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Tractus iliotibialis Syndrom (Runners Knee)

Der Tractus iliotibialis ist ein breiter Faszienstreifen, der vom Darmbeinkamm (Christa iliaca) über den Oberschenkel und Knie bis zum Schienbeinkopf zieht und hierbei die Muskulatur des Oberschenkels stützt.

tractus-iliotibialis-syndrom-anatomie-runners-knee

© Kriwat – Der Fußspezialist

Symptome

Patienten (meist Läufer) klagen über Schmerzen an der Außenseite des Oberschenkels oberhalb des Kniegelenks. Vor allem bei Beugung des Kniegelenks tritt häufig der Schmerz ein, der oftmals nicht nur an der Außenseite des Knies zu lokalisieren ist, sondern über das ganze Kniegelenk ausstrahlt. Der Schmerz tritt zu Beginn der Verletzung primär nach wenigen Minuten beim Laufen ein und wird während der Belastung immer stärker. Nach Belastungsabbruch endet dieser direkt wieder. Bei schwerwiegenden Fällen ist der Schmerz auch beim Gehen vorhanden und hält noch Minuten nach Belastungsabbruch an.

Ursache

Die Schmerzen treten auf, wenn der Tractus iliotibialis an der Epikondylus des Oberschenkels reibt. Hierdurch kommt es zu Reizungen der Knochenhaut oder zu Entzündung des Schleimbeutels unter dem Tractus iliotibialis. Hauptsächlich verantwortlich für das Tractus iliotibaialis Syndrom sind dauerhafte Belastungen des Bewegungsapparates. Oftmals ist eine varische Beinachsenstellung (O-Bein), ein zu energischer Abdruck des Fußes in der Abstoßphase und der Overcrossing-Laufstil (überkreuzen der Beine über die Nulllinie) verantwortlich. Ebenfalls kann eine Überpronation sowie das Laufen auf unebenen Oberflächen zum Tractus iliotibialis Syndrom führen. Bei allen Ursachen für das Läuferknie ist die Muskulatur im Hüftbereich stark verkürzt.

Diagnose

Oftmals kann die Diagnose des Tractus iliotibialis Syndrom nach der Schilderung des Patienten sowie nach Untersuchung der Muskulatur und des Knies gestellt werden. Um andere Verletzungen auszuschließen werden in der Regel Ultraschall, Röntgen sowie Magnetresonanztomographie (MRT) durchgeführt.

Therapie

Zunächst sollte das Sportprogramm stark eingeschränkt werden um eine chronische Entzündung vorzubeugen. Aufgrund der verkürzten Muskulatur im Hüftbereich sollte mehrmals täglich die abspreizende Oberschenkelmuskulatur (Abduktoren) gedehnt werden.

Ein falscher Laufstil (Overcrossing) sollte überprüft werden und etwaige Fußfehlstellungen anhand einer orthopädischen Einlage korrigiert werden.

Bewegungsanalyse

In der Bewegungsanalyse kann man meist ein dynamisches O-Bein feststellen, welches zum Tractus iliotibials Syndrom führt. Bei einer geraden Beinachsenstellung ist meist der Overcrossing-Laufstil für eine Reizung verantwortlich. Statistisch sind in unserer Bewegungsanalyse häufiger Läufer die mehr als 20km/Woche laufen vom Runner’s Knee betroffen, als Personen die nur gelegentlich laufen.

 

WELCHE VERLETZUNG INTERESSIERT DICH ALS NÄCHSTES IN DER REIHE “LAUFSPEZIFISCHE VERLETZUNGEN” ?
HINTERLASSE DEINEN WUNSCH IN DEN KOMMENTAREN.

 

 

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