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Hip muscle response to a fatiguing run in females with iliotibial band syndrome


Tags: etiology, strength, IT band pain, pro, exercise, self-treatment, treatment, knee, leg, limbs, pain problems, overuse injury, injury, running, tendinosis

One article on PainSci cites Brown 2019: The Complete Guide to IT Band Syndrome

PainSci summary of Brown 2019: ?This page is one of thousands in the bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided at the bottom of the page, as often as possible.

This is a tiny study, contributing just a little bit of indirectly relevant data to the contentious question of the relationship between hip weakness and IT band syndrome.

They took some measurements of a couple hip muscles, gluteus medius and tensor fascia latae, before and after running on a treadmill until they were worn out. They were mainly trying to determine the effect of running on the strength and responsiveness of hip muscles, which is kind of an oblique take on the central question.

Unsurprisingly, hip muscles got weaker after hitting the treadmill so hard, and equally so in both groups. Despite that, they authors conclude — on the basis of one other single metric — that the gluteus medius “does demonstrate less resistance to fatigue,” slightly. In other words, they found one subtle and technical sign, in just 12 injured runners, that was more “suggestive of fatigue” than the other signs. Scraps of evidence don’t get much thinner.

They wrap up by recommending strengthening of the gluteus medius, as though their data demonstrated a need for that. It does not. If gluteus medius actually does have poor fatigue resistance in runners with IT band syndrome, there’s no specific reason to think it isn’t just a trivial symptom of the condition — rather than a defect that needs correcting.

~ Paul Ingraham

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

Impaired hip muscle function has often been cited as a contributing factor to the development of iliotibial band syndrome (ITBS), yet our full understanding of this relationship is not well established. The objective of this study was to examine the effect of fatigue on hip abductor muscle function in females with ITBS. Female runners, 20 healthy and 12 with a current diagnosis of ITBS, performed a treadmill run to fatigue. Prior-to and following the run to fatigue, gluteus medius strength and median frequency values (an indicator of fatigue resistance) were measured. Additionally, onset activation timing of the gluteus medius and tensor fascia latae was measured during overground running. Both healthy and injured runners demonstrated decreased gluteus medius strength following the run to fatigue (p = 0.01), but there was no interaction between groups (p = 0.78). EMG onset activation timing did not differ between groups for the gluteus medius (P = 0.19) and tensor fascia latae muscles (P = 0.52). Injured runners demonstrated decreased gluteus medius initial median frequency values suggestive of fatigue (P = 0.01). These findings suggest that the gluteus medius muscle of female runners with ITBS does not demonstrate gross strength impairments but does demonstrate less resistance to fatigue. Clinicians should consider implementation of a gluteus medius endurance training regimen into a runner's rehabilitation program.

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