2012 19 4 24-31 ISSN (Print) 1225-8962, ISSN (Online) 2287-982X

Phys Ther Kor 2012;19(4):24-31 http://dx.doi.org/10.12674/ptk.2012.19.4.024

Comparison of Relative Thickness of the Iliotibial Band

Following Four Self-Stretching Exercises

Hyun-sook Kim1, PhD, PT, Tae-lim Yoon2, MA, PT

1Dept. of Physical therapy, Yeoju Institute of Technology,
2Dept. of Physical Therapy, The Graduate School, Yonsei University

Abstract1)

The aim of this study was to investigate the effectiveness of self-stretching exercises for iliotibial
band (ITB) (Side-lying; right hip and knee were flexed to support the pelvis while left hip was extended
and adducted, Standing A; side-bending of the trunk on standing with crossed leg, Standing B; same as
Standing A, except the hands were clasped overhead and shifted right side, and Standing C; same as
Standing B, except moving the arms diagonally downward) to help determine the most effective
self-stretching method to stretch ITB. Twenty-one healthy subjects who do not have ITB shortness from
Yonsei University (14 men and 7 women) between the ages of 18 to 28 years voluntarily participated.
Ultrasound was performed to measure the thickness of the ITB between the long axis of the ITB and
the level parallel to the lateral femoral epicondyle during four self-stretching exercises. All data were
found to approximate a normal distribution. We used a one-way repeated-measures analysis of variance
(ANOVA) to compare the thickness of the ITB among all self-stretching exercises. The level of
significance was set at =.05. The ANOVA was followed by Bonferronis correction. The overall mean of
ITB thickness was 1.14.4 ( standard deviation) in resting status. The change in the ITB thickness
in percentages between the tested position of each self-stretching exercises and resting status was
significant (p<.05) (Side-lying 26.6210.18% with 95% confidence interval [CI]=21.9931.25%; Standing A
29.4616.19% with 95% CI=22.0936.84%; Standing B 44.0614.82% with 95% CI=37.3150.81%; Standing
C 53.7612.1% with 95% CI=48.2559.29%). Results indicated significant differences among four
self-stretching exercises except Side-lying versus Standing A (p<.01). Based on these findings, the
Standing C self-stretching exercise was the most effective in stretching the ITB thickness among four
types of ITB self-stretching exercises. Additionally, the Side-lying self-stretching exercise using gravity
to stretch the ITB is recommended as a low-load (low-intensity), long-duration stretch.
[Hyun-sook Kim, Tae-lim Yoon. Comparison by Ultrasound of Relative Thickness of the Iliotibial Band in
Healthy Subjects Following Four Self-Stretching Exercises. Phys Ther Kor. 2012;19(4):24-31.]
Key Words: Iliotibial band friction syndrome; Side-lying; Snapping hip; Ultrasound.

Introduction passes distally along the thigh (Fairclough et al,

2006). Proximal to the knee joint, the ITB has at-
The iliotibial band (ITB) is a longitudinal thicken- tachments to the intermuscular septum and the su-
ing of the lateral distal deep fascia latae and the su- pracondylar tubercle of the femur; it continues dis-
perficial one-quarter of the fibers of the gluteus tally to insert on the Gerdy tubercle at the antero-
maximus (Fairclough et al, 2006; Muhle et al, 1999). lateral aspect of the proximal tibia (Fairclough et al,
the ITB is a dense fibrous connective tissue that 2006; Muhle et al, 1999). As it approaches the knee,
Corresponding
This work wasauthor:
Hyun-sook
by YeojuKimInstitute
kimhyun-sook@hanmail.net
supported of Technology Research Fund.
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Phys Ther Kor 2012;19(4):24-31
the ITB separates into two functional components,
the iliopatellar band and the iliotibial tract, which at-
tach to the Gerdys tubercle of the lateral tibia con-
dyle and the lateral patella retinaculum, respectively
(Evans, 1979; Terry et al, 1986).
The tightness of ITB could be a reason for mus-
culoskeletal disorders, such as iliotibial band friction
syndrome (ITBFS) and snapping hip. ITBFS was
rst specically described by Renne (1975) as a pain
felt on the lateral aspect of the knee in lower limb
activities, such as running and cycling (Renne, 1975).
ITBFS is the second most common injury from
overuse and the most commonly diagnosed in run-
ning, soccer, basketball, triathlons, and field hockey
(Barber and Sutker, 1992; Kirk et al, 2000; Noble,
1980; Strauss et al, 2011). Friction of the ITB
against the lateral femoral epicondyle during repeti-
tive flexion and extension activities compresses the
fat and connective tissue deep into the ITB (Strauss
et al, 2011). Patients with ITBFS complain of severe
burning at the area around and under the lateral ep-
icondyle, secondary to tightness, frictional irritation,
and inflammation of the posterior fibers of the ITB
and the periosteum of the epicondyle (Nishimura et
al, 1997; Orchard et al, 1996). Furthermore, external
snapping hip is present when the tightened iliotibial
tract and/or the anterior boarder of gluteus maximus
slide over the greater trochanter (Allen and Cope,
1995; Brignall and Stainsby, 1991; Choi et al, 2002;
Yoon et al, 2009). Symptomatic external snapping hip
is a painful condition affecting physical function in
people between 15 and 40 years (Provencher et al,
2004). Symptoms are often long-standing, and mus-
culoskeletal pain and activity limitations often domi-
nate the clinical picture (Allen and Cope, 1995;
Provencher et al, 2004).
Most rehabilitation plans for managing ITBFS and
snapping hip include stretching exercises to increase
ITB flexibility as a beneficial treatment (DeFranca,
1998; Jones and James, 1987; Lee et al, 2005;
Orchard et al, 1996; Suh et al, 2006). Begun after
acute inflammation subsides, stretching exercise is
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http://dx.doi.org/10.12674/ptk.2012.19.4.024
commonly used to increase the length and ex-
tensibility of soft tissues (Fredericson et al, 2000;
Fredericson and Wolf, 2005). Self-stretching is a one
of stretching type, enables a patient to maintain or
improving flexibility independently, and is often an
essential component of a home exercise program
(Kisner and Colby, 2007). Applying an effective and
practical self-stretching exercise is essential to
stretch the ITB and re-establish functional tissue
length. A previous study compared the effectiveness
of three common variations of the ITB self-stretch-
ing, but only in a standing position (Fredericson et
al, 2002). Other ITB self-stretching exercise in
side-lying positions, similar position of Ober test, has
never been investigated by ultrasound (US) (Strauss
et al, 2011; Wang et al, 2006).
US is a real-time, high-resolution, noninvasive
imaging tool to assess ITB (Bonaldi et al, 1998; Goh
et al, 2003; Wang et al, 2008). Compared with
Magnetic resonance imaging, US is a more suitable
tool for defining morphologic changes in the ITB in
conjunction with the Ober or modified Ober test be-
cause of its dynamic examination capability (Wang
et al, 2006). A study calculated the length of the ex-
tensor carpi radialis muscle from the muscle thick-
ness (Shi et al, 2009). Also, other study conclude
that US is a reliable means to directly assess the
real-time effects of stretching exercises (Wang et al,
2008).
Stretching exercises for the ITB has an important
role in maintaining the flexibility of soft tissue. In
particular, self-stretching exercises are highlighted in
education about home exercise. Therefore, this study
should be investigated further to ensure the most ef-
fective exercise for stretching the ITB and amelio-
rating its tightness. Our research objective was to
investigate the effectiveness of self-stretching ex-
ercises for ITB to help determine the most effective
method for ameliorating ITB tightness. This study
hypothesized that the changes of ITB thickness in
percentage caused by four self-stretching exercises
would show statistical differences.
 2012 19 4 24-31 ISSN (Print) 1225-8962, ISSN (Online) 2287-982X
Phys Ther Kor 2012;19(4):24-31
Methods
Subjects
G-power software was used for power analysis.
From the data of a pilot study of 5 subjects, the
necessary sample size was 6 subjects to achieve a
power of .80 and the effect size of 2.58 (calculated
by partial 2 of .869) with an alpha level of .05.
Twenty-one healthy subjects from Yonsei University
(14 men and 7 women) between the ages of 18 to 28
years participated voluntarily. The characteristics of
the subjects are presented in Table 1. These healthy
volunteers were screened by using historical and
physical assessments by an examiner with nine
years of clinical experience. The inclusion criteria
were as follows: 1) no leg-length discrepancy
(distance from the anterior superior iliac spine
[ASIS] to the superior surface of the most prominent
aspect of the medial malleolus) of more than 1.5 ;
2) no genu varum (tibiofemoral angle < 15); and 3)
no functional over-pronation of the foot arch (the
angle formed between the distal medial malleolus, the
navicular tuberosity, and the first metatarsal head <
90) (Wang et al, 2006). Subjects were excluded
from this study for the following reasons: 1) showed
a positive response in the Ober test, which is con-
sistent with a restricted ITB; 2) had a focally thick-
ened or poorly defined border of ITB, with a fluid
collection between the ITB and the lateral femoral
epicondyle when the US measurements were con-
ducted; 3) previous history of knee surgery, history
of pain in the ITB area; 4) history of anterior or
lateral knee pain; 5) history of low back pain in the
Table1. General characteristics of the subjects
Variables Male (n1=14)
Age (years) 21.52.8
Height () 175.05.5
Weight () 68.98.1
BMI (/)
a 22.52.7
abody mass index, values are presented as meanstandard deviation.
1) SonoAce X8, Medison Co., Ltd, Seoul, Korea.
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http://dx.doi.org/10.12674/ptk.2012.19.4.024
last six months (Bonaldi et al, 1998; Nishimura et al,
1997; Wang et al, 2006). Prior to their participation,
all subjects were informed of the purpose of the
study, and informed consent was obtained. This
study was approved by the Yonsei University Wonju
Campus Human Studies Committee.
Instrumentation2)
US1) was performed on 7.5 mode with L5-12EC
linear-array transducer (40 field of view) to
measure the thickness of the ITB during four
self-stretching exercises. US was a reliable method
for measuring the thickness of ITB. It also has a
potentially important role in the diagnosis and fol-
low-up of ITBFS (Goh et al, 2003; Wang et al, 2006).
Procedures
Four ITB self-stretching exercises (Side-lying,
Standing A, Standing B, and Standing C) evaluated
in this study were selected to compare their wide-
spread usage and prescription, simplicity of perform-
ance, and effectiveness (Fredericson et al, 2002;
Strauss et al, 2011) (Figure 1). The effectiveness of
each self-stretching exercise was evaluated based on
change in the thickness of ITB. Change in the
thickness of ITB was measured with US and calcu-
lated as a percentage (the ITB thickness of resting
status - the ITB thickness of self-stretching []) /
the ITB thickness of resting status [] 100) be-
tween a relaxed supine position and the end point of
each self-stretching exercise. It was assumed that
the most efficient self-stretching exercise would
mostly reduce the thickness of ITB (Goh et al, 2003;
Female (n2=7) Total (N=21)
21.01.8 21.32.5
162.44.4 170.87.9
51.14.4 63.011.1
19.41.2 21.52.7
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Phys Ther Kor 2012;19(4):24-31 http://dx.doi.org/10.12674/ptk.2012.19.4.024

Side-lying Standing A Standing B Standing C

Figure 1. Self-stretching exercises of ITB.
Lai et al, 2011). We investigated the left leg only. the level parallel to the lateral femoral epicondyle
Before the measuring of ITB, familiarization with (Figure 2). After measuring resting status of ITB,
four self-stretching exercises was performed for an the subjects were then allocated in random order to
hour. At first, the subject was positioned as supine perform the Side-lying, Standing A, Standing B, and
on an examination table with knee extended at 0. Standing C self-stretching exercises (Goh et al, 2003;
The ITB was easily visualized and then palpated on Wang et al, 2006). The US measuring performed in
its long axis. A line crossing the long axis of the real-time, usually no more than 10 seconds, at the
ITB at the level parallel to the lateral femoral epi- final angle of hip adduction, and then moved back
condyle, which was identified by palpation 2 starting position. All stretches were performed with-
above the corresponding lateral joint line, was out aid and observed by investigator to prevent
marked with a pen on the subjects skin to indicate compensation movement. When compensation move-
the placement position of the ultrasonic transducer ment was presented, the trial was not measured. All
(Goh et al, 2003; Gyaran et al, 2011; Wang et al, data collection was repeated three times, with a
2006). A water-based hypoallergenic ultrasound gel five-minute rest between each trial (Wang et al,
was applied to the marked area on the lateral femo- 2006). The results for each test were averaged for
ral epicondyle. The transducer was positioned parallel statistical analysis.
to the previously marked line and was held vertical
to the skin surface to prevent compressing the skin 1) Side-lying self-stretching of ITB
and underlying tissues. The thickness of ITB was The subjects lay on their right side, aligning their
measured as a reference of resting status of ITB at shoulders and pelvis with the edge of the examina-
tion table. The hip and knee of the right leg were
flexed to support and stabilize the pelvis. To stretch
the ITB, the left hip was in a straight line to torso
of subject with the knee extended at 0 and dropped
down by gravity into the available range of hip ad-
duction for self-stretching the ITB until hip move-
ment stopped. During asking the subject to not ro-
tate their trunk, plevic and hip and to use only hip
adduction movement. The thickness of ITB was
Figure 2. US image showing the thickness measured by US at the final angle of hip adduction
of ITB. (Wang et al, 2006).

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Phys Ther Kor 2012;19(4):24-31 http://dx.doi.org/10.12674/ptk.2012.19.4.024
2) Standing A, Standing B, and Standing C
self-stretching of ITB
Standing A self-stretching began with the subject
standing upright. The left leg was in a straight line
to the torso of subject and adducted across the right
leg till shoulder width. And then, the foot position
was marked with marking tape to maintain same
foot position in every trial. The subject exhaled
while slowly flexing the trunk in a direction lateral
to the right side. This movement continued until a
stretch was felt on the side of the left hip around
the greater trochanter. Standing B was the same as
Standing A, except the hands were clasped overhead
and shifted to a right side direction until a stretch
was felt on the side of the left hip. The subject was
asked to not rotate their trunk, pelvic and hip and to
use only hip adduction movement during Standing A Figure 3. Change in ITB thickness (*p<.05).
and Standing B self-stretching. Standing C was the (standard deviation). During, all self stretching ex-
same as Standing B, except the subject no longer ercises, the ITB thickness is reduced and shown in
extended the arms overhead but diagonally down- Figure 3 in percentage change (Side-lying
ward as possible (Fredericson et al, 2002). 26.6210.18% with 95% confidence interval [CI]=21.9
931.25%; Standing A 29.4616.19% with 95%
Statical Analysis CI=22.0936.84%; Standing B 44.0614.82% with
Descriptive statistics were calculated for all 95% CI=37.3150.81%; Standing C 53.7612.1% with
variables. All the continuous variables were found to 95% CI=48.2559.29%). Results indicated significant
approximate a normal distribution (Kolmogorov-Smirnov differences among four self-stretching exercises
Z test, p>.05). We used a one-way repeated-meas- (Side-lying, Standing A, Standing B, and Standing
ures analysis of variance (ANOVA) with four with- C) (p<.05). Figure 3 also shows that there were sig-
in-subject factors (Side-lying, Standing A, Standing nificant differences between all self-stretching ex-
B, and Standing C) to compare the thickness of the ercises except between Side-lying versus Standing A
ITB between all self-stretching exercises. The level (p<.01).
of significance was set at =.05. If a significant dif-
ference was found, a Bonferronis correction was
performed. All statistical analyses were performed Discussion
with SPSS, ver. 14.0 software.
This research purpose was to assess the thickness
of ITB by US to help determine the effectiveness of
Result ITB self-stretching exercises. At the parallel level of
the lateral femoral condyle, the thickness of the ITB
At the level of the lateral femoral condyle, the ranged from .8 to 1.8 on the left leg, with an
thickness of the ITB ranged from .8 to 1.8 on the overall mean of 1.14.4 (standard deviation). The
left side, with an overall mean of 1.14.4 result was similar with a previous study that the

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Phys Ther Kor 2012;19(4):24-31
mean values of sonographically measured ITB thick-
ness were 1.1.2 at the lateral femoral epicondyle.
On the other hand, two other study reported that
mean ITB values of 1.9.3 and 1.9.2 at the technique showing no change in ITB thickness (2
lateral femoral epicondyle, respectively (Goh et al,
2003; Wang et al, 2006). The results of this inves-
tigation suggested that Standing C self-stretching
exercise was the most successful method for gen-
erating change in ITB thickness among four types of
ITB self-stretching exercises. In addition, the
Side-lying self-stretching exercise using gravity to
stretch the ITB was considered a low-load (low-in-
tensity), long-duration stretch.
The Standing C self-stretching exercise was the
most effective technique among four types of ITB
self-stretching exercises because the biggest change
of ITB thickness in percentage was presented in the
Standing C self-stretching exercise. The reason
would be facilitation of hip rotation by adding flexion
and rotaion of trunk movement while other stretch
exercises only had hip adduction movement. This re-
sult is not in line with a previous study that used
three-dimensional image measurement, which in-
dicated that Standing B was most effective method
between Standing A, B, and C self-stretching ex-
ercises (Fredericson et al, 2002). Fredericsons study
had main limitation, such as not directly measuring
the ITB. Instead, the study estimated changes in
length according to angular changes in markers of
the iliac crest, greater trochanter, and lateral midline
of the knee (Fredericson et al, 2002). Therefore, this
study directly measuring the change in thickness of
ITB by US would be more objective and apparent
indicator of stretching effects. However, extreme
flexion with rotation of the trunk was observed in
Standing C self-stretching and would aggravate
symptoms for patient with disc disorders (Cohen et
al, 2009). Consequently, the Standing C self-stretch-
ing should be recommended for someone who does
not have disc disorders.
Interestingly, Standing A was the second least ef-
fective method to stretch ITB among the four
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http://dx.doi.org/10.12674/ptk.2012.19.4.024
self-stretching exercises although it is one of the
most common and well-known ITB self-stretching
exercises. In addition, Standing A was the only
out of 21 subjects) from the ITB thickness in resting
status. These results indicated that the Standing A
self-stretching exercise was a complicated method
for stretching the ITB and was not so effective.
Furthermore, the effectiveness of the Side-lying
self-stretching exercise using gravity to stretch ITB
was not significantly different from Standing A al-
though it was reported as the least effective method
in stretching the ITB. The Side-lying self-stretching
exercise had an advantage of performing stretch ef-
fortlessly for a long duration. Two previous studies
claimed that a low-load (low-intensity), long-dura-
tion stretch is considered the safest form of stretch
and yields the most significant, elastic deformation
and long-term, plastic changes in chronic con-
tractures (Kottke et al, 1966; Light et al, 1984).
Therefore, the Side-lying self-stretching exercise is
recommended over the Standing A self-stretching
exercise, especially for chronic contractures of ITB.
A limitation of this study is the sample size.
However, despite the small sample size, the response
of ITB thickness to self-stretching was sufficient to
identify a statistically signicant difference between
self-stretching exercises (p<.05). In addition, because
only healthy young adults were investigated, the re-
sults should not be generalized. Moreover, this study
did not directly assess ITB length but ITB thickness
to estimate ITB length. The change in ITB thickness
does not give perfect assurance of the change in
ITB length. Furthermore, the errors present in using
US were dominated by the position of the transducer
because it was not exactly the same for each trial
However, the potential error was minimized in this
study because all data were collected by one
well-experienced investigator. A longitudinal study is
needed to confirm the immediate effect of the
stretching exercises used in this study in a patient
population or different age groups.
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Phys Ther Kor 2012;19(4):24-31
Conclusion
This research investigated the effectiveness of
self-stretching exercises for ITB to help determine
the most effective method for ameliorating ITB
tightness. The results of this investigation showed
that the Standing C self-stretching exercise was the
most successful among four types of ITB
self-stretching exercises and recommendable method
for someone who does not have low back pain.
Furthermore, the use of the Side-lying self-stretch-
ing exercise using gravity to stretch the ITB is rec-
ommended as a low-load (low-intensity), long-dura-
tion stretch.
References
Allen WC, Cope R. Coxa saltans: The snapping hip
revisited. J Am Acad Orthop Surg. 1995;3(5):
303-308.
Barber FA, Sutker AN. Iliotibial band syndrome.
Sports Med. 1992;14(2):144-148.
Brignall CG, Stainsby GD. The snapping hip.
Treatment by Z-plasty. J Bone Joint Surg Br.
1991;73(2):253-254.
Bonaldi VM, Chhem RK, Drolet R, et al. Iliotibial
band friction syndrome: Sonographic findings. J
Ultrasound Med. 1998;17(4):257-260.
Choi YS, Lee SM, Song BY, et al. Dynamic sonog-
raphy of external snapping hip syndrome. J
Ultrasound Med. 2002;21(7):753-758.
Cohen SP, Argoff CE, Carragee EJ. Management of
low back pain. BMJ. 2009;10(338):100-106.
DeFranca GG. The snapping hip syndrome: A case
study. Chiropr Sports Med. 1998;2(1):8-11.
Evans P. The postural function of the iliotibial tract.
Ann R Coll Surg Engl. 1979;61(4):271-280.
Fairclough J, Hayashi K, Toumi H, et al. The func-
tional anatomy of the iliotibial band during flex-
ion and extension of the knee: Implications for
understanding iliotibial band syndrome. J Anat
- 30 -
http://dx.doi.org/10.12674/ptk.2012.19.4.024
2006;208(3):309-316.
Fredericson M, Guillet M, Debenedictis L. Innovative
solutions for iliotibial band syndrome. Phys
Sportsmed. 2000;28(2):53.
Fredericson M, White JJ, Macmahon JM, et al.
Quantitative analysis of the relative effectiveness
of 3 iliotibial band stretches. Arch Phys Med
Rehabil. 2002;83(5):589-592.
Fredericson M, Wolf C. Iliotibial band syndrome in
runners: Innovations in treatment. Sports Med.
2005;35(5):451-459.
Goh LA, Chhem RK, Wang SC, et al. Iliotibial band
thickness: Sonographic measurements in asymp-
tomatic volunteers. J Clin Ultrasound. 2003;31(5):
239-244.
Gyaran IA, Spiezia F, Hudson Z, et al. Sonographic
measurement of iliotibial band thickness: An ob-
servational study in healthy adult volunteers.
Knee Surg Sports Traumatol Arthrosc. 2011;19
(3):458-461.
Jones DC, James SL. Overuse injuries of the lower
extremity: Shin splints, iliotibial band friction
syndrome, and exertional compartment syndromes.
Clin Sports Med. 1987;6(2):273-290.
Kirk KL, Kuklo T, Klemme W. Iliotibial band friction
syndrome. Orthopedics. 2000;23(11):1209-1214.
Kisner C, Colby LA. Therapeutic Exercise:
Foundation and techniques. 5th ed. Philadelphia,
PA, F.A. Davis Co., 2007:83
Kottke FJ, Pauley DL, Ptak RA. The rationale for
prolonged stretching for correction of shortening
of connective tissue. Arch Phys Med Rehabil.
1966;47(6):345-352.
Lai MH, Chang ST, Chou YC, et al. Real-time ul-
trasonographic characteristics of the lateral col-
lateral ligament of the knee in cross-leg position
with varus stress maneuver. J Med Sci. 2011;31
(4):153-159.
Lee KH, Kim YS, Sung MS, et al. External
Snapping Hip Treated by Z-plasty of the
Iliotibial Band. J Korean Hip Soc. 2005;17(1):
52-57.
 2012 19 4 24-31 ISSN (Print) 1225-8962, ISSN (Online) 2287-982X
Phys Ther Kor 2012;19(4):24-31
Light KE, Nuzik S, Personius W, et al. Low-load
prolonged stretch vs. high-load brief stretch in
treating knee contractures. Phys Ther. 1984;64
(3):330-333.
Muhle C, Ahn JM, Yeh L, et al. Iliotibial band fric-
tion syndrome: MR imaging findings in 16 pa-
tients and MR arthrographic study of six ca-
daveric knees. Radiology 1999;212(1):103-110.
Nishimura G, Yamato M, Tamai K, et al. MR find-
ings in iliotibial band syndrome. Skeletal Radiol.
1997;26(9):533-537.
Noble CA. Iliotibial band friction syndrome in
runners. Am J Sports Med. 1980;8(4):232-234.
Orchard JW, Fricker PA, Abud AT, et al.
Biomechanics of iliotibial band friction syndrome
in runners. Am J Sports Med. 1996;24(3):375-379.
Peggy AH. Therapeutic exercise for athletic injuries.
Champaign, Human Kinetics, 2003.
Provencher MT, Hofmeister EP, Muldoon MP. The
surgical treatment of external coxa saltans (the
snapping hip) by Z-plasty of the iliotibial band.
Am J Sports Med. 2004;32(2):470-476.
Renne JW. The iliotibial band friction syndrome. J
Bone Joint Surg Am. 1975;57(8):1110-1111.
Shi J, Zheng Y, Chen X, et al, Modeling the rela-
tionship between wrist angle and muscle thick-
ness during wrist flexion-extension based on
the bone-muscle lever system: A comparison
- 31 -
http://dx.doi.org/10.12674/ptk.2012.19.4.024
study. Med Eng Phys. 2009;31(10):1255-1260.
Strauss EJ, Kim S, Calcei JG, et al. Iliotibial Band
Syndrome: Evaluation and management. J Am
Acad Orthop Surg. 2011;19(12):728-736.
Suh JT, Lee CK, Hong SH. Effectiveness of
Stetching Exercise in The Treatment of The
Iliotibial Band Friction Syndrome. J Korean
Othop. Sports Med. 2006;5(2):147-154.
Terry GC, Hughston JC, Norwood LA. The anatomy
of the iliopatellar band and iliotibial tract. Am J
Sports Med. 1986;14(1):39-45.
Wang HK., Ting-Fang Shin T, Lin KH, et al.
Real-time morphologic changes of the iliotibial
band during therapeutic stretching: An ultra-
sonographic study. Man Ther. 2008;13(4):334-340.
Wang TG, Jan MH, Lin KH, et al. Assessment of
stretching of the iliotibial tract with Ober and
modified Ober tests: An ultrasonographic study.
Arch Phys Med Rehabil. 2006;87(10):1407-1411.
Yoon TR, Park KS, Diwanji SR, et al. Clinical re-
sults of multiple fibrous band release for the
external snapping hip. J Orthop Sci. 2009;14(4):
405-409.
This article was received September 13, 2012, was
reviewed September 13, 2012, and was accepted
October 5, 2012.