Windshield wiper syndrome, a concern of runners | EUROtoday

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LRunning is having fun with plain success in France, it’s at the moment probably the most practiced actions on the earth. In France, almost 10 million French individuals usually observe this sport, the comfort and free nature of which contribute to this rising success.
But this sport, like every sporting exercise, is accident-prone, significantly for the knees.

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Indeed, the knee is the joint most susceptible to accidents, and it alone accounts for almost a 3rd of the accidents that may happen when working. After patellofemoral ache, windshield wiper syndrome is the second most typical knee situation amongst runners and the fifth most typical trigger for all joints.

Anatomy of the iliotibial band

Windshield wiper syndrome impacts a selected anatomical construction: the iliotibial band. This strip is a fascia, that’s to say a membrane of pretty dense connective tissue, which stretches from the pelvis to the exterior floor of the knee whereas working alongside the lateral floor of the thigh. This band is neither a muscle nor a tendon, so iliotibial band syndrome doesn’t fall into the class of tendinopathy. This fascia has two anatomical particularities which will likely be essential, each within the physio-pathological technique of look of ache and within the therapy.

READ ALSO Running, watch out for windshield wiper syndrome! First, the iliotibial band is inserted on the very higher a part of the tibia, on a bony tubercle – Gerdy's tubercle – and is pressed in opposition to the top of the femur because it passes over the skin of the knee. It is exactly at this level {that a} friction mechanism, just like the play of a windshield wiper blade, is the place the ache happens. The second anatomical characteristic is discovered on the different finish, on the aspect of the pelvis, the place we discover two muscle tissues which have a direct motion on this strip, the gluteus medius muscle and the tensor fascia lata muscle.

Mechanism of damage

From a strictly pathophysiological standpoint, windshield wiper syndrome outcomes from extreme friction of the tape in opposition to the exterior floor of the knee. This friction could be resulting from extra stress within the iliotibial band, thus inflicting irritation of the tissues involved with the exterior floor of the knee.

Many components may be the reason for this damage: the kind of shoe, the fast improve within the coaching load, native anatomical particularities and even the weak point of the pelvic muscle tissues that we talked about beforehand, the center muscle tissues gluteus and tensor fascia lata.

Diagnosis and therapy

The prognosis of iliotibial band syndrome is actually scientific, as a result of it’s completely identifiable. Patients complain of ache occurring after a sure distance – all the time the identical – or after working. The painful level is one to 2 centimeters above the joint line and medical assessments will affirm the suspicion. It is typically essential to do medical imaging to exclude one other pathology however not systematically.

There is not any scientifically validated therapy protocol for windshield wiper syndrome, nonetheless, a broad consensus has emerged on the therapy which is able to primarily be primarily based on physiotherapy classes. In the acute section, will probably be acceptable to impose joint relaxation with stopping working, to ice the painful space if potential a number of instances a day for 10 to twenty minutes and to start rehabilitation with a physiotherapist who will observe a plenty of technical gestures, together with, amongst others, the applying of radial shock waves. Once the acute section has handed, the rehabilitation protocol will evolve extra actively with the efficiency of stretching, muscle strengthening of the gluteal muscle tissues and all the time guide remedy.

The physiotherapist will educate his affected person self-stretching and pelvic muscle strengthening strategies in order that he can carry out them day by day. The resumption of working can happen, underneath the management of the physiotherapist, earlier than the ache has fully disappeared, respecting a gradual resumption whereas combining the prescribed stretching and strengthening. Finally, counting on the experience of a podiatrist is usually priceless, each for making orthopedic insoles and for his recommendation on selecting essentially the most appropriate sneakers.