A prospective study of iliotibial band strain in runners

Background: Iliotibial band syndrome is the leading cause of lateral knee pain in runners. It is thought that pain develops from strain on the iliotibial band due to friction of the iliotibial band sliding over the lateral femoral epicondyle. The purpose of this study was to investigate mechanical strain in the iliotibial band as a possible causative factor in the development of iliotibial band syndrome. Methods: From a large prospective study, female runners who incurred iliotibial band syndrome during the study were compared to a control group who incurred no injuries. Strain, strain rate and duration of impingement were determined from a musculoskeletal model of the lower extremity. Findings: The results indicated that the iliotibial band syndrome subjects exhibited greater strain throughout the support period, but particularly at midsupport compared to the control group. Strain rate was significantly greater in the iliotibial band syndrome group compared to the control group and was greater in the involved limb of the iliotibial band syndrome group compared to their contralateral limb. However, there were no differences in the duration of impingement between the groups. Interpretation: This study indicates that a major factor in the development of iliotibial band syndrome is strain rate. Therefore, we suggest that strain rate, rather than the magnitude of strain, may be a causative factor in developing iliotibial band syndrome. The effect size (>0.5) indicated that strain rate may be biologically significant in the etiology of iliotibial band syndrome.