Curr Rev Musculoskelet Med (2010) 3:18–22 DOI 10.1007/s12178-010-9061-8 Iliotibial band friction syndrome Ronald Lavine Published online: 20 July 2010 Humana Press 2010 Abstract Published articles on iliotibial band friction syndrome have been reviewed. These articles cover the epidemiology, etiology, anatomy, pathology, prevention, and treatment of the condition. This article describes (1) the various etiological models that have been proposed to explain iliotibial band friction syndrome; (2) some of the imaging methods, research studies, and clinical experi- ences that support or call into question these various models; (3) commonly proposed treatment methods for iliotibial band friction syndrome; and (4) the rationale behind these methods and the clinical outcome studies that support their efﬁcacy. Keywords Iliotibial band Knee pain Running injuries Iliotibial band friction syndrome What is iliotibial band friction syndrome? Iliotibial band friction syndrome (ITBFS) involves pain in the region of the lateral femoral condyle or slightly inferior to it, that occurs after repetitive motion of the knee, typi- cally in a runner, cyclist, or other athlete. Most typically a diagnosis is made based on the case history and physical examination, though in some cases MRI’s might be indicated to rule out another disorder in the region. An important ﬁnding on physical examination is local tenderness of the lateral knee inferior to the epicondyle and superior to the joint line. The Ober test for distensibility of R. Lavine (&) Private Practice of Chiropractic, 928 Broadway, Suite 804, New York, NY 10010, USA e-mail: askdrlavine@gmail.com the iliotibial band is also frequently a measurement of interest. What is the prevalence of ITBFS? It is generally accepted that ITBFS is the most common running injury of the lateral knee, with an incidence between 1.6 and 12%. [1–5]. Linenger states that ITBFS comprises 22% of lower extremity injuries [6]. ITBFS is also commonly diagnosed in cyclists, reported as comprising 15% of all overuse injuries of the knee region [7]. Devan and others found iliotibial band friction syn- drome to be the most common overuse injury of the lower extremity in a group of female college athletes who played soccer, basketball, or ﬁeld hockey [8]. Rumball et al. also noted the common occurrence of ITBFS among competi- tive rowers [9]. What is the pathology of the condition? When the concept of iliotibial band friction syndrome was ﬁrst developed, the presumed model was that during activities involving repetitive knee ﬂexion (such as run- ning), the iliotibial band repetitively shifted forward and backward over the lateral femoral condyle, causing friction and thus inﬂammation of the ITB. However, this view has been called into question in several ways. Fairclough and others reason that the ITB is not a dis- tinct anatomical structure but merely a thickened zone within the lateral fascia, which moreover is ﬁrmly con- nected to the linea aspera by an intermuscular septum [10].