Iliotibial band syndrome and patellofemoral pain syndrome aren’t as simple as they seem

Once again, evidence shows that you can’t blame overuse injuries on seemingly obvious structural problems.

I just love me some scientific evidence that thumbs its nose at conventional wisdom. Perhaps it is because professionals who unthinkingly hold and defend conventional wisdom are so irritatingly overconfident that it’s just a pleasure to be able to prove them wrong!

by Paul Ingraham, Vancouver BC in PainScience.com 2007

In 2004, a research group at the University of Connecticut let by Michelle Devan decided to try to figure out the effect of “structural abnormalities” on overuse knee injuries like iliotibial band syndrome and patellofemoral pain syndrome. In particular, they wanted to study women. Some evidence suggests that women get more such knee injuries, but it’s controversial, and the authors wanted to try to clear it up a little — and try to find out why there is a difference, if there is a difference.

Some evidence suggests that women get more such knee injuries, but it’s controversial.

So, they did one of my favourite kinds of studies: they measured a bunch of stuff that every therapist in world “knows” is a risk factor for various knee problems, the usual structural suspects. In fifty young women athletes, they checked the tightness of iliotibial bands, the angles of knee joints, and the strength of their hamstrings and quadriceps. And then they waited to see who got what kinds of knee injuries over the course of the season.

Most health care professionals would fully expect the women with tight iliotibial bands to get more ITB syndrome, and the ones with some wacky knee angles to get patellofemoral pain syndrome.

But that’s not what happened!

Several of these young women got iliotibial band syndrome that season. One of them even got it both knees! But these experts determined that not one of them had tight iliotibial bands!