Iliotibial Band Friction Syndrome (ITBS)

Development of ITBS

Can also develop in fast growing adolescents Results from repetitive bending and straightening of the knee over a long period of time such as in: Cyclists Long distance runners The friction from the fascia gliding over the lateral femoral condoyle irritates and inflames the distal insertion of the IT band fascia Can also develop in fast growing adolescents

Other factors which can lead to development: Abnormal mechanics of the hip, knee, and/or foot Poor hip muscle strength and/or endurance Decreased flexibility Worn out shoes Uneven surface training

Symptoms of Iliotibal Band Syndrome

Diffuse pain over lateral aspect of the knee using the palm of the hand Pain starts insidiously, worsens after a person exercises and the pain onset time gets closer to initiation of the an exercise session

Differential Diagnosis Tests

The Ober’s test can indicate IT band tightness Pain increases likelihood that the patient has ITBS MRI can aid in diagnosis

Ober’s Test

Patient positioned in side-lying Patient’s hip is extended, abducted and patient’s knee flexed. Clinician allows the proximal part of the leg to drop passively onto the contralateral limb. Considered positive when the ipsilateral legs fails to lower.

Recommendation

Patient education and activity modification Initial treatment should include heat and cryotherapy to decrease inflammation IT band massage Stretching of affected limb Strengthening of affected limb Referral for corticosteroid injections can help reduce inflammation

Prognosis

A majority of patients will respond positively to conservative treatment The few who do not will require surgical intervention