Iliotibial band syndrome right and left leg

Man, 42, runner, averages 8,000 steps per day. Iliotibial band syndrome right and left leg. After running 5km the patient has to stop.

PATIENT
Gender
Male
Age
45
Profession
-
Size
-
Height
-
Consultation

Iliotibial band syndrome right and left leg

Biomechanical parameters

Gaitline

Swing phase

Ankle roll

What are the most frequently used parameters?

The sport podiatrist analyses the gait line, the swing phase, and the ankle roll (absolute)

  • The Gaitline provides a quick overall view of the walk and shows what abnormalities may be detected. The contact times are indicated by step phase, allowing one to visualise a potential difference between the two sides and monitor the evolution.
  • The swing phase is used to determine propulsion ratio and the muscles that create  the propulsion. In this way, the symmetry  between the two legs  can be verified. The swing phase is also used to analyse the length of  the stride and the similarity between the two sides. These data help in advising patients regarding daily exercises to avoid asymmetry (strength training, proprioceptivity, etc.).
  • The ankle roll allows for the visualisation angles when striking, flat footed, and during propulsion in specify corrections. The illustrative graphic is explained to patients, who can see their deformations and the differences between the two sides.

What information did you collect for this patient?

The gait line allows us to quickly see how the step rolls and the associated contact times. The patient’s foot, whether left or right, pronates. We also note that the contact times are greater on the left, the foot that is the most deformed.

The ankle roll is used to obtain the precise angles of deformation. In this case, it allowed me to make corrections under the heel, as I had not identified this need during the examinations that I had done before.

What examinations did you have to carry out to complete the analysis?

I carried out the standard examinations that I typically do, a questionnaire and an examination seated in a chair, stationary and standing on one foot.

Upon questioning, we learned that the patient runs regularly, and for several months he has been experiencing from pain in the external face of the knee, which appeared progressively and eventually on both sides.

In a stationary exam, he has very few deformations, the calcaneus is centred, and we note an increasing collapse of the weaker bilateral midfoot.

When observing the patient standing on one foot with the knee bent, we observe a pronation in the foot, and a knee that angles toward the inside. I also carried out a dynamic test and video sequences.

Here we see a pronation of both feet, a genu valgum.

What diagnosis was made?

Iliotibial band syndrome is due in this case to a pronation of the foot that occurs dynamically and is accentuated by running as there is more weight on each support.

This pronation consequently provokes a genu valgum combined with an internal rotation of the knee. The ITBS limits the internal rotation of the knee, it experiences excessive traction and inflammation occurs.

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