Iliotibial band syndrome

Source: Repatriation Medical Authority Statements of Principles as held by the Veterans Health Centre. SoPs are amended and replaced regularly; always confirm the current instrument at rma.gov.au before relying on it.

RH No. 3 of 2019 · BoP No. 4 of 201930 factors

Meaning of iliotibial band syndrome: For the purposes of this Statement of Principles, iliotibial band syndrome: (a) means a condition of the distal portion of the iliotibial tract where it courses over the lateral femoral epicondyle; and (b) is characterised by pain and tenderness over the lateral aspect of the knee which usually worsens with physical activity; and (c) excludes proximal iliotibial band syndrome and iliotibial band insertional tendinosis. (3) While iliotibial band syndrome attracts ICD-10-AM code M76.3, in applying this Statement of Principles the meaning of iliotibial band syndrome is that given in subsection (2). (4) For subsection (3), a reference to an ICD-10-AM code is a reference to the code assigned to a particular kind of injury or disease in The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM), Tenth Edition, effective date of 1 July 2017, copyrighted by the Independent Hospital Pricing Authority, ISBN 978-1-76007-296-4.

Reasonable Hypothesis (RH) — Statement of Principles No. 3 of 2019

At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting iliotibial band syndrome or death from iliotibial band syndrome with the circumstances of a person's relevant service:

(1)
running or jogging an average of at least 30 kilometres per week for at least the four weeks before the clinical onset of iliotibial band syndrome;
(2)
undertaking weight bearing exercise involving repeated flexion and extension of the affected knee, at a minimum intensity of five METs for at least four hours per week, for at least the four weeks before the clinical onset of iliotibial band syndrome;
Note: MET is defined in the Schedule 1 - Dictionary.
(3)
increasing the frequency, duration or intensity of weight bearing activity involving the affected knee by at least 100 percent, to a minimum intensity of five METs for at least two hours per day, for at least the seven days before the clinical onset of iliotibial band syndrome;
Note: MET is defined in the Schedule 1 - Dictionary.
(4)
cycling at a minimum intensity of five METs for at least five hours per week, for at least the four weeks before the clinical onset of iliotibial band syndrome;
Note: MET is defined in the Schedule 1 - Dictionary.
(5)
increasing the frequency, duration or intensity of cycling by at least 100 percent, to a minimum intensity of five METs for at least two hours per day, for at least the seven days before the clinical onset of iliotibial band syndrome;
Note: MET is defined in the Schedule 1 - Dictionary.
(6)
undergoing knee reconstruction surgery with placement of an implant in the distal lateral femur within the one year before the clinical onset of iliotibial band syndrome;
(7)
having weakness or paralysis of an abductor muscle of the hip before the clinical onset of iliotibial band syndrome;
Note: Abductor muscles of the hip are the gluteus medius, gluteus minimus, gluteus maximus and tensor fasciae latae, and weakness may occur following hip injury, hip surgery or diseases that affect the hip joint, such as gluteal tendinopathy.
(8)
having varus malalignment of the knee or varus thrust of the knee before the clinical onset of iliotibial band syndrome;
Note: varus malalignment of the knee and varus thrust of the knee are defined in the Schedule 1 - Dictionary.
(9)
running or jogging an average of at least 30 kilometres per week for at least the four weeks before the clinical worsening of iliotibial band syndrome;
(10)
undertaking weight bearing exercise involving repeated flexion and extension of the affected knee, at a minimum intensity of five METs for at least four hours per week, for at least the four weeks before the clinical worsening of iliotibial band syndrome;
Note: MET is defined in the Schedule 1 - Dictionary.
(11)
increasing the frequency, duration or intensity of weight bearing activity involving the affected knee by at least 100 percent, to a minimum intensity of five METs for at least two hours per day, for at least the seven days before the clinical worsening of iliotibial band syndrome;
Note: MET is defined in the Schedule 1 - Dictionary.
(12)
cycling at a minimum intensity of five METs for at least five hours per week, for at least the four weeks before the clinical worsening of iliotibial band syndrome;
Note: MET is defined in the Schedule 1 - Dictionary.
(13)
increasing the frequency, duration or intensity of cycling by at least 100 percent, to a minimum intensity of five METs for at least two hours per day, for at least the seven days before the clinical worsening of iliotibial band syndrome;
Note: MET is defined in the Schedule 1 - Dictionary.
(14)
undergoing knee reconstruction surgery with placement of an implant in the distal lateral femur within the one year before the clinical worsening of iliotibial band syndrome;
(15)
having weakness or paralysis of an abductor muscle of the hip before the clinical worsening of iliotibial band syndrome;
Note: Abductor muscles of the hip are the gluteus medius, gluteus minimus, gluteus maximus and tensor fasciae latae, and weakness may occur following hip injury, hip surgery or diseases that affect the hip joint, such as gluteal tendinopathy.
(16)
having varus malalignment of the knee or varus thrust of the knee before the clinical worsening of iliotibial band syndrome;
Note: varus malalignment of the knee and varus thrust of the knee are defined in the Schedule 1 - Dictionary.
(17)
inability to obtain appropriate clinical management for iliotibial band syndrome;

Aggravation-only factors: the factors in subsections 9(9) to 9(17) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.

Balance of Probabilities (BoP) — Statement of Principles No. 4 of 2019

13 factors

At least one of the following factors must exist before it can be said that, on the balance of probabilities, iliotibial band syndrome or death from iliotibial band syndrome is connected with the circumstances of a person's relevant service:

(1)
running or jogging an average of at least 60 kilometres per week for at least the four weeks before the clinical onset of iliotibial band syndrome;
(2)
undertaking weight bearing exercise involving repeated flexion and extension of the affected knee, at a minimum intensity of five METs for at least six hours per week, for at least the four weeks before the clinical onset of iliotibial band syndrome;
Note: MET is defined in the Schedule 1 - Dictionary.
(3)
increasing the frequency, duration or intensity of weight bearing activity involving the affected knee by at least 100 percent, to a minimum intensity of five METs for at least four hours per day, for at least the seven days before the clinical onset of iliotibial band syndrome;
Note: MET is defined in the Schedule 1 - Dictionary.
(4)
cycling at a minimum intensity of five METs for at least ten hours per week, for at least the four weeks before the clinical onset of iliotibial band syndrome;
Note: MET is defined in the Schedule 1 - Dictionary.
(5)
increasing the frequency, duration or intensity of cycling by at least 100 percent, to a minimum intensity of five METs for at least four hours per day, for at least the seven days before the clinical onset of iliotibial band syndrome;
Note: MET is defined in the Schedule 1 - Dictionary.
(6)
undergoing knee reconstruction surgery with placement of an implant in the distal lateral femur within the one year before the clinical onset of iliotibial band syndrome;
(7)
running or jogging an average of at least 60 kilometres per week for at least the four weeks before the clinical worsening of iliotibial band syndrome;
(8)
undertaking weight bearing exercise involving repeated flexion and extension of the affected knee, at a minimum intensity of five METs for at least six hours per week, for at least the four weeks before the clinical worsening of iliotibial band syndrome;
Note: MET is defined in the Schedule 1 - Dictionary.
(9)
increasing the frequency, duration or intensity of weight bearing activity involving the affected knee by at least 100 percent, to a minimum intensity of five METs for at least four hours per day, for at least the seven days before the clinical worsening of iliotibial band syndrome;
Note: MET is defined in the Schedule 1 - Dictionary.
(10)
cycling at a minimum intensity of five METs for at least ten hours per week, for at least the four weeks before the clinical worsening of iliotibial band syndrome;
Note: MET is defined in the Schedule 1 - Dictionary.
(11)
increasing the frequency, duration or intensity of cycling by at least 100 percent, to a minimum intensity of five METs for at least four hours per day, for at least the seven days before the clinical worsening of iliotibial band syndrome;
Note: MET is defined in the Schedule 1 - Dictionary.
(12)
undergoing knee reconstruction surgery with placement of an implant in the distal lateral femur within the one year before the clinical worsening of iliotibial band syndrome;
(13)
inability to obtain appropriate clinical management for iliotibial band syndrome;

Aggravation-only factors: the factors in subsections 9(7) to 9(13) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.

Iliotibial band syndrome — DVA SoP factors