Definition/Description
The Noble test (Noble compression test) is an iliotibial band stimulation test developed by Clive Noble. It is commonly used as an indication for iliotibial band syndrome; however, no evidence-based studies have been performed to control the validity of this test. other tests The ones that can be used are the modified Ober test and the Renne Creak test. [1][2][3]
Clinically Relevant Anatomy
The anatomical knowledge relevant to the test is the iliotibial band. It begins with the iliotibial band, which is a thickening of the fascia lata originating from the iliac crest. The iliotibial band runs laterally down from the femur. at the greater trochanter fiber of the tensor The fascia lata muscle and gluteus maximus insert into the iliotibial band. As it approaches the knee joint, the iliotibial band crosses the lateral epicondyle of the femur and splits into two structures: the iliotibial band and a distal extension that inserts into the tubercle of Gerdy (Figure 1). [4]
During walking and running, the iliotibial band experiences frictional and compressive forces on the lateral epicondyle. Repetitive strain injuries, poorly fitting footwear can lead to lower extremity misalignment and muscle imbalances leading to increased friction. [5] Iliotibial band (ITB) friction syndrome is an overuse Injuries are common among runners, cyclists, weight lifters, skiers and soccer players. It is characterized by pain on the lateral epicondyle of the femur.
Purpose
The purpose of this test is to detect painful abnormal tightness of the iliotibial band, which can indicate iliotibial band syndrome. It helps to distinguish iliotibial band syndrome from other common causes of pain on the outside of the knee. [2][4]
Technique[6]
Procedure
The patient lies supine or on their side with the affected side facing up. Grab just above the ankle and slowly bend the knee back and forth from 0-90° several times while palpating and pressing firmly with the thumb of the other hand for crepitus on the lateral epicondyle.
Interpretation
Palpable snapping friction or “squeaky hinge-like” crepitations or localized pain that increases with pressure at or above the epicondyle (usually at 30° of flexion) suggests ITB syndrome.
[7]
Evidence
Reliability & Validity: Unknown[6]
Clinical Bottom Line
This test indicates iliotibial band syndrome, but it must be stated again that no studies have shown the validity of this test. [2][4]
References
- ↑ Kasunich NJ. Changes in low back pain in a long distance runner after stretching the iliotibial band. Journal of Chiropractic Medicine 2003; number 1, volume 2; 37-40. Level of Evidence: B
- ↑ Jump up to:2.0 2.1 2.2 Noble CA. The Treatment of Iliotibial Band Friction Syndrome. Brit. J. Sports Med 1979;13;51-54
- ↑ Rosenthal MD. Clinical Testing for Extra-Articular Lateral Knee Pain. A Modification and Combination of Traditional Tests. North American Journal of Sports Physical Therapy 2008; volume 3, number 2:107-109 LEVEL OF EVIDENCE: B
- ↑ Jump up to:4.0 4.1 4.2 Dubin J. Evidence Based Treatment for Iliotibial Band Friction Syndrome: Review of Literature.Biomechanics August 2005
- ↑ SieunNarine-McKay J. Evaluation of outcomes in assessment of iliotibial band syndrome rehabilitation programs (Doctoral dissertation, University of British Columbia.)
- ↑ Jump up to:6.0 6.1 Knee Orthopaedic Test – A Strategic Approach to Assessing the Knee; University of Western States, College of Chiropractic, Clinic Protocol; Renne; Page No.34; Adopted 12/12. (accessed on 21.07.18 from Knee_Orthopedic_Tests.pdf)
- ↑ Noble’s Compression test. The student physical therapist. Available from https://www.youtube.com/watch?v=eLAU6Xhs2ms
