Iliotibial Band Friction Syndrome

Knee pain has been reported to limit mobility and impair quality of life in 25% of adults. Iliotibial band syndrome (ITBS) is one of the many different causes of lateral knee pain. It was first seen in US Marine Corps recruits during their training in 1975 and has been diagnosed frequently in long-distance runners, cyclists, skiers, and participants of hockey, basketball, and soccer since then. These activities all depend on rapid and prolonged cycling of the knee through flexion and extension. This article will discuss how this cycling can cause the syndrome, as well as, discuss evaluation and treatment modalities.  The iliotibial band (ITB) is the distal fascial continuation of the tensor fascia lata, gluteus medius, and gluteal maximus. It traverses superficial to the vastus lateralis and inserts on the Gerdy tubercle of the lateral tibial plateau and partially to the supracondylar ridge of the lateral femur. There is also an anterior extension called the iliopatella band that connects the lateral patella and prevents medial translation of the patella. The ITB functions as a knee extensor when the knee is less than 30 degrees of flexion but becomes a knee flexor after exceeding 30 degrees of flexion. The ITB has been postulated to acquire a more posterior position relative to the lateral femoral epicondyle with increasing degrees of flexion.