| Author: | Chen, Fei |
| Title: | Biomechanical investigation of the iliotibial band in running and implication for iliotibial band syndrome |
| Advisors: | Zhang, Ming (BME) |
| Degree: | Ph.D. |
| Year: | 2024 |
| Subject: | Knee -- Wounds and injuries Muscles -- Anatomy Myofascial pain syndromes Running injuries Hong Kong Polytechnic University -- Dissertations |
| Department: | Department of Biomedical Engineering |
| Pages: | xiii, 190 pages : color illustrations |
| Language: | English |
| Abstract: | The iliotibial band (ITB) is a thick band of connective tissue that runs along the outside of the thigh. It forms connections with the tensor fasciae latae muscle (TFL) and the gluteus maximus muscle(Gmax)in the hip region. The ITB then extends down the outside of the thigh, passing over the lateral femoral epicondyle. The ITB plays an important role in stabilizing the knee joint during various activities such as running and cycling. It functions as a tensioning element, delivering lateral stability to the knee and inhibiting excessive side-to-side motion. The ITB also interacts with various muscles, including the gluteus maximus (Gmax), gluteus medias (Gmed), tensor fasciae latae (TFL), vastus lateralis (VL), and biceps femoris (BF), to coordinate movement and maintain proper alignment of the lower extremity. ITBS, a prevalent ailment, frequently affects individuals engaged in running activities. It is often characterized by pain on the outside of the knee, especially during activities that involve repetitive knee bending, such as running. ITBS can be caused by factors such as overuse, muscle imbalances, poor biomechanics, excessive training load, or inadequate stretching and conditioning. Understanding the anatomy and biomechanics of the iliotibial band is important in diagnosing and treating ITBS, as well as in optimizing performance and preventing injuries in individuals engaged in activities that place stress on the knee and hip joints. Therefore, the current study aims to investigate the biomechanics of ITB during running and its implication for ITBS by using the musculoskeletal model with ITB and a subject-specific finite element (FE) model. The biomechanical study discussed the changes in the activation of ITB-related muscles and influential factors to the biomechanics of ITB during an exhaustive run. Furthermore, we studied the compressive pressures on the lateral femoral epicondyle applied by ITB where this area was proposed to be the ‘pain zone’ for ITBS under different running conditions. In the initial segment, we investigated the impact of in-series musculature on the behavior of the ITB in healthy participants during a strenuous run. A total of twenty-five healthy participants, consisting of 15 males and 10 females, performed a 30-minute exhaustive run at a self-selected speed while wearing laboratory-provided footwear. Surface electromyography (EMG) was employed to capture muscle activities of ITB-related muscles, encompassing the TFL, Gmax, Gmed, BF, and VL. The findings indicated a declining trend in the maximum amplitudes of the TFL, Gmax, Gmed, and BF during the exhaustive run. However, the onset and offset of muscle activation remained consistent throughout the running session. These findings suggest that the behavior of the healthy ITB may be altered by the activities of the in-series musculature, potentially leading to increased compression forces applied to the lateral femoral epicondyle for knee joint stability during exhaustive running. In the second part, we examined the effects of influential factors including exhaustion state and running speed on ITB strain and strain rate using the multibody musculoskeletal model. The strain rate in ITB has been identified as a key factor contributing to the development of ITBS. A total of 26 participants performed running trials at their normal preferred speed and a faster speed, followed by a 30-minute exhaustive treadmill run. Afterward, running trials with similar speeds to the speeds before the treadmill run were performed. The results revealed that both exhaustion states and running speeds significantly influenced ITB strain rate, with an increase observed after exhaustion for the similar speed condition before and after the exhaustive run and rapid increases in running speed. It is suggested that an exhaustion state and rapid speed changes may contribute to a higher ITB strain rate, emphasizing the importance of considering these factors in the prevention and treatment of ITBS. Running at a normal speed in a non-exhaustive state may be beneficial in managing this overuse injury. In the third part, we aimed to investigate the interaction between ITB and the lateral femoral epicondyle using a subject-specific FE model. The compressive force between ITB and lateral femoral epicondyle, as well as the stress on the anterior cruciate ligament (ACL), were analyzed at different phases of the running cycle. The results showed that the peak values of compressive force and ACL stress occurred at a knee flexion angle of 20－30 degrees. The study also highlighted the impingement zone between ITB and lateral femoral epicondyle, which occurs when ITB compresses against the femur during knee flexion of 30°. The findings contribute to understanding the biomechanics of ITB and its role in knee joint stability during running. The results enhance the understanding of the biomechanics of ITB during running by incorporating dynamic loading conditions. The findings have significant implications for injury prevention, rehabilitation strategies, and the customization of interventions for individuals with ITB-related problems. By considering the individual variability in biomechanics, this research provides valuable insights that can guide the development of personalized approaches to improve performance and reduce the risk of ITB-related injuries. |
| Rights: | All rights reserved |
| Access: | open access |
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