamics of the race at the end of the session. The disease disappears when the race ends, the pain is worse in downhill racing circuits or circular and can be present in up and down scaleNormalmente the pain is in the side of the knee and exacerbates with finger pressure on the lateral condyle in knee flexion of the femur. With every passing day, if the picture does not improve, the pain induced to reduce miles and the speed of the race.
The pain may be sufficient to stop the training. Following the increasingly early onset and can occur even in activities of daily living (such as descending stairs). The athlete is
forced to discontinue the sport and can get to walk in knee extended to not feel pain.
4) How do I find
to diagnose with certainty the ilio-tibial syndrome bandelletta should see a specialist (orthopedic surgeon or sports physician) as a pain in the same home could be caused by damage to the lateral meniscus, from patella femoral syndrome, tendinitis of the popliteal or a suffering of the external collateral ligament. Only a specialist with a thorough examination, he manages to make the correct diagnosis.
The Diagnosis is based on objective highlights pressopalpazione pain in the tarsal sinus. Any inquiries are not instrumental to both the diagnosis as to exclude other conditions with similar clinical manifestations, the differential diagnosis with the distal tendon of biceps femoris, the popliteal tendon, the lesion of the lateral meniscus, synovial cysts, the lateral gonarthrosis and outcomes the reconstruction of the anterior cruciate ligament. Examinations are usually required knee radiography and ultrasound, and very rarely resorts to nuclear magnetic resonance, almost never decisive for the diagnosis and that, among other things, can give false or excessive information.
5) How is
Cold is the first therapy to fall back on. The ice pack should be applied immediately after the race (race or workout that is) or just get home. Be careful, however, not to keep more than 15-20 minutes, in fact, a nerve in that area is extremely shallow (the external popliteal sciatic), who could be adversely affected by prolonged cold. Immediately after the visit to be programmed by a medical specialist. Again, it is wrong to do it yourself without recourse to have a precise diagnosis.
The race is absolutely broken and, unfortunately, in this case is not possible to maintain the form devoted to alternative sports, as any movement of the knee flexion / extension can generate friction between tendon and bone, in fact, replace temporarily run with alternative sports such as cycling can be counterproductive because they increase the number of stress on the knee and even greater degrees of flexion.
In less severe cases can be examined, along with the doctor, the possibility of reducing training loads (no suspend all activity), avoiding overloads (eg. Hillclimb, land disconnected, ran along the roadside) continuing treatment with cryotherapy at the end of training.
6) The course
The problem usually resolves over a period of time ranging from 15 days to one month, but unfortunately there are cases with slower healing.
If the injury is not resolved, the orthopedic usually acts with infiltration of anesthetic and steroid medications, iontophoresis, ultrasound, Tecartherapy, laser therapy etc.. In some cases, very rare indeed, need surgery on bandelletta. Since the most serious cases, the stop is quite long, it is necessary to resume after a period of strengthening the muscles of the abdomen, buttocks and quadriceps.
The prognosis of the syndrome of the tibial bandelletta is good in most cases. In any case, it can only return to full recovery.
The gradual resumption of training must be done on a flat and smooth, with appropriate footwear (Eliminating the running shoes worn).
syndrome may recur if there are anatomical predispositions mentioned above. In any case it is useful to agree with the expert, a preventive program.
7) How do I prevent
Stretching plays a vital role in the treatment and prevention of the syndrome of the ilio-tibial bandelletta
After an initial period of rest and reduction of acute inflammation, it is useful to include exercises stretching specific muscles and tendons that help the outside of the thigh and pelvis, stiff and congested inflammation, to regain elasticity and health. Once a definitive solution to the problem, to prevent harmful effects it is best to enter the years even in the normal routine of daily stretching. Here are some examples of exercises to help. Seated Twist
Sitting on the ground with his left leg stretched and twisted with the right knee toward your chest, turn your torso, bring your left elbow touching the knee of his right leg and push inward so to stretch the outer thigh. Hold for 30 seconds without stopping breathing. Reverse the position to stretch the other side.
Weeping Willow
Standing, cross your left leg in front of the right, then bends to the left side and push the pelvis to the right, until you feel the muscles stretch side of the basin. To increase the effect you can flex your right arm to the left. To stretch the other side reverses the position.
To conclude with stretching exercises also suggest that on the tensor fascia lata.
To prevent the problem you should run over to the stretching of the tensor fascia lata and knee flexors also to be borne by the hamstring muscles, hamstring and quadriceps and hamstrings that is, respectively, interior and front of the thigh (such as shown in the examples).
can also be very useful for strengthening the small muscles and gluteus medius.
In the video below is an example of muscle strengthening exercises to prevent this problem.
Among the useful devices can also remember the need to wear proper running shoes (essential in any case, even in the absence of problems), and if necessary wear orthotics to prevent excessive pronation, gradually increase the program training, the downhill race and avoid circular tracks (still bind the flattest part of the track) and put the rest in the program training, to assess the conditions of the training ground, where there is a slight slope on the outer edges of the road, it is recommended to run on the edge by the path from the same side both outward and return. Likewise if you train on the track, or trails with curves, in these cases it will be good forever change the direction of travel.
Linkografia essential
- http://www.salcus.it/2010/12/ginocchio-la-croce-del-podista/
- http://www.podisti.net/2010 / index.php? option = com_content & view = article & id = 1117:
bandelletta-ilio-tibial & catid = 16: medicine-and-feed & Itemid = 100 - http://www.albanesi.it/Arearossa/Articoli/01bandel18.htm
- http://www.osteopata.it/consultazione.asp?Id=62&canale=3
- http://www.antoniosiepi.com/articoli/sindrome-da-frizione-della-bandelletta-ileotibiale/
- http://www.siciliapodistica.it/Oggetti/Esperti/Tipa_06-08.pdf
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