National Board of Chiropractic Examiners (NBCE) Practice Test

Repetition of which activity is most likely to result in iliotibial syndrome?

1. Walking on flat surfaces

2. Running downhill

3. Cycling

4. Jumping rope

The correct answer is: Running downhill

Iliotibial syndrome, often referred to as IT band syndrome, occurs due to friction and irritation of the iliotibial band—the connective tissue that runs along the outer thigh from the hip to the knee. It is commonly associated with activities that involve repetitive knee bending and straightening. Running downhill is particularly associated with the development of iliotibial syndrome because this action places increased stress on the lateral aspect of the knee, where the iliotibial band crosses. When running downhill, the biomechanics change, putting more strain on the muscles and tendons around the knee, leading to irritation of the iliotibial band. The repetitive nature of downhill running can cause the band to repeatedly rub against the lateral epicondyle of the femur, contributing to inflammation and pain. In contrast, activities such as walking on flat surfaces involve less knee flexion and extension under load, reducing the risk of irritation to the iliotibial band. Cycling, while it involves repetitive motion, generally does not stress the iliotibial band in the same way running does. Jumping rope, although it can involve considerable leg use, typically does not lead to the same pattern of friction across the knee joint as running downhill. Thus, repetitive