Iliotibial band tightness and patellofemoral pain syndrome: a case-control study

Tight lateral structures have been implicated in subjects presenting with patellofemoral pain syndrome (PFPS). It has been proposed that a tight iliotibial band (ITB) through its attachment of the lateral retinaculum into the patella could cause lateral patella tracking, patella tilt and compression. Twelve subjects presenting with PFPS were compared with 12 matched control subjects. Hip adduction was measured using the Ober test in each subject as an indirect measure of ITB length. The mean values for hip adduction in the control group were 21.4 (+/-4.9) and 20.3 (+/-3.8) degrees in the left and right legs, respectively, and in the PFPS group, 17.3 (+/-6.1) and 14.9 (+/-4.2) degrees in the non-painful leg and painful leg, respectively. One way analysis of variance (ANOVA) revealed a highly significant difference between groups (F=4.485, p=0.008) and post-hoc analysis showed a significant difference between the painful leg in the PFPS group and the left and right legs in the control group, p=0.002 and 0.009, respectively. The results from this study show that subjects presenting with PFPS do have a tighter ITB. Future work should investigate this observation prospectively in order to determine whether a tight ITB is the cause or effect of PFPS.