Lower extremity kinematics during running and hip abductor strength in iliotibial band syndrome: A systematic review and meta-analysis.

Iliotibial band syndrome, or ITBS, is a painful condition that stops many runners in their tracks, and it shows up twice as often in female runners as in male runners. Researchers wanted to know whether runners who develop this injury share common movement patterns or strength weaknesses. They pooled data from seventeen published studies to see if there were consistent differences in hip motion and hip strength between runners with ITBS and those without it.

What they found was fairly modest: female runners currently dealing with ITBS showed somewhat smaller amounts of hip internal rotation (the inward twist of the thigh bone) and weaker hip abductor muscles (the muscles on the side of the hip) compared to uninjured runners. The catch is that this pattern appeared mostly in studies looking at people who had ITBS at the time of testing, not so much in studies that followed runners over time to predict who would get injured later.

This study looked at whether people with iliotibial band syndrome share certain movement patterns or muscle weaknesses that might explain why they developed the condition. For female runners with current ITBS, the researchers found two things that stood out: a smaller degree of inward rotation at the hip and weaker muscles on the outside of the hip compared to runners without the condition.

It is important to know that these findings are not huge differences, and they were clearest when researchers looked at people who already had the injury rather than trying to predict who would get injured in the future. The science here is still developing, and it remains unclear how much these movement and strength patterns actually cause ITBS versus being a result of having the injury.

This suggests that ITBS may develop differently in female and male runners, though more research is needed to understand those differences fully.

This is a summary of research, not medical advice. Talk to your own healthcare provider about anything affecting your care.

This systematic review and meta-analysis adds some useful nuance to how we think about ITBS in different populations. The main finding is that female runners with active ITBS showed smaller peak hip internal rotation and lower isometric hip abductor strength compared to controls, though the authors note that the biomechanical evidence overall remains limited.

Notably, this pattern appeared only in cross-sectional studies of people with current symptoms, not in prospective studies designed to identify risk factors before injury occurred. This temporal distinction matters because it leaves open the question of whether these kinematic and strength differences are causal factors or consequences of the condition.

The authors appropriately highlight that risk factors may differ between sexes and that transverse plane motion and abductor strength weakness may be relevant in female runners specifically. The evidence base is still thin enough that we cannot yet treat these as established mechanisms, but the suggestion of sex-specific patterns is worth keeping in mind when evaluating individual runners.