iliotibiale

The iliotibial band, also known as the tractus iliotibialis, is a thick band of fascia lata on the lateral aspect of the thigh. It functions as a stabilizing structure for the knee and serves as an extension of the hip muscles. Proximally, it arises mainly from the tensor fasciae latae and the gluteus maximus near the iliac crest and anterior superior iliac spine. Distally, it inserts on the lateral aspect of the tibia at Gerdy’s tubercle, with some fibers blending into the lateral patellar retinaculum. The band runs along the outer thigh and crosses the knee, lying superficial to the knee joint and over the lateral femoral epicondyle.

Functionally, the iliotibial band helps stabilize the knee during gait, particularly in the stance phase and during activities such as running and cycling. It transmits forces from the hip abductors and extensors to the tibia, contributing to lateral stabilization of the knee and aiding in controlled knee movement.

Clinically, the iliotibial band is associated with iliotibial band syndrome (ITBS), a common overuse injury in runners and cyclists. ITBS presents with lateral knee pain, often near the lateral femoral epicondyle, and may be aggravated by knee flexion and hip adduction. Risk factors include rapid increases in training, leg length discrepancies, and biomechanical factors such as overpronation or excessive hip adduction. Diagnosis is typically clinical, supported by reproducible tenderness or pain with activities. Management emphasizes activity modification, physical therapy focusing on hip abductor and gluteal strengthening, flexibility work, and gradual return to activity. NSAIDs may be used for short-term relief; corticosteroid injections are rarely indicated, and surgical intervention is uncommon, reserved for refractory cases.