The iliotibial band is the thickened lateral fascial condensation from the TFL and gluteus maximus. Its Kaplan fibres from the lateral femur provide static restraint equivalent to an extra-articular lateral ligament — ALL reconstruction mimics the Kaplan fibre function anatomically. The IT band's impingement at the lateral femoral epicondyle during the 30-degree knee flexion impingement zone produces the lateral knee pain of IT band syndrome in runners.
Lateral knee stabilisation; hip abduction and extension force transmission; the Kaplan fibres provide static lateral knee stability — functionally equivalent to a lateral extra-articular ligament
The compression-impingement model of IT band syndrome (the IT band compresses the richly innervated fat pad between the ITB and the lateral femoral epicondyle at 30 degrees) has replaced the friction model. Foam rolling the ITB compresses the underlying muscle and fascia but cannot mechanically lengthen the dense IT band fibres. Hip abductor strengthening reduces excessive ITB tension from TFL overactivity.
IT band fat pad compression at 30 degrees of knee flexion during running managed with hip strengthening, foam rolling, and running technique correction.
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