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Sonographic evaluation of the iliotibial band at the lateral femoral epicondyle: does the iliotibial band move?

PainSci » bibliography » Jelsing et al 2013
updated
Tags: IT band pain, etiology, anatomy, knee, leg, limbs, pain problems, overuse injury, injury, running, exercise, self-treatment, treatment, tendinosis, pro

Two articles on PainSci cite Jelsing 2013: 1. The Complete Guide to IT Band Syndrome 2. Does the IT Band Move After All? 

PainSci notes on Jelsing 2013:

With this paper, Jelsing et al. have contradicted previously published studies (Fairclough, Fairclough) that strongly concluded that motion of the IT band relative to the lateral epicondyle is an illusion, suggesting that iliotibial band syndrome cannot be a "friction" syndrome. Using ultrasound, they’ve clearly shown that the forward edge of the IT band moves about .7cm through the first 45˚ of knee flexion. Although it needs replication and it’s possible that their single expert examiner found the results he wanted to find, rather than the truth, the evidence is straightforward and it’s more likely that the results are correct. Previously considered settled science, IT band movement at the knee is now an open question again.

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.

OBJECTIVES: The purpose of this study was to determine whether the iliotibial band (ITB) moves relative to the lateral femoral epicondyle (LFE) as a function of knee flexion in both non-weight-bearing and weight-bearing positions in asymptomatic recreational runners.

METHODS: Five male and 15 female asymptomatic recreational runners (10-30 miles/wk) aged 18 to 40 years were examined with sonography to assess the distance between the anterior fibers of the ITB and the LFE in full extension, 30° of knee flexion, and 45° of knee flexion. Measurements were obtained on both knees in the supine (non-weight-bearing) and standing (weight-bearing) positions.

RESULTS: The distance between the anterior fibers of the ITB and the LFE decreased significantly from full extension to 45° of knee flexion in both supine (0.38-cm average decrease; P < .001) and standing (0.71-cm average decrease; P < .001) positions. These changes reflect posterior translation of the ITB during the 0° to 45° flexion arc of motion in both the supine and standing positions.

CONCLUSIONS: Sonographic evaluation of the ITB in our study population clearly revealed anteroposterior motion of the ITB relative to the LFE during knee flexion-extension. Our results indicate that the ITB does in fact move relative to the femur during the functional ranges of knee motion. Future investigations examining ITB motion in symptomatic populations may provide further insight into the pathophysiologic mechanisms of ITB syndrome and facilitate the development of more effective treatment strategies.

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