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Writer's pictureLuke Nelson

Outside of hip pain? It's not always the glutes! 🍑

Whilst many associate ITB pain with pain distally on the outside of the knee, the proximal ITB can also be a source of pain, and should be a differential for lateral hip pain!

The ITB originates outside the hip, at the iliac crest (the top of your waist) where the TFL attaches to the bone. If this muscle is overloaded, it can become painful!


🔑Where this proximal ITB pain differs from gluteal tendinopathy is the pain tends to be located on the iliac crest of the hip. Imaging can also be used to confirm this diagnosis, although rarely is it required.


🔎Other differentials to consider with pain in this area are referred pain from the spine or iliohypogastric nerve irritation.


🙋🏼‍♂️How do you treat proximal ITB pain?

Some of the key management tips include:

🎯Strengthening lateral hip & core muscles

🎯Correcting increased pelvic drop on running if present

🎯Avoid compression on this area with things like tight belts or tool belts

🎯Gradual progression of running & jumping loads


👋Runners & health professionals, share this blog to inform others of this potential cause of hip pain!





📚References

  • Huang, B. K., et al. (2013). "Injury of the gluteal aponeurotic fascia and proximal iliotibial band: anatomy, pathologic conditions, and MR imaging." Radiographics 33(5): 1437-1452.

  • Khoury, A. N., et al. (2018). "Proximal iliotibial band thickness as a cause for recalcitrant greater trochanteric pain syndrome." Journal of Hip Preservation Surgery 5(3): 296-300.

  • Sher, I., et al. (2011). "Proximal iliotibial band syndrome: what is it and where is it?" Skeletal Radiol 40(12): 1553-1556.

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