I spent my last clinic session for the year, applying a sports massage to a 20-year-old female, basketball player with pain in her legs in the area of the ITB, before having a break from the course over the summer period. After going through THREADS and contraindications, pop was found all along the ITB (especially lateral femoral condyle) and the TFL (tensor fascia latae) in both sides. Positive Ober test was found which indicates tight ITB. Treatment was a Brief STM to the quads and abductors to try and relax the muscles followed by deep transverse frictions close to the ITB insertion to try and break down adhesions and promote fibroblast activity and finally MET stretches for the TFL and ITB were performed as shown below:
After the session I did some reading on the treatment of Iliotibial band friction syndrome (ITBFS) and found that stretching and manual therapy techniques have shown evidence in helping with this condition. Deep transverse frictions were suggested not to provide any added benefit in treatment, but trigger-point therapy has been shown to help significantly with ITBFS. Strengthening the hip abductor muscles including the gluteus medius, minimus and TFL are also recommended (Lavine, 2010). For future reference, I will remove deep transverse frictions but add trigger-point therapy in my treatment for conditions like ITBFS. Finally, I will revise abduction muscle origins and insertions as my knowledge was lacking in this regard.
Lavine, R. (2010). Iliotibial band friction syndrome. Current Reviews In Musculoskeletal Medicine, 3(1-4), 18-22. doi: 10.1007/s12178-010-9061-8