Mid-South Biomechanics Conference, 2022
University of Memphis, Memphis, TN
Optimizing lower-body kinematics to reduce peak non-sagittal knee loads in silico: Implications
for ITBS injury risk
Joshua M. Lardie1, Joshua T. Weinhandl1
1
University of Tennessee, Knoxville, TN, U.S.A
Iliotibial band syndrome (ITBS) accounts for ~12% of running overuse injuries, the second most
common knee injury and most common lateral knee injury 1. There has been no difference found in
sagittal plane range of motion (ROM) between afflicted and healthy populations, as well as no
difference in hip musculature strength2,3. Excessive knee adduction and hip adduction angle has been
associated with ITBS, causing tension in the IT band, as its primary function is lateral stabilization 4,5.
Alterations of running mechanics have shown success in decreasing ITBS related pain, however they are
sagittal plane based. PURPOSE: The purpose of this study is to use OpenSim to examine the
relationship between the hip and knee in the frontal plane as it pertains to ITBS. METHODS: The
residual reduction algorithm (RRA) in OpenSim will be used to create ten torque-driven model. These
models will go through an additional RRA with hip penalty factors decreased, allowing hip kinematics
to alter from the original subjects. The knee adduction moment (KADM) before and after the second
RRA will be analyzed for significant differences, as well as hip kinematics. EXPECTED RESULTS:
We expect to see a significant reduction in KADM as well as significant changes in hip kinematics.
SIGNIFICANCE: A reduction in KADM can reduce excessive loading as well as decrease pain
symptoms of ITBS. By analyzing the differences in the hip kinematics that led to the reduction, a
protocol can be developed to train runners on altering running mechanics to lessen symptoms or risk of
ITBS.
Figure 1. Pre RRA KADM compared to post RRA KADM following decrease of hip penalty factors, a reduction of 30%.
References
1. Fredericson, M., Cookingham, C.L., Chaudhari, A.M., Dowdell, B.C., Oestreicher, N., Sahrmann, S.A., 2000. Hip abductor weakness in distance
runners with iliotibial band syndrome. Clin J Sport Med 10, 169-175.
2. Ferber, R., Noehren, B., Hamill, J., Davis, I.S., 2010. Competitive female runners with a history of iliotibial band syndrome demonstrate atypical hip
and knee kinematics. J Orthop Sports Phys Ther 40, 52-58.
3. 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.
4. Miller RH, Lowry JL, Meardon SA, Gillette JC. Lower extremity mechanics of iliotibial band syndrome during an exhaustive run. Gait Posture.
2007;26(3):407-413.
5. Baker RL, Souza RB, Rauh MJ, Fredericson M, Rosenthal MD. Differences in Knee and Hip Adduction and Hip Muscle Activation in Runners With
and Without Iliotibial Band Syndrome. PM R. 2018;10(10):1032-1039