Is iliotibial band syndrome really a friction syndrome?

Fairclough J, Hayashi K, Toumi H, Lyons K, Bydder G, Phillips N, Best T and Benjamin M.

Iliotibial band (ITB) syndrome is a common sports injury.  It is regarded as an overuse injury that causes pain when there is excessive friction between the ITB and the lateral femoral condyle.  This article challenges this view and reviews the functional anatomy of the ITB.  Key anatomical features are as follows; the ITB is not a discrete structure, but a thickened part of fascia that envelopes the thigh.  It is connected to the linea aspera and the supra-condylar region of the femur by course fibrous bands.  Bursa are rarely present.  These findings suggest that the ITB can not generate frictional forces by moving forwards and backwards over the lateral epicondyle.  The authors propose that the pain associated with this syndrome is caused by compression of highly vascularised and innervated layer of fat and connective tissue that lies between th ITB and the lateral epicondyle.  The authors advocate addressing hip biomechanics in treatment.

Journal of Science and Medicine in Sport, 2007, 10(2), 74-76

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