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

Abstract

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.

Iliotibial band syndrome

“…This includes activity modification (reducing or stopping exercise sessions to avoid the pain), stretching, simple analgesics, and addressing training errors (avoiding running downhill or running on cambered circuits). Forty four per cent of people with ITBS can expect to return to sport at eight weeks and 92% by six months 3. We recommend a shared decision making approach to management, particularly in light of the limited evidence base for treatments, mostly from small trials with methodological limitations 4.…”

Endoscopic Gluteus Medius Repair With an ITB-Sparing Versus ITB-Splitting Approach: A Systematic Review and Meta-analysis

“…8 It should also be acknowledged that ITB release is not a wholly benign procedure, with one example being concerns about slowed return to performance after ITB release in athletic populations. 2…”

Iliotibial Band Pathology: Synthesizing the Available Evidence for Clinical Progress

“…7 Despite this relatively common and problematic ailment, effective treatment approaches for ITBPS have been elusive for clinicians in sports medicine, largely due to the conceptual model used to explain its pathoetiological nature. 8 This paper endeavors to outline the historical paradigm used to inform our understanding of ITBPS in order to better understand the poor clinical outcomes associated with the condition. Secondarily, this clinical update will introduce practitioners to an updated, evidence-based paradigm for the assessment and treatment of ITBPS that leads to improved clinical outcomes.…”