Evaluation of Treatment Factors in the Management of Chronic Iliotibial Band Syndrome in Female Distance Runners

Study Overview
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Brief Summary
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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).

Detailed Description
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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.

Official Title
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Evaluation of Treatment Factors in the Management of Chronic Iliotibial Band Syndrome in Female Distance Runners.

Conditions
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Iliotibial Band Syndrome

Intervention / Treatment
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* Other: Gluteus medius strengthening
* Other: iliotibial band stretches


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Female between the ages of 19-45 years; Have been diagnosed or been affected by ITBS (pain on the outside of the knee) for no less than 3 months; A distance runner averaging a minimum of 15 Km per week of road running; Exclusion Criteria: Have previous history of knee surgery or knee trauma to the affected side; Have been diagnosed with any other knee pathology such as patellofemoral pain syndrome, degenerative joint disease, chondromalacia patella, tendinitis or tendinopathy in the affected knee;

Ages Eligible for Study
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Minimum Age: 19 Years
Maximum Age: 45 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Factorial Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Placebo Comparator: Group A<br>Four iliotibial band stretches; to be completed 3 days per week. | Other: iliotibial band stretches<br>* Iliotibial band stretches<br>|
| Active Comparator: Group B<br>Four conventional hip exercises (Hip abductor, gluteus medius strengthening); to be completed 3 days per week. | Other: Gluteus medius strengthening<br>* Hip abductor, gluteus medius strengthening<br>|
| Experimental: Group C<br>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. | Other: Gluteus medius strengthening<br>* Hip abductor, gluteus medius strengthening<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Hip dynamometer strength | Hip dynamometer strengthening will be measured biweekly for the 8-week period | 8-weeks | 

Secondary Outcome Measures

| Outcome Measure | 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. | Measured pre and post 8-week study |