跑步者中的运动控制训练
虽然证据仅限于病例研究,但使用慢速运动捕捉方法识别和修正跑步形态,可能有助于恢复到跑步阶段。 观察的关键领域包括:躯干倾斜、交叉足部落地、足跟落地时的膝关节延展、每分钟的低跨步以及足部落地时脚跟后的质量中心。[30]Meardon SA, Campbell S, Derrick TR. Step width alters iliotibial band strain during running. Sports Biomech. 2012 Nov;11(4):464-72.http://www.ncbi.nlm.nih.gov/pubmed/23259236?tool=bestpractice.com[41]Allen DJ. Treatment of distal iliotibial band syndrome in a long distance runner with gait re-training emphasizing step rate manipulation. Int J Sports Phys Ther. 2014 Apr;9(2):222-31.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4004127/http://www.ncbi.nlm.nih.gov/pubmed/24790783?tool=bestpractice.com[42]Foch E, Reinbolt JA, Zhang S, et al. Associations between iliotibial band injury status and running biomechanics in women. Gait Posture. 2015 Feb;41(2):706-10.http://www.ncbi.nlm.nih.gov/pubmed/25701012?tool=bestpractice.com[43]Heiderscheit BC, Chumanov ES, Michalski MP, et al. Effects of step rate manipulation on joint mechanics during running. Med Sci Sports Exerc. 2011 Feb;43(2):296-302.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3022995/http://www.ncbi.nlm.nih.gov/pubmed/20581720?tool=bestpractice.com
髋外展加强实时反馈
实时减退反馈的应用(如跑步时显示髋内收运动图及口头指令减少髋内收)具有协助减少致伤因素如过度髋内收和膝关节内收的潜在作用,但对髂胫束综合征患者的治疗效果尚无相关研究。[44]Noehren B, Scholz J, Davis I. The effect of real-time gait retraining on hip kinematics, pain and function in subjects with patellofemoral pain syndrome. Br J Sports Med. 2011 Jul;45(9):691-6.http://bjsm.bmj.com/content/45/9/691.longhttp://www.ncbi.nlm.nih.gov/pubmed/20584755?tool=bestpractice.com[45]Barrios JA, Crossley KM, Davis IS. Gait retraining to reduce the knee adduction moment through real-time visual feedback of dynamic knee alignment. J Biomech. 2010 Aug 10;43(11):2208-13.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2914211/http://www.ncbi.nlm.nih.gov/pubmed/20452595?tool=bestpractice.com
针对髂胫束的筋膜性质实施治疗
支持髂胫束综合征跑步者存在髂胫束长度缩短的证据较弱。[24]Noehren B, Schmitz A, Hempel R, et al. Assessment of strength, flexibility, and running mechanics in men with iliotibial band syndrome. J Orthop Sports Phys Ther. 2014 Mar;44(3):217-22.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4258688/http://www.ncbi.nlm.nih.gov/pubmed/24450366?tool=bestpractice.com 但是,新兴的理论思考观点将髂胫束描述为能够在拉伸时吸收能量然后在收缩阶段贡献能量的筋膜结构,这是影响跑步效率的一个因素。[46]Eng CM, Arnold AS, Lieberman DE, et al. The capacity of the human iliotibial band to store elastic energy during running. J Biomech. 2015 Sep 18;48(12):3341-8.http://www.ncbi.nlm.nih.gov/pubmed/26162548?tool=bestpractice.com