Iliotibial band friction syndrome in runners

The iliotibial band friction syndrome is an overuse injury found in long-distance runners. It is characterized by pain on the outer aspect of the knee in close relation to the lateral femoral epicondyle. It is usually poorly localized, is aggravated by running long distances or excessive striding, and is more severe running downhill. It may be prevented by walking with a stiff knee. In a series of 100 consecutive knees, including 6 patients with the syndrome in both knees (age range, 19 to 48 years; average, 31 years), of which 73 were available for follow-up evaluation, only 30 patients were resolved on the initial regimen of a single injection of local steroid and reduction in the training program. Twenty-one patients had two injections and 8 patients required the third injection. The remaining 14 patients were placed on a regimen of total rest from running for 4 to 6 weeks. Nine patients returned to training and had no recurrence of pain. Five patients consented to surgery and returned to long-distance running between 2 and 7 weeks later. The syndrome apparently has a higher incidence in areas where long-distance running is the vogue, such as, South Africa, or where the climate is cool and running surfaces are slippery.