Changes in low back pain in a long distance runner after stretching the iliotibial band.

OBJECTIVE: This case report describes a long distance runner with low-back pain and sacroiliac pain and proposes iliotibial band tightness as a possible causative factor.

CLINICAL FEATURES: A 38-year-old female amateur runner experienced an exacerbation of right-sided lower back and sacroiliac pain, which she had experienced for several months. The problem became worse as she increased the miles she ran. She had a positive Noble compression test and tightness of the iliotibial band on the right. Gaenslen's, Kemp's, and Patrick's tests were negative on the right, but created her pain of chief complaint. Trigger points were found in the gluteus maximus, gluteus medius, and tensor fascia lata muscles.

INTERVENTION AND OUTCOME: The patient was treated using chiropractic manipulative therapy, trigger point therapy and stretching of the iliotibial band. Her running schedule was also changed; at the beginning of treatment, she stopped running. As she progressed, she ran on flat surfaces, and with further rehabilitation, she resumed her pre-injury schedule and route. She did not demonstrate much improvement until extensive stretching was included in the treatment plan.

CONCLUSION: A patient had low back and sacroiliac pain that seemed to originate from a dysfunctional iliotibial band. This case illustrates that it is important to consider iliotibial band tightness as a possible cause of low back and sacroiliac pain and that proper management may need to include stretching of the iliotibial band along with trigger point therapy and chiropractic manipulation.