Is iliotibial band syndrome really a friction syndrome?
Five articles on PainSci cite Fairclough 2007: 1. The Complete Guide to IT Band Syndrome 2. The Complete Guide to Patellofemoral Pain Syndrome 3. Is IT Band Tendinitis Really a Tendinitis? 4. Patellofemoral Tracking Syndrome 5. Does the IT Band Move After All?
original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
Iliotibial band (ITB) syndrome is regarded as an overuse injury, common in runners and cyclists. It is believed to be associated with excessive friction between the tract and the lateral femoral epicondyle-friction which 'inflames' the tract or a bursa. This article highlights evidence which challenges these views. Basic anatomical principles of the ITB have been overlooked: (a) it is not a discrete structure, but a thickened part of the fascia lata which envelops the thigh, (b) it is connected to the linea aspera by an intermuscular septum and to the supracondylar region of the femur (including the epicondyle) by coarse, fibrous bands (which are not pathological adhesions) that are clearly visible by dissection or MRI and (c) a bursa is rarely present, but may be mistaken for the lateral recess of the knee. We would thus suggest that the ITB cannot create frictional forces by moving forwards and backwards over the epicondyle during flexion and extension of the knee. The perception of movement of the ITB across the epicondyle is an illusion because of changing tension in its anterior and posterior fibres. Nevertheless, slight medial-lateral movement is possible and we propose that ITB syndrome is caused by increased compression of a highly vascularised and innervated layer of fat and loose connective tissue that separates the ITB from the epicondyle. Our view is that ITB syndrome is related to impaired function of the hip musculature and that its resolution can only be properly achieved when the biomechanics of hip muscle function are properly addressed.
- “The functional anatomy of the iliotibial band during flexion and extension of the knee: implications for understanding iliotibial band syndrome,” Fairclough et al, Journal of Anatomy, 2006.
- “Iliotibial band syndrome: an examination of the evidence behind a number of treatment options,” Falvey et al, Scandinavian Journal of Medicine & Science in Sports, 2010.
- “Sonographic evaluation of the iliotibial band at the lateral femoral epicondyle: does the iliotibial band move?,” Jelsing et al, J Ultrasound Med, 2013.
- “The source of fluid deep to the iliotibial band: documentation of a potential intra-articular source,” Jelsing et al, PM & R: The Journal of Injury, Function, and Rehabilitation, 2014.
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
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