Association between Iliotibial Band Syndrome Status and Running Biomechanics in Women

Iliotibial band syndrome (ITBS) is a common overuse running injury. Atypical secondary plane lower-extremity and trunk biomechanics during running are likely to play a role in the etiology of ITBS [1, 2]. Proximal factors such as a large hip adduction angle may increase the tensile strain in the iliotibial band during the stance phase of running [1]. A lack of ability to limit hip adduction may be due to hip abductor muscle weakness [1]. Furthermore, it has been postulated that runners with ITBS exhibit contralateral pelvic drop coupled with trunk lateral flexion away from the stance limb [2]. In this scenario, the whole body center of mass moves away from the stance limb. This would increase the moment arm between the knee joint and resultant ground reaction force. Consequently, a greater external knee adduction moment is produced potentially resulting in greater tensile strain in the iliotibial band [2]. In the transverse plane, the iliotibial band functions to limit knee internal rotation [3]. Excessive knee internal rotation may also increase the strain experienced by the iliotibial band [1]. The aforementioned joint and segment variables provide indirect information about the status of the iliotibial band during running. Musculoskeletal modeling and simulation can complement biomechanical analyses of lowerextremity joint motion to investigate how running pattern affects iliotibial band strain. Therefore, the purpose of this cross-sectional study was to determine if biomechanics during the stance phase of overground running, as well as isometric hip abduction strength differ among female runners with current ITBS, previous ITBS, and controls. It was hypothesized that biomechanics during running would differ among groups in peak: trunk contralateral flexion, contralateral pelvic drop, hip adduction, knee internal rotation, iliotibial band strain, and external knee adduction moment. Second, we hypothesized that hip abduction strength would be less in runners with current ITBS and previous ITBS compared to controls.