[進階肌動學] 不存在的髂脛束摩擦症候群 ITB Friction is Just an Illusion

許多的跑步以及單車愛好者都曾經遭遇過這種情況
在運動中或運動後
你的股骨外上髁感到疼痛, 有時甚至伴隨著燒灼感
特別是落地時的那一刻感覺特別劇烈
然後你上網查詢
得到了一個看起來很厲害的名詞"髂脛束摩擦症候群"
Many runners and/or cyclists have met this condition.
During the exercise or after the exercise,
you feel painful over you femoral epicondyle.
Sometimes it's even burning or stabbing.
And you feel more painful especially the heel-strike phase.
Back home, you google it.
Then you get a fancy word "ITB friction syndrome"

膝蓋移動的時候
緊繃的髂脛束在股骨外上髁前後磨擦導致疼痛的產生
治療的方式就是放鬆你的髂脛束
一時之間 人手一支狼牙棒瘋狂的滾ITB
很遺憾的 效果似乎不如想像中的有效
甚至造成了更嚴重的疼痛
研究表示以摩擦為理論基礎的治療並沒有得到令人滿意的成效
When the knee is moving,
your tight ITB move anterior and posterior over your femoral epicondyle that causes the pain.
The treatment is relax your ITB.
Suddenly, everyone gets the foam roller and roll their ITB badly.
You feel pain, you feel relieved.
But, it seems not work well, even makes the symptom worse.
The evidence shows that treatment based on the friction theory does not giving the satisfied result.
 

The functional anatomy of the iliotibial band during flexion and extension of the knee:
implications for understanding iliotibial band syndrome

那我們的髂脛束究竟發生了什麼事
解剖學以及核磁共振研究都指出
你的髂脛束是不會前後移動的
而是膝蓋彎曲的過程中 髂脛束不同部分的張力不同造成影像上的變化
此外 髂脛束與股骨外上髁近端側也有一個斜向並且成扇形的結締組織
將髂脛束固定在股骨之上
Then what's really happened on the ITB.
The anatomy and MR researches show that
your ITB WON'T move forward and backward.
The study suggests that an illusion of movement is due to the tension change of it's anterior and posterior part.
Moreover, there's a fibrous strand connects between ITB and femoral epicondyle and fanned out to the femur bone that secures your ITB over you femur.

而在髂脛束與股骨之間的區域
有著豐富的血管以及神經分佈的的脂肪墊存在
這個組織的發炎被認為是更可能的疼痛源頭
在這個情況下 滾筒使用的越多 疼痛的程度就越高
The area between ITB and lateral femur is filled with highly vascularized and innervated fat pad.
The inflammation of this structure might be the true origin of the pain.
In this case, roll more, pain more.

這是一個"壓迫"造成的問題 而不是"摩擦"造成的問題
跟我之前提及的伸展概念連結
髂脛束又替其他人揹了一次黑鍋
"千萬不要貿然放鬆緊繃的肌肉"
It's actually a "Compression" issue, not "Friction" issue.
As I mentioned earlier about the concept of stretch in the previous article,
your ITB is made a scapegoat again.
Remember, DONT release the tight tissue without thinking about it.

如果你有急性的髂脛束症候群
降低發炎以及休息是你的第一要務
當症狀解除後
請尋求動作分析矯正專家的協助
也許問題是臀肌
也許問題是股二頭肌
也許問題是髖關節不穩定
也許問題是腳踝活動度不足
找出壓迫的源頭
才能夠健康的回到運動場上
If you get the acute ITBS
Resting and decreasing inflammation are the most important things to do.
After the acute stage,
find a movement specialist to help you.
The problem might come from your butt.
The problem might come from your bicep femoris.
The problem might come from the instable hip joint.
The problem might come from the improper movement of the foot.
Find the true origin, correct it and back to your field.

本著作由I-Chen Liu, PT, MS製作，以創用CC 姓名標示-非商業性-相同方式分享 4.0 國際 授權條款釋出。