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Quantitative analysis of the relative effectiveness of 3 iliotibial band stretches,☆☆,,★★

https://doi.org/10.1053/apmr.2002.31606Get rights and content

Abstract

Fredericson M, White JJ, MacMahon JM, Andriacchi TP. Quantitative analysis of the relative effectiveness of 3 iliotibial band stretches. Arch Phys Med Rehabil 2002;83:589-92. Objective: To compare the relative effectiveness of 3 common standing stretches for the iliotibial band (ITB): arms at side (stretch A), arms extending overhead (stretch B), and arms reaching diagonally downward (stretch C). Design: Each subject's biomechanics was captured as a 3-dimensional image by using a 4-camera gait acquisition system with a forceplate. Setting: University biomotion laboratory. Participants: Five male elite-level distance runners. Interventions: All participants performed each of the 3 standing stretches for the ITB. Main Outcome Measures: For each stretch, change in ITB tissue length and the force generated within the stretched complex was measured. Data were then combined and analyzed by using kinetic values assessment. Results: All 3 stretches created statistically significant changes in ITB length (P<.05), but stretch B, incorporating overhead arm extension, was consistently most effective both for average ITB length change and average adduction moments at the hip and knee. Conclusions: Adding an overhead arm extension to the most common standing ITB stretch may increase average ITB length change and average external adduction moments in elite-level distance runners. © 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

Section snippets

Methods

Previous studies have been hindered by human measurement error.8 This study minimizes such errors by using a new approach developed at the Biomotion Laboratory at Stanford University, Stanford, CA, to evaluate stretch effectiveness.9 Each subject's biomechanics were captured as a 3-dimensional image by using a 4-camera gait acquisition systema with a forceplate. Change in ITB tissue length and the force generated within the stretched complex were measured for each stretch. The data was combined

Results

All 3 stretches created statistically significant changes in ITB length (P<.05), but stretch B was consistently most effective in both average ITB length change and in average adduction moments at the hip and knee (table 1).

Table 1: Ensemble average measures for each stretch (A, B, C)

Empty CellStretches
MeasuresABC
ITB length % increase9.8411.1510.52
Hip adduction moment % (BW · H)6.808.257.16
Knee adduction moment % (BW · H)4.865.624.75
Statistical comparisonA vs BB vs CA vs C
ITB length % increase**
Hip

Discussion

Myofascial trigger points, hip abductor muscle inhibition, and fascial adhesions can all contribute to increased tension on the ITB and friction at the ITB-epicondyle point of contact.7, 10, 11 A comprehensive stretching protocol is thus a component of a comprehensive treatment protocol to decrease ITB complex tension and restore functional tissue length. This study suggests that adding an overhead arm extension (stretch B) to the most common standing ITB stretch increases average ITB length

Conclusion

This study helps answers the question, Which is the best ITB stretch? By using advanced methods and apparatus at the Biomotion Laboratory, this study suggests that adding an overhead arm extension to the most common lateral ITB stretch increases average ITB length change and average external adduction moments in male elite-level distance runners, and that these differences are statistically significant. Additionally, the use of the methods and equipment used by the Biomotion Laboratory can now

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No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors(s) or upon any organization with which the author(s) is/are associated.

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Reprint requests to Michael Fredericson, MD, Stanford University Medical Center, Division of Physical Medicine and Rehabilitation, 300 Pasteur Dr, Edwards Bldg R107B, Stanford, CA 94305-5336, e-mail: [email protected].

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a. MCU-240s; Qualisys, 2A Pasco Dr, E Windsor, CT 06088.

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