08/01/2023
There have been many biomechanical studies investigating ITBS, outlined in a number of recent reviews, often creating more questions than answers. Is ITBS a function of lower limb kinematics as well as ITB force transmission? Are changes in the kinematics of the lower limbs the cause of ITBS or are they a compensatory strategy to accommodate and minimize pain? When investigating sagittal plane kinematics, Orchard et al. found no differences between participants’ healthy (asymptomatic) and affected limbs. Prospectively, Noehren et al. and Friede et al. found that individuals who would go on to develop ITBS exhibited greater hip adduction and knee internal rotation during running when compared with matched controls. Foch et al. found that runners with past histories of ITBS had reduced hip adduction when compared to healthy controls . Noehren et al. found that male runners with ITBS ran with significantly greater hip internal rotation and knee adduction angle. These altered kinematics combined with the increased prevalence of ITBS in men (50–81% of those affected) may allude to pain compensation strategies resulting in kinematic changes. This is supported by studies showing that there is a progressive reduction in peak hip adduction angle during prolonged runs, which may be associated with strategies to reduce pain . Overall, these papers suggest that runners may adopt a pattern that places less strain on the ITB once pain is present.