Iliotibial band

The ITB running down the outer thigh.

What does the iliotibial band do?

The iliotibial band (ITB) and the muscles associated with it (gluteus maximus and tensor fasica lata) function to extend, abduct, and laterally rotate the hip.

Problems with the feet, like flat-footedness, may stress the ITB and cause pain on the outer side of the knee.

• Quote from peer-reviewed paper:

  "....The mechanical importance of the ITB is highlighted by the prevalence with which it is injured, particularly in runners...."

  Citation: Hutchinson LA, Lichtwark GA, Willy RW, Kelly LA. The Iliotibial Band: A Complex Structure with Versatile Functions. Sports Med. 2022 May;52(5):995-1008. doi: 10.1007/s40279-021-01634-3. Epub 2022 Jan 24. PMID: 35072941; PMCID: PMC9023415.

• Quote from peer-reviewed paper:

  ....[The gluteus maximus and tensor fascia lata] muscles....directly insert (either partially or fully) into the ITB, contributing to the functional mechanics...."

  Citation: Hutchinson LA, Lichtwark GA, Willy RW, Kelly LA. The Iliotibial Band: A Complex Structure with Versatile Functions. Sports Med. 2022 May;52(5):995-1008. doi: 10.1007/s40279-021-01634-3. Epub 2022 Jan 24. PMID: 35072941; PMCID: PMC9023415.

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Iliotibial band overuse injury

Repetitive bending and straightening activities of the knee, for example in running, may irritate a tight iliotibial band, leading to pain in the knee and possibly the hip.

Problems in the ankle and foot, eg flat feet, also cause strain in the ITB.

• Quote from peer-reviewed paper:

  "Abnormal pronation of the subtalar joint may cause increased internal rotation of the tibia, which increases the tension on the ITB at its insertion point on Gerdy’s tubercle during each foot strike."

  Citation: Brandon K, Patla C. Differential diagnosis and treatment of iliotibial band pain secondary to a hypomobile cuboid in a 24-year-old female tri-athlete. J Man Manip Ther. 2013 Aug;21(3):142-7. doi: 10.1179/2042618613Y.0000000031. PMID: 24421625; PMCID: PMC3744847.

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Management of iliotibial band problems

Management involves -

• alteration of running patterns (eg wider step width, higher stride frequency)
• foam rolling of the ITB
• ITB stretching
• hip strengthening

• Quote from peer-reviewed paper:

  "....Current approaches to diagnosis, treatment and understanding of ITBS function are insufficient, indicating a much larger issue of a lack of understanding of the ITB’s fundamental mechanical function...."

  Citation: Brandon K, Patla C. Differential diagnosis and treatment of iliotibial band pain secondary to a hypomobile cuboid in a 24-year-old female tri-athlete. J Man Manip Ther. 2013 Aug;21(3):142-7. doi: 10.1179/2042618613Y.0000000031. PMID: 24421625; PMCID: PMC3744847.

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Forum discussions

• Wyn's Left TKR,HELP WITH Tendinopathy & Iliotibial Band Syndrome

  After both osteotomy and total knee replacement, this patient developed problems with the ITB.

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