Iliotibial Band Syndrome

Key Features

• Iliotibial band syndrome and associated trochanteric bursitis result when the bursa and iliotibial band become inflamed because of repetitive friction from the underlying greater trochanter and lateral femoral condyle

• Overuse injury seen in runners

Clinical Findings

• Movement is painful and may be limited

• Pain

  • Occurs over lateral knee or hip

  • Reproducible when the hip or knee is actively flexed from a fully extended position

Diagnosis

• The Ober test may be positive

  • Patient lies on his or her side with the affected leg on top

  • The examiner stabilizes the pelvis with one hand while the other hand moves the tested leg into knee flexion, hip abduction and extension and then lowers the leg into adduction until it stops via soft tissue stretch, posterior rotation of the pelvis, or both

  • The test is positive if the tested leg fails to adduct parallel to the table in a neutral position

Treatment

• Alter the offending activity

• Start a stretching program geared at the iliotibial band and hip abductors

• Core and pelvic stabilization are also important

• Ultrasound can be beneficial and corticosteroid injections may be used after conservative treatment has failed