Current Clinical Concepts: Synthesizing the Available Evidence for Improved Clinical Outcomes in Iliotibial Band Impingement Syndrome

J Athl Train. 2021 Aug 1;56(8):805-815. doi: 10.4085/1062-6050-548-19.

Abstract

The current paradigm of insidious lateral knee pain involving the iliotibial band (ITB) in repetitive knee-flexion activities has been termed ITB friction syndrome since 1975. The original model for ITB pain was based on a limited or incorrect understanding of the relevant anatomy, biomechanics, and tissue science, which gradually led to a plethora of frustrating and ineffective interventional strategies. Mounting evidence from arthroscopic, cadaveric, and biomechanical studies, as well as from diagnostic imaging and histologic reports, has helped deconstruct this long-held paradigm for ITB-related pathology and treatment. By outlining the historical paradigm for our understanding of ITB pain and gathering newer evidence through extensive research, I will synthesize the available data in this clinical update to present an updated, more informed model for understanding insidious-onset ITB-related pathology and treating patients. The result is called ITB impingement syndrome.

Keywords: iliotibial band; impingement; pathology; running.

MeSH terms

  • Biomechanical Phenomena
  • Humans
  • Iliotibial Band Syndrome* / pathology
  • Iliotibial Band Syndrome* / therapy
  • Joint Diseases* / pathology
  • Joint Diseases* / therapy
  • Knee
  • Knee Joint / anatomy & histology
  • Knee Joint / diagnostic imaging