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İliotibial Bant Gerginliği Olan Sporcularda Ober Eğim Açısının Basınç Ağrı Eşiği ve Kalça Abdüktör Kas Kuvvetiyle İlişkisi

Yıl 2022, , 92 - 99, 11.04.2022
https://doi.org/10.22312/sdusbed.949307

Öz

Amaç: Diz ekleminin stabilizasyonundaki görevlerinden dolayı ve dizin tekrarlı fleksiyon-ekstansiyon hareketleriyle birlikte İliotibial Bant (İTB) üzerindeki gerginlik artar. Diz ve kalça eklemi ile bağlantısı olan İTB'de oluşacak gerginlik sporcunun performansında ve sporcu yaralanmalarında kritik öneme sahiptir. Bu çalışma İTB gerginliği olan sporcularda Ober eğim açısı (OEA) ile basınç ağrı eşiği (BAE) ve kalça abdüktör kas kuvveti arasındaki ilişkiyi araştırmak amacıyla planlandı.
Materyal-Metot: Çalışmaya İTB gerginliği olan 18-25 yaşları arasında 45 erkek sporcu (yaş: 19,53±1,58 yıl, vücut kütle indeksi: 22,08±1,87 kg/m2) dahil edildi. İliotibial bant gerginliğinin belirlenmesinde Ober Testi kullanıldı. Ober eğim açısı bubble inklinometre ile, BAE dijital algometre ile ve kalça abdüktör kas kuvveti izokinetik dinamometre ile değerlendirildi. Bağımsız grupların karşılaştırılmasında Student T-Testi kullanıldı. Ober eğim açısı, BAE ve kalça abdüktör kas kuvveti arasındaki ilişki Pearson korelasyon testi ile analiz edildi.
Bulgular: İliotibial bant gerginliği olan sporcularda OEA ile BAE arasında pozitif yönde güçlü derece (p<0,001; rho: 0,774); kalça abdüktör kasları tepe tork değeri arasında ise pozitif yönde orta derece ilişki (p<0,001; rho: 0,492) olduğu belirlendi.
Sonuç: İliotibial bant gerginliği olan sporcularda OEA’nın BAE seviyesi ve kalça abdüktör kas kuvvetiyle arasında ilişki olduğu görüldü. Ober eğim açısı azaldıkça kalça abdüksiyon kuvveti ve BAE seviyesi azalmaktadır. İliotibial bant gerginliği olan bireylerde kalça abdüktörlerinin kuvvetlendirilmesi ve İTB germe egzersizleri, ağrı eşik seviyesinde, eklem hareket açıklığında ve kalça kas kuvvetinde iyileşmeye katkı sağlayabilir.

Kaynakça

  • [1] Flato R, Passanante GJ, Skalski MR, Patel DB, White EA, Matcuk GR. The iliotibial tract: imaging, anatomy, injuries, and other pathology. Skeletal Radiol. 2017;46(5):605-622.
  • [2] Strauss EJ, Kim S, Calcei JG, Park D. Iliotibial band syndrome: evaluation and management. Am Acad Orthop Surg. 2011;19(12):728-736.
  • [3] Aderem J, Louw QA. Biomechanical risk factors associated with iliotibial band syndrome in runners: a systematic review. BMC Musculoskelet Disord. 2015;16(1):356.
  • [4] Orchard JW, Fricker PA, Abud AT, Mason BR. Biomechanics of iliotibial band friction syndrome in runners. Am J Sports Med. 1996;24(3):375-379.
  • [5] Baker RL, Fredericson M. Iliotibial band syndrome in runners. Phys Med Rehabil Clin N Am. 2016;27(1):53-77.
  • [6] Ober FR. In defense of the fascia lata and the iliotibial band: a comment on back strain and sciatica-Reply. J Am Med Assoc. 1935;105(14):1136.
  • [7] Reese NB, Bandy WD. Use of an inclinometer to measure flexibility of the ıliotibial band using the ober test and the modified ober test: differences in magnitude and reliability of measurements. J Orthop Sport Phys Ther. 2003;33(6):326-330.
  • [8] Melchione WE, Sullivan MS. Reliability of measurements obtained by use of an instrument designed to indirectly measure iliotibial band length. J Orthop Sports Phys Ther. 1993;18(3):511-515
  • [9] Willett GM, Keim SA, Shostrom VK, Lomneth CS. An anatomic investigation of the ober test. Am J Sports Med. 2016;44(3):696-701.
  • [10] Hamstra-Wright KL, Jones MW, Courtney CA, Maiguel D, Ferber R. Effects of iliotibial band syndrome on pain sensitivity and gait kinematics in female runners: A preliminary study. Clin Biomech. 2020;76:105017.
  • [11] Fischer AA. Pressure algometry over normal muscles. Standard values, validity and reproducibility of pressure threshold. Pain. 1987;30(1):115-126.
  • [12] van der Heijden RA, Rijndertse MM, Bierma-Zeinstra SMA, van Middelkoop M. Lower pressure pain thresholds in patellofemoral pain patients, especially in female patients: a cross-sectional case-control study. Pain Med. 2018;19(1):184-192.
  • [13] Fredericson M, Cookingham CL, Chaudhari AM, Dowdell BC, Oestreicher N, Sahrmann SA. Hip abductor weakness in distance runners with iliotibial band syndrome. Clin J Sport Med. 2000;10(3):169-175.
  • [14] Stark T, Walker B, Phillips JK, Fejer R, Beck R. Hand-held dynamometry correlation with the gold standard isokinetic dynamometry: A systematic review. PM R. 2011;3(5):472-479.
  • [15] Fairclough J, Hayashi K, Toumi H, Lyons K, Bydder G, Phillips N, Best TM, Benjamin Mike. The functional anatomy of the iliotibial band during flexion and extension of the knee: implications for understanding iliotibial band syndrome. J Anat. 2006;208(3):309-316.
  • [16] Beals C, Flanigan D. A review of treatments for ıliotibial band syndrome in the athletic population. J Sports Med. 2013;2013:1-6.
  • [17] Ferber R, Kendall KD, McElroy L. Normative and critical criteria for iliotibial band and ıliopsoas muscle flexibility. J Athl Train. 2010;45(4):344-348.
  • [18] Sugimoto D, Mattacola CG, Mullineaux DR, Palmer TG, Hewett TE. Comparison of Isokinetic Hip Abduction and Adduction Peak Torques and Ratio Between Sexes. Clin J Sport Med. 2014;24(5):422.
  • [19] Emery CA, Maitland ME, Meeuwisse WH. Test-retest reliability of isokinetic hip adductor and flexor muscle strength. Clin J Sport Med. 1999;9(2):79-85.
  • [20] Patel DR, Villalobos A. Evaluation and management of knee pain in young athletes: overuse injuries of the knee. Transl Pediatr. 2017;6(3):190-198.
  • [21] Hawrylak A, Chromik K, Barczyk-Pawelec K, Demczuk-Włodarczyk E. Assessment of spine mobility and a level of pressure pain threshold in judo contestants. Sci Sports. 2019;34(4):274–5.
  • [22] Dancey C, Reidy J. Statistics without maths for psychology. Pearson education, 2007.
  • [23] Harput G. Kadın ve Erkek Sporcularda Biyomekaniksel Farklılıklar. Turkiye Klin Sport Med. 2019;5(1):6–9.
  • [24] Phinyomark A, Osis S, Hettinga BA, Leigh R, Ferber R. Gender differences in gait kinematics in runners with iliotibial band syndrome. Scand J Med Sci Sports. 2015;25(6):744–753.
  • [25] Fernández-Pérez AM, Villaverde-Gutiérrez C, Mora-Sánchez A, Alonso-Blanco C, Sterling M, Fernández-de-las-Peñas C. Muscle trigger points, pressure pain threshold, and cervical range of motion in patients with high level of disability related to acute whiplash ınjury. J Orthop Sport Phys Ther. 2012;42(7):634-641.
  • [26] Knutson GA. The role of the gamma-motor system in increasing muscle tone and muscle pain syndromes: a review of the Johansson/Sojka hypothesis. J Manipulative Physiol Ther. 2000;23(8):564–572.
  • [27] Yıldırım Güzelant A. Effectiveness of mobilization practices for patients with neck pain due to myofascial pain syndrome: a randomized clinical trial. Türkiye Fiz Tıp ve Rehabil Derg. 2016;62(4):337-345.
  • [28] Cheatham SW, Stull KR. Roller massage: Comparison of three different surface type pattern foam rollers on passive knee range of motion and pain perception. J Bodyw Mov Ther. 2019;23(3):555-560.
  • [29] Kim H, Shin W. Immediate effect of pressure pain threshold and flexibility in tensor fascia latae and ıliotibial band according to various foam roller exercise methods. J Int Acad Phys Ther Res. 2019;10(4):1879-1888.
  • [30] Lavine R. Iliotibial band friction syndrome. Curr Rev Musculoskelet Med. 2010;3(1-4):18-22.
  • [31] Macmahon JM, Chaudhari AM, Andriacchi TP. Biomechanical injury predictors for marathon runners: striding towards iliotibial band syndrome injury prevention. In: ISBS-Conference Proceedings Archive. 2000.
  • [32] Noehren B, Davis I, Hamill J. ASB Clinical Biomechanics Award Winner 2006: Prospective study of the biomechanical factors associated with iliotibial band syndrome. Clinical biomechanics, 2007;22(9), 951-956.
  • [33] Grau S, Krauss I, Maiwald C, Best R, Horstmann T. Hip abductor weakness is not the cause for iliotibial band syndrome. Int J Sports Med. 2008;29(7):579-583.

The Relationship of Ober Inclination Angle with Pressure Pain Threshold and Hip Abductor Muscle Strength in Athletes with Iliotibial Band Tightness

Yıl 2022, , 92 - 99, 11.04.2022
https://doi.org/10.22312/sdusbed.949307

Öz

Objective: Due to its role in stabilizing the knee joint and with repeated flexion-extension movements of the knee, the tightness on the Iliotibial Band (ITB) increases. The tightness that will occur in the ITB, which is connected to the knee and hip joints, has a critical importance in the performance of the athlete and in athlete injuries. This study was planned to investigate the relationship between Ober inclination angle (OIA), pressure pain threshold (PPT) and hip abductor muscle strength in athletes with ITB tightness.
Material-Method: Forty-five male athletes (age: 19.53±1.58 years, body mass index: 22.08±1.87 kg/m2) between the ages of 18-25 with ITB tightness were included in the study. Ober Test was used to determine ITB tightness. OIA was evaluated with bubble inclinometer, PPT with digital algometer and hip abductor muscle strength with isokinetic dynamometer. Student T-Test was used to compare independent groups. The relationship between OIA, PPT and hip abductor muscle strength was analyzed with the Pearson correlation test.
Results: In athletes with ITB tightness, OIA showed a strong positive correlation with PPT (p<0.001; rho: 0.774), OIA showed a moderate positive correlation with hip abduction peak torque (p<0.001; rho: 0.492).
Conclusion: It was observed that OIA was correlated with PPT and hip abductor muscle strength in athletes with ITB tightness. As the OIA decreases, the hip abduction strength and the PPT level decrease. Strengthening the hip abductors and ITB stretching exercises may contribute to improvement in pain threshold level, range of motion and hip muscle strength in individuals with ITB tightness.

Kaynakça

  • [1] Flato R, Passanante GJ, Skalski MR, Patel DB, White EA, Matcuk GR. The iliotibial tract: imaging, anatomy, injuries, and other pathology. Skeletal Radiol. 2017;46(5):605-622.
  • [2] Strauss EJ, Kim S, Calcei JG, Park D. Iliotibial band syndrome: evaluation and management. Am Acad Orthop Surg. 2011;19(12):728-736.
  • [3] Aderem J, Louw QA. Biomechanical risk factors associated with iliotibial band syndrome in runners: a systematic review. BMC Musculoskelet Disord. 2015;16(1):356.
  • [4] Orchard JW, Fricker PA, Abud AT, Mason BR. Biomechanics of iliotibial band friction syndrome in runners. Am J Sports Med. 1996;24(3):375-379.
  • [5] Baker RL, Fredericson M. Iliotibial band syndrome in runners. Phys Med Rehabil Clin N Am. 2016;27(1):53-77.
  • [6] Ober FR. In defense of the fascia lata and the iliotibial band: a comment on back strain and sciatica-Reply. J Am Med Assoc. 1935;105(14):1136.
  • [7] Reese NB, Bandy WD. Use of an inclinometer to measure flexibility of the ıliotibial band using the ober test and the modified ober test: differences in magnitude and reliability of measurements. J Orthop Sport Phys Ther. 2003;33(6):326-330.
  • [8] Melchione WE, Sullivan MS. Reliability of measurements obtained by use of an instrument designed to indirectly measure iliotibial band length. J Orthop Sports Phys Ther. 1993;18(3):511-515
  • [9] Willett GM, Keim SA, Shostrom VK, Lomneth CS. An anatomic investigation of the ober test. Am J Sports Med. 2016;44(3):696-701.
  • [10] Hamstra-Wright KL, Jones MW, Courtney CA, Maiguel D, Ferber R. Effects of iliotibial band syndrome on pain sensitivity and gait kinematics in female runners: A preliminary study. Clin Biomech. 2020;76:105017.
  • [11] Fischer AA. Pressure algometry over normal muscles. Standard values, validity and reproducibility of pressure threshold. Pain. 1987;30(1):115-126.
  • [12] van der Heijden RA, Rijndertse MM, Bierma-Zeinstra SMA, van Middelkoop M. Lower pressure pain thresholds in patellofemoral pain patients, especially in female patients: a cross-sectional case-control study. Pain Med. 2018;19(1):184-192.
  • [13] Fredericson M, Cookingham CL, Chaudhari AM, Dowdell BC, Oestreicher N, Sahrmann SA. Hip abductor weakness in distance runners with iliotibial band syndrome. Clin J Sport Med. 2000;10(3):169-175.
  • [14] Stark T, Walker B, Phillips JK, Fejer R, Beck R. Hand-held dynamometry correlation with the gold standard isokinetic dynamometry: A systematic review. PM R. 2011;3(5):472-479.
  • [15] Fairclough J, Hayashi K, Toumi H, Lyons K, Bydder G, Phillips N, Best TM, Benjamin Mike. The functional anatomy of the iliotibial band during flexion and extension of the knee: implications for understanding iliotibial band syndrome. J Anat. 2006;208(3):309-316.
  • [16] Beals C, Flanigan D. A review of treatments for ıliotibial band syndrome in the athletic population. J Sports Med. 2013;2013:1-6.
  • [17] Ferber R, Kendall KD, McElroy L. Normative and critical criteria for iliotibial band and ıliopsoas muscle flexibility. J Athl Train. 2010;45(4):344-348.
  • [18] Sugimoto D, Mattacola CG, Mullineaux DR, Palmer TG, Hewett TE. Comparison of Isokinetic Hip Abduction and Adduction Peak Torques and Ratio Between Sexes. Clin J Sport Med. 2014;24(5):422.
  • [19] Emery CA, Maitland ME, Meeuwisse WH. Test-retest reliability of isokinetic hip adductor and flexor muscle strength. Clin J Sport Med. 1999;9(2):79-85.
  • [20] Patel DR, Villalobos A. Evaluation and management of knee pain in young athletes: overuse injuries of the knee. Transl Pediatr. 2017;6(3):190-198.
  • [21] Hawrylak A, Chromik K, Barczyk-Pawelec K, Demczuk-Włodarczyk E. Assessment of spine mobility and a level of pressure pain threshold in judo contestants. Sci Sports. 2019;34(4):274–5.
  • [22] Dancey C, Reidy J. Statistics without maths for psychology. Pearson education, 2007.
  • [23] Harput G. Kadın ve Erkek Sporcularda Biyomekaniksel Farklılıklar. Turkiye Klin Sport Med. 2019;5(1):6–9.
  • [24] Phinyomark A, Osis S, Hettinga BA, Leigh R, Ferber R. Gender differences in gait kinematics in runners with iliotibial band syndrome. Scand J Med Sci Sports. 2015;25(6):744–753.
  • [25] Fernández-Pérez AM, Villaverde-Gutiérrez C, Mora-Sánchez A, Alonso-Blanco C, Sterling M, Fernández-de-las-Peñas C. Muscle trigger points, pressure pain threshold, and cervical range of motion in patients with high level of disability related to acute whiplash ınjury. J Orthop Sport Phys Ther. 2012;42(7):634-641.
  • [26] Knutson GA. The role of the gamma-motor system in increasing muscle tone and muscle pain syndromes: a review of the Johansson/Sojka hypothesis. J Manipulative Physiol Ther. 2000;23(8):564–572.
  • [27] Yıldırım Güzelant A. Effectiveness of mobilization practices for patients with neck pain due to myofascial pain syndrome: a randomized clinical trial. Türkiye Fiz Tıp ve Rehabil Derg. 2016;62(4):337-345.
  • [28] Cheatham SW, Stull KR. Roller massage: Comparison of three different surface type pattern foam rollers on passive knee range of motion and pain perception. J Bodyw Mov Ther. 2019;23(3):555-560.
  • [29] Kim H, Shin W. Immediate effect of pressure pain threshold and flexibility in tensor fascia latae and ıliotibial band according to various foam roller exercise methods. J Int Acad Phys Ther Res. 2019;10(4):1879-1888.
  • [30] Lavine R. Iliotibial band friction syndrome. Curr Rev Musculoskelet Med. 2010;3(1-4):18-22.
  • [31] Macmahon JM, Chaudhari AM, Andriacchi TP. Biomechanical injury predictors for marathon runners: striding towards iliotibial band syndrome injury prevention. In: ISBS-Conference Proceedings Archive. 2000.
  • [32] Noehren B, Davis I, Hamill J. ASB Clinical Biomechanics Award Winner 2006: Prospective study of the biomechanical factors associated with iliotibial band syndrome. Clinical biomechanics, 2007;22(9), 951-956.
  • [33] Grau S, Krauss I, Maiwald C, Best R, Horstmann T. Hip abductor weakness is not the cause for iliotibial band syndrome. Int J Sports Med. 2008;29(7):579-583.
Toplam 33 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makaleleri
Yazarlar

Bayram Sönmez Ünüvar 0000-0003-2095-3645

Ertuğrul Demirdel 0000-0002-7139-0523

Yayımlanma Tarihi 11 Nisan 2022
Gönderilme Tarihi 7 Haziran 2021
Yayımlandığı Sayı Yıl 2022

Kaynak Göster

Vancouver Ünüvar BS, Demirdel E. İliotibial Bant Gerginliği Olan Sporcularda Ober Eğim Açısının Basınç Ağrı Eşiği ve Kalça Abdüktör Kas Kuvvetiyle İlişkisi. Süleyman Demirel Üniversitesi Sağlık Bilimleri Dergisi. 2022;13(1):92-9.

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