Iliotibial Band Syndrome

(“friction syndrome”)

What is it?

The iliotibial band runs from the hip to the lateral side of the proximal end of the tibia. Its function is to resist internal rotation of the tibia as well as to maintain the lateral integrity of the leg. Iliotibial band “friction syndrome” is a condition wherein the iliotibial band is stretched and torqued and the distal end rubs across the lateral condyle of the femur.

What are the common symptoms/complaints?

Patients complain of pain on the lateral side of the knee often extending up the lateral side of the thigh as high as the hip.

How is it caused?

Overstress of the iliotibial band. During a normal gait cycle, the femur and the tibia rotate in unison (i.e. internally during pronation and externally during supination). However, when a person over-pronates, the tibia is locked into the Talus by the saddle joint and therefore continues to rotate internally past the end of the contact phase while the femur receives its orders from the brain and begins to rotate externally at the beginning of midstance. The resulting counter-rotation of the femur and the tibia causes a shearing force to occur in the iliotibial band which becomes torqued and stretched. The result is that the distal end of the band rubs across the lateral condyle of the femur.

How is it treated?

Since the problem is the over-pronation, the patient should be fitted with orthotics, to correct the counter-rotation between the femur and the tibia.