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Iliotibial Band Syndrome

Iliotibial Band Syndrome or 'Ilitibial Band Friction Syndrome' is a common sports injury generally associated with running. This syndrome is bound to cause lateral knee pain in runners. This injury can also be caused by biking, hiking and weight lifting. This Iliotibial band is a thick fibrous tissue that runs from the outside of the pelvis, over the hip, knee and below the knee joint. The band stabilizes the knee during movements like running. The band coordinates with several other thigh muscles and moves from behind the femur in the thigh to the front during the gait cycle. The Iliotibial Band Syndrome refers to the superficial thickening of the tissue that is on the outside of the thigh. Continuous rubbing and flexing of the band causes irritation usually over the outside of the knee joint.


Common causes of the Iliotibial Band Syndrome among runners


  • Iliotibial Band Syndrome occurs when the level of activity increases especially among runners who tend to increase their mileage. Increasing distance too quickly or excessive downhill running is a common cause among runners.
  • Poor training habits in runners can cause this syndrome. While running on an indoor track, the leg bends slightly inwards and this causes extreme stretching of the Iliotibial band and the resultant injury.
  • Inadequate warm up and cool down sessions among sports persons can cause this syndrome.
  • While cycling, having the feet 'toed in' at an extreme and excessive angle can cause the Iliotibial band injury.

Individuals with anatomical abnormalities of the leg such as bow legs, high or low arches, overpronation of the foot and uneven leg length are prone to this condition. Muscle imbalance such as weak hip abductor muscles can lead to iliotibial band syndrome.


Symptoms of this syndrome include pain in the knee joint that worsens with continued movement and resolves on rest. There is persistent pain below the knees or stinging sensation just above the knee joint. Often swelling or thickening is noticed at the point of knee joint where the band moves over the femur. Persons suffering these symptoms must avoid running downhill or squatting, playing tennis or basketball and indulging in martial arts.

Treatment for Iliotibial Band Syndrome normally begins with applying ice the area of injury, selection of proper footwear and stretching routine. While icing, the injured part has to be kept elevated as this helps to reduce swelling. Anti-inflammatory medications and cortisone injections may be prescribed to reduce the inflammation. Surgery is rarely resorted to.

Windburn

Windburn is not sunburn in the winter. It feels similar as in it makes the skin red, dry and irritated. Any exposed skin can get windburn. This happens in the cold temperature with low humidity. It robs the skin of its natural oils making it start peeling. The blood vessels in the skin's outer layer start dilating making the skin appear red. The skin then becomes sensitive to any product. Skiers and winter runners suffer this condition if not adequately protected.


Preventing and treating windburn

Cover your skin before exposing to cold winds. Wear a hat and sunglasses. Apply thick moisturizer to exposed skin every few hours.

If your skin is already sore with windburn, wash it with lukewarm water and apply a healing moisturizer. Coconut oil also works well. Keep yourself well hydrated and stay in humidified room if possible. Stay clear of harsh exfoliators on the skin. Allow the peeling to heal the skin and resist the urge to pick at it.

Aloe Vera Gel, cucumber, potato slices or oatmeal are excellent home remedies to soothe windburned skin. You can also apply Vitamin E oil or a paste of cornstarch or baking soda.


Windburn Vs Sunburn

Sunburn and Windburn may appear alike and often occur together but are not same. It often becomes difficult to be able to distinguish.

Windburn occurs due to depletion of natural oils from the outer layer of the skin. It does not result in long-term skin damage. It is similar to 'irritant dermatitis'. Preventive measures include covering the skin and keeping it well moisturized.

Sunburn occurs due to harmful UV rays of the sun causing damage to the skin cells resulting in discoloration and age spots. Prolonged sun exposure and sunburn can lead to skin cancer.



Subungual Hematoma

If you had just slammed your finger on your car door and the pain is unbearable and the nail has turned black and blue, then you are likely to have Subungual hematoma. The nail hematoma is seldom serious but always painful.
Also called Runner's Toe or Tennis Toe, Subungual Hematoma is a collection of blood under the fingernail or toenail.


This may have been caused by an injury such as slamming the nail in a door or dropping a heavy object on the nail. Subungual Hematoma can occur when blood thinning or cancer treatment medicines are consumed or you have an autoimmune condition. Subungual Hematoma can be extremely painful for an injury of its size although otherwise it is not a serious medical condition.


Signs and symptoms


  • A discoloration in red or purple or maroon under the nail after an injury.
  • Throbbing and intense pain; pressure generated between the nail and the nail bed where the blood collects causes this pain.
  • Swelling in the affected nail or toe.
  • Tender to the touch.

Causes

Subungual hematomas commonly occur after a crush type of injury at the tip of the finger or toe – hitting your finger with a hammer, dropping a heavy object on your toe or closing your finger in a door. Subungual Hematoma may be caused by ill fitting shoes and insufficient space for the toes.

The condition also results from slamming a finger in a door or from sports activities such as climbing or hiking in a rugged terrain. Due to running injuries, a foot might have lost a toenail and this is exacerbated by poorly fitting shoes.

Subungual Hematoma that occurs from repetitive thrusting of the longest toe into a shoe's toe box is called jogger's toe or runner's toe. Here bleeding occurs from the nail bed underlying the nail plate.


Runners toe is caused by downward pressure or horizontal separation of nail plate from nail bed. Repetitive traumatic injury leads to bleeding and blood gets pooled underneath the toe nail. The deformed nail plate gradually grows out and is replaced by new nail plate several months later. Sometimes the toe may become painful and require surgical drainage.


Treatment of Subungual Hematoma

A small hole is made in the nail to drain the blood. This will decrease pain and swelling. Following commonly used methods for draining hematoma include:

Cautery, a battery operated device used to burn a hole in the nail until the blood is reached and drained out of the hole. In case the patient is using artificial acrylic nails which might be flammable, this method should not be used.

A large diameter needle is used to drill or bore into the nail to create a hole to allow the blood to drain out.

Nail removal may be done if the nail is damaged. The doctor may also have to repair the tissue under the nail. Although anesthesia is generally not required, a digital nerve block is recommended to be performed if the nail is to be removed.

A splint may be placed on the finger or toe to prevent movement and protect the area while it heals. Subungual hematoma may typically heal without incident, although infection of the nail may occur.


Caring for Subungual hematoma

Keep injured finger or toe dry as long as directed.

Trim nails gently if it begins to fall off in pieces. This may decrease risk for catching the nail on an object or ripping it off.

Wear shoes that are comfortable and fit correctly to prevent injury to the toe.

Ice is used to elevate the affected finger. Place ice wrapped in a towel over the painful area for as long as directed and then elevate hand or foot on pillows above the level of the heart to help decrease swelling and pain.


If the nail was removed by the injury and the nail bed is not cut, then it is recommended to have the following home treatment done until the nail bed begins to be less sensitive, usually in a week to ten days. Twice daily soak with antibacterial soap and water for ten to fifteen minutes. After soaking, apply a topical antibiotic ointment and a dry sterile bandage.


Prevention

Exert caution when dealing with heavy objects. While on some high risk jobs, used steel toed shoes. Watch children's hands while opening and closing doors. Give full attention to the task on hand. Finger injuries often happen when the person using the hammer is distracted. In case of heavy objects, find people who can carry them – instead of dropping them on your toes.


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Collection of Pages - Last revised Date: August 24, 2019