eMedicine Specialties > Physical Medicine and Rehabilitation > Lower Limb Musculoskeletal Conditions

Iliotibial Band Syndrome

John M Martinez, MD, Medical Director, Primary Care Sports Medicine, Coastal Sports and Wellness Medical Center
Kenneth Honsik, MD, Consulting Staff, Department of Primary Care Sports Medicine, Kaiser Permanente; Consuelo T Lorenzo, MD, Consulting Staff, Department of Physical Medicine and Rehabilitation, Alegent Health Care, Immanuel Rehabilitation Center

Updated: Apr 17, 2009

Introduction

Background

Iliotibial band syndrome (ITBS) is the result of inflammation and irritation of the distal portion of the iliotibial tendon as it rubs against the lateral femoral condyle, or less commonly, the greater tuberosity. This overuse injury occurs with repetitive flexion and extension of the knee. Inflammation and irritation of the iliotibial band (ITB) also may occur because of a lack of flexibility of the ITB, which can result in an increase in tension on the ITB during the stance phase of running. (See image below and Image 1.)

In this 27-year-old female marathon runner with anterolateral pain superior to the joint line, a coronal fast spin-echo T2-weighted magnetic resonance imaging scan with fat suppression demonstrates edema between the iliotibial band and the lateral femoral condyle (arrow). The edema's location is consistent with a clinical diagnosis of iliotibial band syndrome.

Pathophysiology

The iliotibial band (ITB) is a dense fibrous band of tissue that originates from the anterior superior iliac spine region and extends down the lateral portion of the thigh to the knee. The ITB has insertions on the lateral tibial condyle (ie, the Gerdy tubercle) and the distal portion of the femur. When the knee is extended, the ITB is anterior to the lateral femoral condyle. When the knee is flexed more than 30º, the ITB is posterior to the lateral femoral condyle. (See images below and Images 2, 3, 4.)

Iliotibial band at the lateral femoral condyle, with the posterior fibers denoted.

Iliotibial band noted prominently along the lateral thigh.

Lateral hip stabilizers.

Frequency

United States

Iliotibial band syndrome (ITBS) is most common in athletes who participate in long-distance running. Studies have indicated a 4.3-7.5% occurrence rate for ITBS in long-distance runners. ITBS is less common in shorter-distance or sprint-distance runners. The higher rate in long-distance runners is primarily because of the increased stance phase during longer-distance running. ITBS also has been reported in military recruits, cyclists, and tennis players. The frequency of ITBS is also increased in adolescents undergoing the rapid growth phase.^1,2,3,4

Mortality/Morbidity

No mortality has been associated with iliotibial band syndrome.

Race

No known association exists between race and iliotibial band syndrome.

Sex

Iliotibial band syndrome has been reported in men and women equally; however, women may be more susceptible to developing the syndrome because of anatomical differences of the thigh and knee, such as genu varum and increased internal tibial rotation. These anatomical differences result in weakness of the quadriceps muscle and an increased varus angle of the femur in relation to the knee.

Age

Iliotibial band syndrome usually is seen in individuals aged 15-50 years, an age range that generally includes active athletes.

Clinical

History

The patient with iliotibial band syndrome typically reports pain at the lateral aspect of the knee; however, in some cases, the presenting symptom is hip pain over the greater trochanter. The pain usually worsens with physical activity, such as running or cycling. Pain may be exacerbated by running hills and is most intense at heel-strike. Some patients may also report lateral knee pain when walking up or down stairs. The patient also may report an audible, repetitive popping noise in the knee with walking or running.⁵

Physical

The physical examination should include the entire lower extremity to rule out other causes of lateral knee or hip pain. In most cases, point tenderness occurs with palpation of the lateral femoral condyle or lateral tibial condyle, especially when flexing or extending the knee, as the iliotibial band (ITB) slides across the lateral femoral condyle. Some patients may have tenderness over the greater trochanteric region of the hip.⁵

• Strength testing - Strength testing may reveal knee flexor or extensor weakness or hip abductor weakness.
• Tests - Increased or noticeable tightness of the ITB also may be noted upon examination with the Ober test. A modified Thomas test can be performed to assess flexibility of the hip flexors, hamstrings, and ITB. (See images below and Images 5, 6.)

The Thomas test can be used to evaluate restriction in the iliotibial band and hip flexors.

The Ober test.

Causes

Iliotibial band syndrome (ITBS) typically is due to overuse. The injury is seen most commonly in runners, although other athletes (eg, cyclists, tennis players) also may be affected. The usual mechanism is irritation of the iliotibial tract as it crosses over the lateral femoral condyle and, less commonly, the greater tuberosity. Increased tension or friction of the ITB in this area can result in an increase of irritation or inflammation. Abnormal gait or running biomechanics also have been implicated.^1,2,3,4,6

• Cyclists may experience ITBS due to improper positioning on their bike. Excessive internal or medial rotation of bike cleats and a bike seat that is too high are 2 main causes of ITBS among cyclists.
• Long-distance runners have a higher incidence of ITBS than do short-distance runners and sprinters. This higher incidence may be due to the change in the biomechanics of running versus sprinting. Long-distance runners tend to have a more prominent and extended heel-strike and stance phase in comparison with sprinters. The ITB is under its greatest tension during the first third of the stance phase.
• Weakness of muscle groups in the kinetic chain may also result in the development of ITBS. Weakness in the hip abductor muscles, such as the gluteus medius, may result in higher forces on the ITB and the tensor fascia lata.

Differential Diagnoses

Other Problems to Be Considered

Muscle strain
Degenerative joint disease
Biceps femoris tendinitis
Popliteus tendinitis

Workup

Laboratory Studies

• Laboratory studies are not indicated for the diagnosis of iliotibial band syndrome. However, laboratory tests may help rule out other sources of knee pain, such as rheumatoid arthritis or a septic joint.

Imaging Studies

• Imaging tests are not necessary to confirm the diagnosis of iliotibial band syndrome (ITBS). Depending on the findings of the physical examination, the physician may want to obtain radiographs of the knee to rule out other pathology such as a fracture or bone spur. In severe cases, magnetic resonance imaging (MRI) may be helpful in identifying the extent of inflammation of the ITB. Findings on MRI most commonly include thickening of the ITB in the region overlying the lateral femoral condyle and fluid collection underneath the ITB at this area. (See image below and Image 1.)

In this 27-year-old female marathon runner with anterolateral pain superior to the joint line, a coronal fast spin-echo T2-weighted magnetic resonance imaging scan with fat suppression demonstrates edema between the iliotibial band and the lateral femoral condyle (arrow). The edema's location is consistent with a clinical diagnosis of iliotibial band syndrome.

Procedures

• Local injection with corticosteroids may be indicated in patients with iliotibial band syndrome (ITBS) who do not respond to stretching, physical therapy, and exercise modification.⁵ If the patient still does not improve, then tendon-lengthening surgery with excision of the damaged ITB may be required.
• Surgery for the correction of ITBS has typically been an open procedure using a Z-plasty technique, although small prospective studies have used arthroscopy to create a diamond-shaped defect in the ITB.^7,8,9

Histologic Findings

Histologic changes associated with acute and chronic inflammation of the iliotibial band are observed.

Treatment

Rehabilitation Program

Physical Therapy

Physical therapy is one of the mainstays of treatment for ITBS, in addition to reducing the amount of inflammation and irritation.^1,2,5 The physical therapist can advise the athlete about ways to modify his/her training program so that faster results are seen with therapy. Running and cycling should be decreased or avoided to prevent further repetitive stress to the ITB. Wearing proper shoes also is very important in individuals with ITBS. Frequently, patients with ITBS demonstrate excessive pronation of their feet. The physical therapist should evaluate the patient's biomechanics during walking and running and should assist him/her in obtaining custom-made orthotics to correct faulty mechanics that may be causing the ITBS.

Physical therapy treatment in the acute stage may include modalities such as phonophoresis or iontophoresis in addition to cryotherapy to decrease the inflammation. Since some cases of ITBS are caused by excessive tension on the ITB, physical therapy can help to incorporate proper stretching techniques into the patient's exercise routine. These exercises concentrate on increasing flexibility of the ITB and of the gluteus muscles. Other muscles that commonly need attention for flexibility include the hamstrings, quadriceps, gastrocnemius, and soleus. (See images below and Images 7, 8.)

This illustration demonstrates active stretching of the iliotibial band (ITB). The athlete stands a comfortable distance from a wall and, with the contralateral knee extended, leans the proximal shoulder against the wall to stretch the ipsilateral ITB.

This illustration demonstrates iliotibial band syndrome stretching performed in a side-lying position.

As the patient's symptoms improve, the physical therapy can progress toward strength development and maintenance. The physical therapist should instruct the patient in a home exercise program that continues to improve the strength and endurance of the hip and knee, as well as the back and abdominals. Strengthening of the hip abductors and knee flexors and extensors is an important component of rehabilitation. Once the patient is able to complete all strengthening exercises without discomfort, he/she may gradually return to the previous training regimen.

Occupational Therapy

Occupational therapy usually is not indicated in the treatment of individuals with iliotibial band syndrome.

Surgical Intervention

Reports of surgical intervention exist for recurrent iliotibial band syndrome (ITBS) that has not been responsive to previous conservative treatment. The operation may involve (1) releasing the posterior portion of the ITB, (2) performing an osteotomy of the lateral femoral epicondyle, or (3) performing a bursectomy.^7,8

A Belgian study investigated the effectiveness of arthroscopic treatment for ITBS, specifically, resection of the lateral synovial recess, in 33 patients.⁹ The authors reported that all of the patients returned to sports after 3 months. At follow-up (a mean period of 2 years and 4 months), good to excellent results were found in 32 of the patients, and a fair result in 1 of them. 

Consultations

Patients with iliotibial band syndrome that is recurrent and difficult to treat may be referred to a sports medicine specialist.

Other Treatment

Local injections with corticosteroids may be indicated for symptoms of iliotibial band syndrome that do not respond to nonsteroidal anti-inflammatory drugs (NSAIDs), relative rest, stretching, and physical therapy.⁵

Medication

The goals of pharmacotherapy are to reduce morbidity and prevent complications.

Nonsteroidal anti-inflammatory drugs

Have analgesic, anti-inflammatory, and antipyretic activities. Their mechanism of action is not known, but they may inhibit cyclooxygenase (COX) activity and prostaglandin synthesis. Other mechanisms may exist as well, such as inhibition of leukotriene synthesis, lysosomal enzyme release, lipoxygenase activity, neutrophil aggregation, and various cell membrane functions.

Ibuprofen (Advil, Motrin)

DOC for patients with mild to moderate pain. Inhibits inflammatory reactions and pain by decreasing prostaglandin synthesis.

Dosing

Adult

Up to 600-800 mg PO q6h

Pediatric

10 mg/kg PO q6h

Interactions

Coadministration with aspirin increases risk of inducing serious NSAID-related side effects; probenecid may increase concentrations and, possibly, toxicity of NSAIDs; may decrease effect of hydralazine, captopril, and beta-blockers; may decrease diuretic effects of furosemide and thiazides; may increase PT when taking anticoagulants (instruct patients to watch for signs of bleeding); may increase risk of methotrexate toxicity; phenytoin levels may be increased when administered concurrently

Contraindications

Documented hypersensitivity; peptic ulcer disease, recent GI bleeding or perforation, renal insufficiency, or high risk of bleeding

Precautions

Pregnancy

C - Fetal risk revealed in studies in animals but not established or not studied in humans; may use if benefits outweigh risk to fetus

D - Fetal risk shown in humans; use only if benefits outweigh risk to fetus

Precautions

Caution in congestive heart failure, hypertension, and decreased renal and hepatic function; caution in coagulation abnormalities or during anticoagulant therapy

Naproxen (Naprelan, Naprosyn, Anaprox)

For relief of mild to moderate pain. Inhibits inflammatory reactions and pain by decreasing activity of cyclo-oxygenase, which results in a decrease of prostaglandin synthesis.

Dosing

Adult

500 mg PO followed by 250 mg q6-8h; not to exceed 1.25 g/d

Pediatric

<2 years: Not established
>2 years: 2.5 mg/kg/dose PO; not to exceed 10 mg/kg/d

Interactions

Coadministration with aspirin increases risk of inducing serious NSAID-related side effects; probenecid may increase concentrations and, possibly, toxicity of NSAIDs; may decrease effect of hydralazine, captopril, and beta-blockers; may decrease diuretic effects of furosemide and thiazides; may increase PT when taking anticoagulants (instruct patients to watch for signs of bleeding); may increase risk of methotrexate toxicity; phenytoin levels may be increased when administered concurrently

Contraindications

Documented hypersensitivity; peptic ulcer disease; recent GI bleeding or perforation; renal insufficiency

Precautions

Pregnancy

B - Fetal risk not confirmed in studies in humans but has been shown in some studies in animals

D - Fetal risk shown in humans; use only if benefits outweigh risk to fetus

Precautions

Acute renal insufficiency, interstitial nephritis, hyperkalemia, hyponatremia, and renal papillary necrosis may occur; patients with preexisting renal disease or compromised renal perfusion risk acute renal failure; leukopenia occurs rarely, is transient, and usually returns to normal during therapy; persistent leukopenia, granulocytopenia, or thrombocytopenia warrants further evaluation and may require discontinuation of drug

Ketoprofen (Oruvail, Orudis, Actron)

For relief of mild to moderate pain and inflammation. Small dosages initially are indicated in small and elderly patients and in those with renal or liver disease.
Doses over 75 mg do not increase therapeutic effects. Administer high doses with caution, and closely observe patient for response.

Dosing

Adult

25-50 mg PO q6-8h prn; not to exceed 300 mg/d

Pediatric

<3 months: Not established
3 months to 12 years: 0.1-1 mg/kg PO q6-8h
>12 years: Administer as in adults

Interactions

Coadministration with aspirin increases risk of inducing serious NSAID-related side effects; probenecid may increase concentrations and, possibly, toxicity of NSAIDs; may decrease effect of hydralazine, captopril, and beta-blockers; may decrease diuretic effects of furosemide and thiazides; may increase PT when taking anticoagulants (instruct patients to watch for signs of bleeding); may increase risk of methotrexate toxicity; phenytoin levels may be increased when administered concurrently

Contraindications

Documented hypersensitivity

Precautions

Pregnancy

B - Fetal risk not confirmed in studies in humans but has been shown in some studies in animals

D - Fetal risk shown in humans; use only if benefits outweigh risk to fetus

Precautions

Caution in congestive heart failure, hypertension, and decreased renal and hepatic function; caution in coagulation abnormalities or during anticoagulant therapy

Cyclooxygenase-2 Inhibitors

COX-2 inhibitors are a new class of NSAIDs that report a lower incidence of GI side effects, such as gastritis and ulcers. COX-2 inhibitors may be indicated in patients who require anti-inflammatory medications but who have a history of gastric ulcers.

Celecoxib (Celebrex)

For relief of mild to moderate pain. Primarily inhibits COX-2. COX-2 is considered an inducible isoenzyme, induced during pain and with inflammatory stimuli. Inhibition of COX-1 may contribute to NSAID-related GI toxicity. At therapeutic concentrations, COX-1 isoenzyme is not inhibited, thus GI toxicity may be decreased. Seek lowest dose of celecoxib for each patient.

Dosing

Adult

200 mg/d PO qd; alternatively, 100 mg PO bid

Pediatric

Not established

Interactions

Coadministration with fluconazole may cause increase in celecoxib plasma concentrations because of inhibition of celecoxib metabolism; coadministration of celecoxib with rifampin may decrease celecoxib plasma concentrations

Contraindications

Documented hypersensitivity

Precautions

Pregnancy

C - Fetal risk revealed in studies in animals but not established or not studied in humans; may use if benefits outweigh risk to fetus

D - Fetal risk shown in humans; use only if benefits outweigh risk to fetus

Precautions

May cause fluid retention and peripheral edema; caution in compromised cardiac function, hypertension, conditions predisposing to fluid retention, severe heart failure, and hyponatremia because may deteriorate circulatory hemodynamics; NSAIDs may mask usual signs of infection; caution in the presence of existing controlled infections; evaluate symptoms and signs suggesting liver dysfunction

Follow-up

Further Outpatient Care

• The patient should continue physical therapy until the symptoms of iliotibial band syndrome improve or he/she can continue the exercises independently. See Physical Therapy for treatment recommendations.

Inpatient & Outpatient Medications

• The patient with iliotibial band syndrome is treated as an outpatient with medications that include NSAIDs or corticosteroid injections, as discussed above (see Medication).

Transfer

• Transfer of care (referral) is warranted if the patient's symptoms do not improve with conservative management.

Deterrence

• The key to preventing iliotibial band syndrome (ITBS) is having a well-balanced approach to training. Runners need to limit their uphill/downhill training and to run on level surfaces as much as possible. When training on a track, it is important to alternate the direction of running from clockwise to counterclockwise regularly to avoid repetitive stress to 1 leg. Preventative stretching of the ITB and gluteals also is important. Individuals with known subtalar joint hyperpronation may occasionally avoid developing ITBS by wearing proper shoes and orthotics to correct faulty biomechanics.

Complications

• Complications of iliotibial band syndrome (ITBS) can include continued pain and an inability to maintain a training program. Some patients may demonstrate significant biomechanical abnormalities of the lower extremity as they attempt to compensate for ITBS-related pain.

Prognosis

• Prognosis for iliotibial band syndrome is very good with the appropriate treatment.

Patient Education

• Education is important in preventing recurrence of iliotibial band syndrome (ITBS).
• Education should focus on instructing the patient in proper stretching techniques, as well as on educating patients about the use of ice and NSAIDs for minor irritation or inflammation of the ITB.
• More importantly, the patient should learn to recognize symptoms that indicate when training volume should be decreased and when training surfaces should be changed.

Miscellaneous

Medicolegal Pitfalls

• Misdiagnosing a more severe knee condition, such as femoral rhabdomyosarcoma, as iliotibial band syndrome results in a subsequent delay of appropriate treatment.

Multimedia

Media file 1: In this 27-year-old female marathon runner with anterolateral pain superior to the joint line, a coronal fast spin-echo T2-weighted magnetic resonance imaging scan with fat suppression demonstrates edema between the iliotibial band and the lateral femoral condyle (arrow). The edema's location is consistent with a clinical diagnosis of iliotibial band syndrome.

Media file 2: Iliotibial band at the lateral femoral condyle, with the posterior fibers denoted.

Media file 3: Iliotibial band noted prominently along the lateral thigh.

Media file 4: Lateral hip stabilizers.

Media file 5: The Thomas test can be used to evaluate restriction in the iliotibial band and hip flexors.

Media file 6: The Ober test.

Media file 7: This illustration demonstrates active stretching of the iliotibial band (ITB). The athlete stands a comfortable distance from a wall and, with the contralateral knee extended, leans the proximal shoulder against the wall to stretch the ipsilateral ITB.

Media file 8: This illustration demonstrates iliotibial band syndrome stretching performed in a side-lying position.

References

1. Fredericson M, Weir A. Practical management of iliotibial band friction syndrome in runners. Clin J Sport Med. May 2006;16(3):261-8. [Medline].

2. Fredericson M, Wolf C. Iliotibial band syndrome in runners: innovations in treatment. Sports Med. 2005;35(5):451-9. [Medline].

3. Hamill J, Miller R, Noehren B, Davis I. A prospective study of iliotibial band strain in runners. Clin Biomech (Bristol, Avon). Oct 2008;23(8):1018-25. [Medline].

4. Grau S, Maiwald C, Krauss I, Axmann D, Horstmann T. The influence of matching populations on kinematic and kinetic variables in runners with iliotibial band syndrome. Res Q Exerc Sport. Dec 2008;79(4):450-7. [Medline].

5. Khaund R, Flynn SH. Iliotibial band syndrome: a common source of knee pain. Am Fam Physician. Apr 15 2005;71(8):1545-50. [Medline]. [Full Text].

6. Grau S, Krauss I, Maiwald C, et al. Hip abductor weakness is not the cause for iliotibial band syndrome. Int J Sports Med. Jul 2008;29(7):579-83. [Medline].

7. Ilizaliturri VM Jr, Martinez-Escalante FA, Chaidez PA, et al. Endoscopic iliotibial band release for external snapping hip syndrome. Arthroscopy. May 2006;22(5):505-10. [Medline].

8. Hariri S, Savidge ET, Reinold MM, Zachazewski J, Gill TJ. Treatment of recalcitrant iliotibial band friction syndrome with open iliotibial band bursectomy: indications, technique, and clinical outcomes. Am J Sports Med. Mar 13 2009;[Medline].

9. Michels F, Jambou S, Allard M, Bousquet V, Colombet P, de Lavigne C. An arthroscopic technique to treat the iliotibial band syndrome. Knee Surg Sports Traumatol Arthrosc. Mar 2009;17(3):233-6. [Medline].

10. Adams WB. Treatment options in overuse injuries of the knee: patellofemoral syndrome, iliotibial band syndrome, and degenerative meniscal tears. Curr Sports Med Rep. Oct 2004;3(5):256-60. [Medline].

11. Biundo JJ Jr, Irwin RW, Umpierre E. Sports and other soft tissue injuries, tendinitis, bursitis, and occupation-related syndromes. Curr Opin Rheumatol. Mar 2001;13(2):146-9. [Medline].

12. Brosseau L, Casimiro L, Milne S. Deep transverse friction massage for treating tendinitis. Cochrane Database Syst Rev. 2002;CD003528. [Medline].

13. Faraj AA, Moulton A, Sirivastava VM. Snapping iliotibial band. Report of ten cases and review of the literature. Acta Orthop Belg. Feb 2001;67(1):19-23. [Medline].

14. Fredericson M, Cookingham CL, Chaudhari AM. Hip abductor weakness in distance runners with iliotibial band syndrome. Clin J Sport Med. Jul 2000;10(3):169-75. [Medline].

15. Garrick JG, Webb DR. Sports Injuries. Diagnosis and Management. Philadelphia, Pa: WB Saunders; 1999.

16. Jones RL. The injured or painful knee and its evaluation. In: Clinics in Family Medicine. 1999 Dec:209.

17. Kendal FP, et al. Muscles: Function and Testing. 4th ed. Baltimore, Md: Williams & Wilkins; 1993.

18. Noble CA. The treatment of iliotibial band friction syndrome. Br J Sports Med. Jun 1979;13(2):51-4. [Medline]. [Full Text].

19. Sutker AN, Barber FA, Jackson DW, Pagliano JW. Iliotibial band syndrome in distance runners. Sports Med. Nov-Dec 1985;2(6):447-51. [Medline].

Keywords

iliotibial band syndrome, hip pain, iliotibial band, iliotibial, IT band, ITBS, iliotibial syndrome, running injury, IT band syndrome, pain in hip, IT band pain, greater trochanter, ITB syndrome, lateral femoral condyle, IT band stretch, iliotibial band friction syndrome, IT band knee, overuse injury, iliotibial band tendonitis, trochanteric bursitis, lateral knee pain

Contributor Information and Disclosures

Author

John M Martinez, MD, Medical Director, Primary Care Sports Medicine, Coastal Sports and Wellness Medical Center
John M Martinez, MD is a member of the following medical societies: American Academy of Family Physicians, American College of Sports Medicine, and American Medical Society for Sports Medicine
Disclosure: Nothing to disclose.

Coauthor(s)

Kenneth Honsik, MD, Consulting Staff, Department of Primary Care Sports Medicine, Kaiser Permanente
Disclosure: Nothing to disclose.

Consuelo T Lorenzo, MD, Consulting Staff, Department of Physical Medicine and Rehabilitation, Alegent Health Care, Immanuel Rehabilitation Center
Consuelo T Lorenzo, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation
Disclosure: Nothing to disclose.

Medical Editor

Robert E Windsor, MD, FAAPMR, FAAEM, FAAPM, President and Director, Georgia Pain Physicians, PC; Clinical Associate Professor, Department of Physical Medicine and Rehabilitation, Emory University School of Medicine
Robert E Windsor, MD, FAAPMR, FAAEM, FAAPM is a member of the following medical societies: American Academy of Pain Medicine, American Academy of Physical Medicine and Rehabilitation, American College of Sports Medicine, American Medical Association, International Association for the Study of Pain, Physiatric Association of Spine, Sports and Occupational Rehabilitation, and Texas Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Michael T Andary, MD, MS, Residency Program Director, Professor, Department of Physical Medicine and Rehabilitation, Michigan State University College of Osteopathic Medicine
Michael T Andary, MD, MS is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine, American Medical Association, and Association of Academic Physiatrists
Disclosure: allergan Honoraria Speaking and teaching; Pfizer Honoraria Speaking and teaching

CME Editor

Kelly L Allen, MD, Regional Medical Director, IMX-Medical Management Services
Disclosure: Nothing to disclose.

Chief Editor

Rene Cailliet, MD, Professor-Chairman Emeritus, Department of Rehabilitation Medicine, University of Southern California School of Medicine; Former Director, Department of Rehabilitation Medicine, Santa Monica Hospital Medical Center
Rene Cailliet, MD is a member of the following medical societies: American Academy of Pain Medicine, American Academy of Physical Medicine and Rehabilitation, American Pain Society, Association of American Medical Colleges, International Association for the Study of Pain, and Pan American Medical Association
Disclosure: Nothing to disclose.

Related eMedicine topics:
Iliotibial Band Friction Syndrome
Iliotibial Band Syndrome [Sports Medicine]
Knee, Extensor Mechanism Injuries (MRI)
Knee Injury, Soft Tissue
Lateral Collateral Knee Ligament Injury
Overuse Injury
Snapping Hip Syndrome

Clinical guidelines:
ACR Appropriateness Criteria® Nontraumatic Knee Pain
Review Criteria for Knee Surgery

Clinical studies:
Validity and Reliability in Measuring Iliotibial Tract by Using Ultrasound

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