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Background and Purpose:

Iliotibial Band Syndrome (ITBS) is the second leading cause of pain in runners and there are a number of theories related to its etiology. Multiple theories exist for the etiology of ITBS related symptoms including anterior-posterior friction of the IT band on the lateral femoral condyle during knee flexion and extension activities, compression of a layer of fat near the IT band distal attachment, and inflammation of the IT band bursa. The purpose of this literature review and clinical commentary was to explore the potential factors that contribute to ITBS development in runners.

Description of Topic with Related Evidence:

A literature review was performed to gather relevant evidence related to the topic and then categorized according to prospective and retrospective results. The electronic databases PubMed, EBSCOhost, CINAHL, and SportDiscus were utilized with the search terms iliotibial band, iliotibial band syndrome, iliotibial pain, and runners. The inclusion criteria included English-language, peer-reviewed journals; adult male or female runners, whether competitive or recreational with regard to mileage; subjects that either had a previous or existing diagnosis of ITBS or were at risk for developing ITBS; retrospective and prospective designs were included and the majority of studies reviewed were cohort or case-control designs.

Discussion/Relation to Clinical Practice:

The literature was either contradictory or inconclusive to support a link between ITBS and decreased muscle strength or endurance. A weak correlation existed between strain rate of the hip abductor muscles with hip adduction and knee internal rotation, increased knee internal rotation during the stance phase of gait, and a diminished rearfoot eversion angle at heel strike. Additionally, decreased hip adduction angles during stance phase were observed in individuals without active symptoms but who had a previous history of ITBS. Finally, the female gender may be a predisposing factor.

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