Iliotibial tract

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Iliotibial tract
Posterior Hip Muscles 3.PNG
Iliotibial tract.
Details
Origin Anterolateral iliac tubercle portion of the external lip of the iliac crest
Insertion Lateral condyle of the tibia
Identifiers
Latin tractus iliotibialis
TA98 A04.7.03.003
TA2 2690
FMA 51048
Anatomical terminology

The iliotibial tract or iliotibial band (ITB; also known as Maissiat's band or the IT band) is a longitudinal fibrous reinforcement of the fascia lata. The action of the muscles associated with the ITB (tensor fasciae latae and some fibers of gluteus maximus) flex, extend, abduct, and laterally and medially rotate the hip. The ITB contributes to lateral knee stabilization. During knee extension the ITB moves anterior to the lateral condyle of the femur, while ~30 degrees knee flexion, the ITB moves posterior to the lateral condyle. However, it has been suggested that this is only an illusion due to the changing tension in the anterior and posterior fibers during movement. [1] It originates at the anterolateral iliac tubercle portion of the external lip of the iliac crest and inserts at the lateral condyle of the tibia at Gerdy's tubercle. The figure shows only the proximal part of the iliotibial tract.

Contents

The part of the iliotibial band which lies beneath the tensor fasciae latae is prolonged upward to join the lateral part of the capsule of the hip-joint. The tensor fasciae latae effectively tightens the iliotibial band around the area of the knee. This allows for bracing of the knee especially in lifting the opposite foot. [2]

The gluteus maximus muscle and the tensor fasciae latae insert upon the tract. [3]

Clinical significance

The IT band stabilizes the knee both in extension and in partial flexion, and is therefore used constantly during walking and running. When a person is leaning forwards with a slightly flexed knee, the tract is the knee's main support against gravity.

Iliotibial band syndrome (ITBS or ITBFS, for iliotibial band friction syndrome) is a common thigh injury generally associated with running. It can also be caused by cycling or hiking. The onset of iliotibial band syndrome occurs most commonly in cases of overuse. The iliotibial band itself becomes inflamed in response to repeated compression on the outside of the knee or swelling of the fat pad between the bone and the tendon on the side of the knee. ITB syndrome can also be caused by poor physical condition, lack of warming up before exercise, or drastic changes in activity levels. Until recent anatomical studies showed differently, the previously held belief was that the distal portion of the iliotibial band rubbed over a bursa, however this bursa was found not to exist. Additionally, the theory that the iliotibial band needs to stretch has been questioned as, in cadaveric studies under extreme load, the flexibility of the iliotibial band has been shown to be minimal with greater stiffness than capsular fibers. [4] [5] [6]

Symptoms of iliotibial band syndrome may include pain on the outside of the knee at the beginning of exercise which persists through the exercise or specific movements like running downhill and having the knee bent for prolonged periods of time. [4]

This syndrome is usually developed by people who suddenly increase their level of activity, such as runners who increase their mileage. Other risk factors for ITBS include gait abnormalities such as overpronation, leg length discrepancies, or bow-leggedness. ITB Syndrome is an overuse condition of the distal ITB near the lateral femoral condyle and at Gerdy's tubercle. The most vulnerable range of knee flexion for this condition is at 30-40 degrees; this is where the ITB crosses the lateral femoral epicondyle.

Postural function

The IT band is of critical importance to asymmetrical standing (pelvic slouch). The upward pull on the lower attachment of the IT band thrusts the knee back into hyperextension, thereby locking the knee and converting the limb into a rigid supportive pillar. [7]

Related Research Articles

<span class="mw-page-title-main">Human leg</span> Lower extremity or limb of the human body (foot, lower leg, thigh and hip)

The human leg is the entire lower limb of the human body, including the foot, thigh or sometimes even the hip or buttock region. The major bones of the leg are the femur, tibia, and adjacent fibula. The thigh is between the hip and knee, while the calf (rear) and shin (front) are between the knee and foot.

Iliotibial band syndrome (ITBS) is the second most common knee injury, and is caused by inflammation located on the lateral aspect of the knee due to friction between the iliotibial band and the lateral epicondyle of the femur. Pain is felt most commonly on the lateral aspect of the knee and is most intensive at 30 degrees of knee flexion. Risk factors in women include increased hip adduction and knee internal rotation. Risk factors seen in men are increased hip internal rotation and knee adduction. ITB syndrome is most associated with long-distance running, cycling, weight-lifting, and with military training.

<span class="mw-page-title-main">Knee</span> Leg joint in primates

In humans and other primates, the knee joins the thigh with the leg and consists of two joints: one between the femur and tibia, and one between the femur and patella. It is the largest joint in the human body. The knee is a modified hinge joint, which permits flexion and extension as well as slight internal and external rotation. The knee is vulnerable to injury and to the development of osteoarthritis.

Articles related to anatomy include:

<span class="mw-page-title-main">Gluteus minimus</span> Smallest of the three gluteal muscles

The gluteus minimus, or glutæus minimus, the smallest of the three gluteal muscles, is situated immediately beneath the gluteus medius.

<span class="mw-page-title-main">Hip</span> Anatomical region between the torso and the legs, holding the buttocks and genital region

In vertebrate anatomy, hip refers to either an anatomical region or a joint.

The biceps femoris is a muscle of the thigh located to the posterior, or back. As its name implies, it consists of two heads; the long head is considered part of the hamstring muscle group, while the short head is sometimes excluded from this characterization, as it only causes knee flexion and is activated by a separate nerve.

<span class="mw-page-title-main">Quadratus lumborum muscle</span> Muscle in the lower back

The quadratus lumborum muscle, informally called the QL, is a paired muscle of the left and right posterior abdominal wall. It is the deepest abdominal muscle, and commonly referred to as a back muscle. Each is irregular and quadrilateral in shape.

<span class="mw-page-title-main">Adductor magnus muscle</span> Muscle in the thigh

The adductor magnus is a large triangular muscle, situated on the medial side of the thigh.

The rectus femoris muscle is one of the four quadriceps muscles of the human body. The others are the vastus medialis, the vastus intermedius, and the vastus lateralis. All four parts of the quadriceps muscle attach to the patella by the quadriceps tendon.

<span class="mw-page-title-main">Tensor fasciae latae muscle</span> Muscle of the thigh

The tensor fasciae latae is a muscle of the thigh. Together with the gluteus maximus, it acts on the iliotibial band and is continuous with the iliotibial tract, which attaches to the tibia. The muscle assists in keeping the balance of the pelvis while standing, walking, or running.

<span class="mw-page-title-main">Anterior superior iliac spine</span> Bony projection of the iliac bone

The anterior superior iliac spine (ASIS) is a bony projection of the iliac bone, and an important landmark of surface anatomy. It refers to the anterior extremity of the iliac crest of the pelvis. It provides attachment for the inguinal ligament, and the sartorius muscle. The tensor fasciae latae muscle attaches to the lateral aspect of the superior anterior iliac spine, and also about 5 cm away at the iliac tubercle.

<span class="mw-page-title-main">Gluteal muscles</span> Group of three muscles which make up the buttocks

The gluteal muscles, often called glutes, are a group of three muscles which make up the gluteal region commonly known as the buttocks: the gluteus maximus, gluteus medius and gluteus minimus. The three muscles originate from the ilium and sacrum and insert on the femur. The functions of the muscles include extension, abduction, external rotation, and internal rotation of the hip joint.

<span class="mw-page-title-main">Muscles of the hip</span> Causes movement in the hip

In human anatomy, the muscles of the hip joint are those muscles that cause movement in the hip. Most modern anatomists define 17 of these muscles, although some additional muscles may sometimes be considered. These are often divided into four groups according to their orientation around the hip joint: the gluteal group; the lateral rotator group; the adductor group; and the iliopsoas group.

<span class="mw-page-title-main">Snapping hip syndrome</span> Medical condition

Snapping hip syndrome, also referred to as dancer's hip, is a medical condition characterized by a snapping sensation felt when the hip is flexed and extended. This may be accompanied by a snapping or popping noise and pain or discomfort. Pain often decreases with rest and diminished activity. Snapping hip syndrome is commonly classified by the location of the snapping as either extra-articular or intra-articular.

<span class="mw-page-title-main">Fascia lata</span> Deep fascia of the thigh

The fascia lata is the deep fascia of the thigh. It encloses the thigh muscles and forms the outer limit of the fascial compartments of thigh, which are internally separated by the medial intermuscular septum and the lateral intermuscular septum. The fascia lata is thickened at its lateral side where it forms the iliotibial tract, a structure that runs to the tibia and serves as a site of muscle attachment.

<span class="mw-page-title-main">Superior gluteal artery</span>

The superior gluteal artery is the terminal branch of the posterior division of the internal iliac artery. It exits the pelvis through the greater sciatic foramen before splitting into a superficial branch and a deep branch.

<span class="mw-page-title-main">Wing of ilium</span> Flat portion of the hip bone

The wing(ala)of ilium is the large expanded portion of the ilium, the bone which bounds the greater pelvis laterally. It presents for examination two surfaces—an external and an internal—a crest, and two borders—an anterior and a posterior.

<span class="mw-page-title-main">Iliac crest</span> Top border of the hip

The crest of the ilium is the superior border of the wing of ilium and the superiolateral margin of the greater pelvis.

<span class="mw-page-title-main">Pelvis</span> Lower part of the trunk of the human body between the abdomen and the thighs

The pelvis is the lower part of the trunk, between the abdomen and the thighs, together with its embedded skeleton.

References

PD-icon.svgThis article incorporates text in the public domain from page 468 of the 20th edition of Gray's Anatomy (1918)

  1. Fairclough; Hayashi (2006). "The functional anatomy of the iliotibial band during flexion and extension of the knee: implications for understanding iliotibial band syndrome". Journal of Anatomy. 208 (3): 309–316. doi:10.1111/j.1469-7580.2006.00531.x. PMC   2100245 . PMID   16533314.
  2. Saladin. Anatomy & Physiology: 7th Edition. McGraw Hill. pg.347
  3. Carnes, M. & Vizniak, N. (2009). Quick Reference Evidence-Based Conditions Manual: 3rd Edition. Professional Health Systems Inc., Canada, pg. 240-241.
  4. 1 2 Akuthota V, Stilp SK, Lento P, Gonzalez P. Iliotibial band syndrome. In: Frontera W, Silver JK, Tizzo TD Jr, eds. Essentials of Physical Medicine and Rehabilitation, 2nd ed. St. Louis, MO: W.B. Saunders Elsevier, 2008: chap 60.
  5. Fairclough, John; Hayashi, Koji; Toumi, Hechmi; Lyons, Kathleen; Bydder, Graeme; Phillips, Nicola; Best, Thomas M; Benjamin, Mike (Mar 2006). "The functional anatomy of the iliotibial band during flexion and extension of the knee: implications for understanding iliotibial band syndrome". J. Anat. 208 (3): 309–316. doi:10.1111/j.1469-7580.2006.00531.x. PMC   2100245 . PMID   16533314.
  6. Rahnemai-Azar, AA; Miller, RM; Guenther, D; Fu, FH; Lesniak, BP; Musahl, V; Debski, RE (Apr 2016). "Structural Properties of the Anterolateral Capsule and Iliotibial Band of the Knee". Am J Sports Med. 44 (4): 892–7. doi:10.1177/0363546515623500. PMID   26811306. S2CID   12136011.
  7. Evans P. The postural function of the iliotibial tract. Ann R Coll Surg Engl. 1979 Jul;61(4):271-80. PMC   2492187