Effectiveness of Manual Therapy Versus Strength Training for Iliotibial Band Syndrome on Pain and Functional Recovery in Runners: A Pilot Study

Abstract

Background: Iliotibial band syndrome (ITBS) is a prevalent overuse injury among runners, characterized by lateral knee pain and associated functional limitations. Rehabilitation strategies commonly include manual therapy and strength training, yet their comparative effective-ness remains under investigation. This study aims to evaluate the efficacy of these interventions in reducing pain and promoting functional recovery in runners with ITBS. The findings are intended to inform evidence-based treatment strategies and contribute to the prevention of symptom recurrence.

Methods: Thirty-four runners diagnosed with ITBS were randomly assigned to two equal groups (n = 17). Group A received manual therapy, including deep friction massage, stretching, and soft tissue mobilization. Group B followed a structured strength training program that targeted the hip and knee. The Numerical Pain Rating Scale (NPRS) and Lower Extremity Functional Scale (LEFS) were used to evaluate pain and function, respectively, both before and after a 6-week intervention. Statistical analysis was conducted using the Wilcoxon signed-rank test and the Mann–Whitney U test.

Results: The study indicates that both groups exhibited significant improvements in pain and functional scores following the 6-week intervention. Participants in group A (manual therapy) demonstrated a statistically significant reduction in pain, measured by the NPRS (p = 0.002), and a significant improvement in function, as assessed by the LEFS (p = 0.002). In group B (strength training), there was a statistically significant improvement in both pain, as measured by the NPRS (p < 0.001), and function, as measured by the LEFS (p < 0.001). When comparing post-intervention results between groups, strength training demonstrated greater improvement than manual therapy in both NPRS and LEFS. Future research should consider including a third group that receives a combination of manual therapy and exercise to explore potential synergistic effects.

Conclusion: This pilot study concludes that both manual therapy and strength training are effective in reducing pain and improving function in runners with ITBS. However, strength training demonstrated significantly greater benefits over a 6-week intervention period. These findings support the prioritization of hip- and knee-focused strengthening programs in short-term rehabilitation. Further studies with larger samples and longer follow-up periods are needed, including exploration of combined treatment approaches for potential synergistic health effects.