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Iliotibial Band Friction Syndrome (ITBFS) is a common overuse injury primarily affecting runners and cyclists, characterized by pain and inflammation along the lateral aspect of the knee. The iliotibial band, a thick band of connective tissue that extends from the hip to the shin, plays a crucial role in stabilizing the knee during movement. In ITBFS, the band becomes irritated due to repetitive friction against the lateral femoral epicondyle, particularly during activities involving repetitive knee flexion and extension. The primary symptoms often include sharp or aching pain on the outside of the knee, which may worsen with activity, particularly during downhill running or cycling. Additionally, individuals may experience a popping or snapping sensation at the site of the irritation. The condition is frequently seen in athletes who suddenly increase their training intensity or volume, leading to an imbalance between the demands placed on their bodies and their physical conditioning. Various factors contribute to the development of ITBFS, including biomechanical abnormalities, such as excessive pronation of the foot, leg length discrepancies, and weak hip abductors or external rotators. These anatomical and functional issues may alter the alignment and movement patterns of the knee, further predisposing individuals to this syndrome. Furthermore, overtraining, insufficient recovery periods, and improper footwear can exacerbate the friction and inflammation of the iliotibial band. Environmental factors such as running on sloped surfaces or uneven terrain can also contribute, as they place additional strain on the lateral structures of the knee. Effective management of ITBFS typically involves a combination of conservative treatment strategies, including rest, ice application, and anti-inflammatory medications to alleviate pain and swelling. Physical therapy focusing on stretching and strengthening exercises, particularly for the hip and core muscles, has been shown to aid in the rehabilitation process. Additionally, the use of foam rollers and other myofascial release techniques can help relieve tension in the iliotibial band. Modifying training habits, such as gradually increasing mileage and avoiding running on sloped surfaces, can significantly reduce the risk of recurrence. In some cases, orthotic devices may be recommended to address foot mechanics and provide better support during activities. If conservative measures fail, more advanced interventions such as corticosteroid injections or surgical options may be considered, although surgical intervention is rarely required. Overall, understanding the mechanics and causative factors of Iliotibial Band Friction Syndrome is crucial for athletes and healthcare providers alike in both the prevention and effective management of the condition, allowing individuals to return to their desired activities while minimizing the likelihood of recurrent injuries.