Tractus syndrome

Synonyms

Runners knee, ilio-tibial ligament syndrome, friction syndrome

definition

A tractus syndrome is understood to be a pain syndrome that has arisen, primarily as a result of overuse, and which spreads primarily in the area of ​​the outside of the knee

  • Pain and
  • Can trigger movement impairments.

causes

To the movement of the lower extremity to ensure pull Muscles and their Tendons of the hip arising on the outside of the Thigh direction knee and are just above the Lower leg with a Tendon plate attached.

This also as Ilio-tibial band designated part of the Musculoskeletal system is responsible for making certain movements when

  • Go and
  • To run can be carried out.

The muscle plate attaches to a small one Bony prominence and is attached to it. Depending on the anatomy of the person concerned, it may be that this protruding bone with the muscle attachment protrudes too far and is therefore minimal when moving friction on tendon and muscle is exercised.

If only minor movements are carried out, the affected person usually does not perceive this anatomical condition. It does not cause any discomfort. But are always repetitive movements or a

  • permanent overload carried out,
    there is increased friction, which leads to the symptoms. Other reasons for developing a runner's knee can also
  • chronic inappropriate stress running and walking, which despite normal anatomy in the knee can lead to friction during movement with associated discomfort.

Symptoms

At large burden it comes with Tractus syndrome to be pulled during the movement. The pain is mainly due to the Outside of Knees localized and are saved as

  • pulling or
  • cutting described.

The pain is

  • easy to localize,
  • but can also radiate.

The further that Tractus syndrome as the pain progresses, the pain becomes worse. In extreme cases it can happen that already Pain at rest enter. Even with severe courses are also sometimes Movement impairments available.

diagnosis

In most cases that is enough Health survey and the physical examination off to a Runner's knees to diagnose. If patients are the typical pain localization especially after To run and after Sports indicate, this is already indicative of a runner's knee.

During the physical examination, the doctor leaves the patient lying down Lift leg. He himself feels the gliding ahead Tendons- and Muscle plate above the knee. When it comes to appropriate movement Pain comes is a Tractus syndrome as good as proven.
Differential diagnosis can still be

  • Ruptured muscle fibers or
  • Injuries of the tendon act or
  • Osteoarthritis in the Knee joint or
  • meniscus-and Ligament damage can lead to similar symptoms.

therapy

In most cases that is enough conservative therapy. This consists of first physical protection.
The patient should be in the next few days

  • do not do sports and
  • Avoid strenuous movements of the legs.

Furthermore, an adequate one Pain therapy sensible,

  • the medicinal but also
  • physically can be.

Physical pain treatments include Refrigeration applications. Patients should put their legs up and use an ice pack to cool them. The tract syndrome comes from a Improper loading should be taken care of, these misalignments by means of insoles balance. With sporty Exercises should be started again slowly in the course. Overloading should be avoided. In extreme cases, conservative therapy is not enough. In this case the Bottleneck on the knee operational to allow muscle movements to take place unhindered.

Duration

The duration varies greatly as the inflammation progresses. Are often affected inexperienced athleteswho have only recently started a new and intensely practiced sport. After a few but long training sessions, pain occurs. If immediate rest is observed and the inflammation is given time, the pain can go away within a few days to weeks. The longer the pain is ignored, the more severe and common it becomes. In the case of severe inflammation, which can already be felt at rest or with slight movement, the healing takes accordingly longer time. In these cases you can up to 8 weeks of rest be necessary. Even after that, the load should only be increased slowly again.

Exercises against the tract syndrome

If a tractus syndrome is present, stretching as both a therapeutic and a prophylactic agent. They serve to stretch the iliotibial tract directly on the one hand and to strengthen the pelvic stabilizing muscles on the other.

The following stretching exercises are particularly suitable for therapy:
In a first exercise, the Legs crossed become. When the right leg is in front of the left, the left, extended arm including the upper body must be tilted to the right. Repeat the same thing with the other leg forward, tilting your body to the left and extending your right arm. The respective position should be for about 15-20 seconds be respected.

A second exercise calls for yourself on one leg and lift the other leg. You hold your knee with one hand and your ankle with the other so that it looks like a kind of cross-legged position. In this position, the lower leg should now be carefully pulled upwards until you feel a stretch on the thigh down to the buttocks. This stretch position should be around 15 seconds long adhered to. It is important that the Always keep your back straight is.
More exercises are best done by those affected Physiotherapists show or look at each other Videos with detailed descriptions to correct execution.

If the reason for the tractus syndrome is a Pelvic muscle weakness is, this absolutely must trained and strengthened become. A simple exercise is suitable for this, the only tool of which is a stairway is. You stand on the stairs in such a way that you stand with one leg on the edge of the stairs and that the other leg swings freely. Now the pelvis must be lowered on the side of the freely hanging leg and then raised again. Depending on your fitness level, the exercise can 10-15 times per side be repeated.

Since tractus syndrome is a common symptom of runners, it is advisable to prevent the whole thing. This can be achieved by making the training varied and not only consisting of jogging, but also of Stretching units and Strength training. This avoids a monotonous and one-sided strain on the muscles, which can ultimately reduce the risk of a tractus syndrome. In addition, the application of a so-called "Blackroll“Helpful to loosen the iliotibial band of fascia and make it supple so that shortening or hardening is less likely.

In conclusion, it's important to mention that one Overload through the exercises mentioned avoid is. In order to achieve optimal healing, the exercises should controlled and with moderate exercise are executed.

Taping in tractus syndrome

Taping is a conservative treatment option for tractus syndrome. The properties of elasticity and the self-adhesive function make the tape a functional bandage that allows the reduce pain should. also stabilized the tape covers the area of ​​the iliotibial band and acts stimulates the muscles and the fascia of the tract.
The tape can usually up to 5 days be left. Showering or swimming is also generally possible, but only reduces the duration of liability if necessary. In general, this can also be done by laypeople, but in the case of extreme complaints and the need for the effective effect to occur in any case, it is advisable to place the taping in the hands of specialists.

The following explains briefly how the tape is to be attached in the case of the tract syndrome. Sufferers should lie on their side so that the painful side of the leg is facing up. In addition, it should Knees slightly bent so that the foot comes to rest on the lower leg of the lower leg. A long strip of tape will now along the iliotibial band glued. The middle part is attached with slight tension, but the two ends in the area of ​​the hip and knee are glued on very loosely.
When sufferers experience the pain from a tract syndrome pinpoint exactly it makes sense to fix two additional small strips of tape in the appropriate place. The point of pain should be the point where the two stripes cross. It's important, that neither of the two tapes pulls into the hollow of the knee or sticks to the kneecapas this can cause irritation when running. Rather, they should be slightly offset from the first long tape, i.e. at a slight angle to the iliotibial tract. Rubbing the tape improves the adhesion to the skin and at the same time increases the blood circulation in the corresponding area.

Blackroll

The Blackroll is one Foam rollwhich is used for self-massage. The principle behind it is to loosen muscle fascia in the upper body and to prevent tension, sore muscles, blockages and other orthopedic problems and to treat them. She provides one Alternative to professional physiotherapy and can be carried out independently.

Initially, the exercises should be carried out under professional guidance so as not to incorrectly irritate and strain certain structures and fascia. The Blackroll can then also be used at the ITBS and prevents further complaints. However, they should not be the only therapy for acute pain.

Surgery for tract syndrome

If any conservative therapeutic approaches unsatisfactory or ineffective surgery may be necessary if there is a pronounced tract syndrome. The aim of the surgery is to remove the trigger that caused the pain. On the one hand, this can be the Narrow point in the knee be in the insertion area of ​​the iliotibial band.

One can of a kind "Relief operation“Speak because of the intraoperative Removal of the excess bone there is more space again and there can be no pain-inducing friction between muscle and tendon tissue and bones.
If the bone portion is not enlarged, but the Shortened iliotibial band, the relief is achieved in one operation by opening the tract itself cuts in. The tract can then lengthen and no longer rub over the protruding bone. The cut is usually made in a z-shape.

In addition, the inflamed and painful tissue in a Arthroscopy of the knee joint, i.e. a joint speculum, can be removed. Another variant is corrective surgery for malpositions such as bow legs. By straightening the leg axis, the symptoms of the tractus syndrome can be eliminated.

Risk factors

Risk factors get tractus syndrome

  • Overuse in sports as well
  • one-sided movements,
  • missing Warm up before sport and
  • Incorrect loads such as Misalignments of the Joints.

Hip tract syndrome

Pain caused by a tractus syndrome occurs mainly in the knee area, hence the synonym "Runner's knees". However, it can also cause complaints in the Thigh umd especially in the hip come. The reason for this is the course of the iliotibial band. This is because it arises near the hip joint on the pelvic bone and then runs along the outside of the thigh to near the knee joint on the lower leg.
The tractus syndrome can be caused by a Weakness or instability of the pelvic stabilizing muscles be conditional. If the muscles are poorly developed, the hip sinks to the side that is not used under stress. This results in a extreme pull on the iliotibial bandwhich ultimately leads to the symptoms of a tractus syndrome. Thus, in the context of the tractus syndrome, the hip can be the location of Expression of pain On the other hand, it is also the area in which the syndrome arises due to muscle weakness.

Summary

The tractus syndrome is a Overuse Syndrome of the lower extremity, which is the result of a raised friction of the muscle- and Tendon plate in the area of Knees leads to severe pain.

Imaging is usually not necessary for diagnosis and is sufficient physical examination. This is dealt with Pain syndrome With

  • discharge,
  • cooling and
  • medicinal Pain therapies.

In severe cases a Relief operation respectively.