A Review of Treatments for Iliotibial Band Syndrome in the Athletic Population

Iliotibial band syndrome (ITBS) is a common injury in runners and other long distance athletes with the best management options not clearly established. This review outlines both the conservative and surgical options for the treatment of iliotibial band syndrome in the athletic population. Ten studies met the inclusion criteria by focusing on the athletic population in their discussion of the treatment for iliotibial band syndrome, both conservative and surgical. Conservative management consisting of a combination of rest (2–6 weeks), stretching, pain management, and modification of running habits produced a 44% complete cure rate, with return to sport at 8 weeks and a 91.7% cure rate with return to sport at 6 months after injury. Surgical therapy, often only used for refractory cases, consisted of excision or release of the pathologic distal portion of the iliotibial band or bursectomy. Those studies focusing on the excision or release of the pathologic distal portion of the iliotibial band showed a 100% return to sport rate at both 7 weeks and 3 months after injury. Despite many options for both surgical and conservative treatment, there has yet to be consensus on one standard of care. Certain treatments, both conservative and surgical, in our review are shown to be more effective than others; however, further research is needed to delineate the true pathophysiology of iliotibial band syndrome in athletes, as well as the optimal treatment regimen. 1. Introduction Iliotibial band syndrome is a common knee injury caused by inflammation of the distal portion of the iliotibial band (ITB), which results in lateral knee pain. The distal iliotibial band slides over the lateral femoral epicondyle, and during repetitive flexion and extension activities of the knee excessive friction and potential irritation results in pain. Potential risk factors for the development of iliotibial band syndrome include preexisting iliotibial band tightness, high weekly mileage, time spent walking or running on a track, interval training, and muscular weakness of knee extensors, flexors, and hip abductors [1, 2]. Populations who expose their knees to a greater amount of flexion and extension activities, such as athletes, particularly long distance athletes, put themselves at a higher risk for iliotibial band syndrome. Due to the pathophysiology of IT band syndrome, runners have been a group often looked at for prevalence and management of this syndrome. ITB syndrome has been documented to have as high as a 22.2% incidence of all lower extremity injuries in runners [3]. Despite a