Institute for Sports Medicine Frankfurt Main

1. Risk kinds of sport:

Often with sportsmen with high run load (Triathlon, long-distance run, Marathon, ski long run)

2. Anatomy:

The so-called Tractus iliotibialis (flat tendon fraying rank) represents the stringy extension M. tensor fascia latae. This muscle rises at the front upper basin comb and pulls over the exterior of the thigh up to the lateral seeming leg head.

3. Function:

It presses the thigh head against the socket of the hip joint. At the same time, interiorrotated and spreads he bends the leg. It stabilizes the knee against lateral deviating.

4. Injury mechanism:

First must be differentiated between proximal and distal pain syndrome
A cause:
the reciprocation sliding motion of the Tractus iliotibialis over the lateral hip bone(= Trochanter major/proximal syndrome) or over the lateral thigh bone knee joint near (=lateraler Femurcondylus/distal syndrome).
Favorably for this syndrome work:
Leg axle bad positions (Valgus/Varusstellung of the leg), break descending of spreading feet, frequent running on a road dropping to the side or one-sided “rounding deer” on the sports field. By these causes it can come to a wear of the chord or to an inflammatory provoking of the down-lying bursa.

5. Symptoms:

- Pain within the range of the lateral hip bone (Trochanter major) and/or lateral knee range, which can radiate however into the entire lateral thigh
- every now and then noticeable snatching/sliding of the chord over the bony projections/leads
- Beginning of pain usually only after longer run stress

6. First measures:

- stress break
- in the acute phase cooling within the range concerned
- Spare training (wheel or Wasser=Aquajogging)

7. Diagnostics:

- orthopedic investigation
- Ultrasonic (exclusion of Bursitis or external meniscus problem)
- Roentgen

8. Therapy:

a) Conservative therapy
- optimal sport shoes
- Changes of the fetch (not at the roadside etc.)
- anti-inflammtory medicines
- Injections
- Sport shoe inserts
b) Operational therapy
- with the chronic occurrence by z-shaped extension or groove of the Tractus

9. Physiotherapie:

- Electrical therapy
- Stretch of the outside thigh
- Massage
- Physical therapy cooling/heat application
- Exercises to stabilize the leg axis

10. Prevention:

- one-sided running on diagonal underground avoid
- Stretch exercises strengthen

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