Iliotibial (IT) Band Syndrome and Biomechanical Risk Factors in Running

The iliotibial band is a long track of fascia and connective tissue running from the lateral hip muscles including the tensor fascia lata down to the lateral aspect of the knee.  Contrary to popular belief and utilization, foam rolling is ineffective at changing the length or flexibility of this structure secondary to its' density and strength.  The IT band passes behind the bony prominence of the knee as we move our knee from a straight to a bent position.  In the presence of muscle imbalances and poor running technique friction develops between the IT band the bone leading to a painful overuse condition on the outside of the knee called IT band syndrome. 

IT band syndrome is the second most common running injury and is responsible for 1 in 10 running injuries (Taunton et al. 2002).  Runner's most commonly experience a progressively more intense and severe lateral knee pain aggravated by squatting, stair climbing, and running.  Due to its' overuse nature, IT band pain is either precipitated or perpetuated by biomechanical errors in the runner's gait at stance phase.  A recent review article of 13 studies found an inward movement of the thigh under the pelvis and a compensatory movement of the trunk toward the same side at stance phase was associated with future development of IT band syndrome (Aderem et al. BMC Musculoskeletal Disorders. 2015).  Thankfully, these biomechanical changes are successfully treated with Physical Therapy running gait retraining treatments.  

Runners are encouraged to undergo a Physical Therapy screening to identify proximal muscle imbalances and running gait errors associated with the development of future running injuries.