The iliotibial band is in the news as a popular and common running injury. Doctors, physical therapists, chiropractors, and shoe stores are quick to diagnose IT band syndrome, but most do not properly describe the IT bands insertion on the tibia. Explaining the anatomy of the fascia, tendon, femur, and tibia help explain the pain associated with runner’s knee.
The tensor fascia latae muscle originates on the anterior aspect of the iliac crest and anterior superior iliac spine. The muscle inserts on the iliotibial tract or band. The band is a broad sheet of fascial tissue that narrows to a tendon before inserting on the lateral (outside) of the tibia. Right before the Iliotibial band tendon inserts on the tibia it broadens as it inserts on the tibial bone.
The IT band can be injured with overuse, especially running, cycling, hiking, up and down hill running, running on a slant (angle of a road), or treading water for prolonged periods of time.
Anatomically the tendon experiences increased stressed with structural changes high or low arches, foot supination, excessive pronation with walking or running, excessive foot strike or inefficient running gaits, or anatomically short legs. More on Runner’s knee or IT band syndrome.
Muscle imbalances or weakness commonly leads to injuries, such as weak hip abductors or multifidus muscles. It is also seen with weak foot arch muscles or lack of hip stabilization during walking or running.