Lower extremity overuse injuries account for 50% to 75% of all injuries in recreational runners and 35% of all musculoskeletal injuries in military personnel. Iliotibial band syndrome is an overuse injury. Iliotibial band syndrome is the most common cause of lateral knee pain in runners, affecting 7% to 14% of runners, and participants in other sports.

This video demonstrates ultrasonographic-guided distal release of the iliotibial band. Our preliminary results of ultrasonographic-guided distal release of the iliotibial band in 31 patients were excellent. Few complications occurred, and no contraindications to the procedure exist. Ultrasonographic-guided release of the iliotibial band is a novel form of surgery that is minimally aggressive and potentially results in a faster recovery. Ultrasonographic-guided release of the iliotibial band allows surgeons to decrease the size of the incision and may be performed under local anesthesia in an outpatient setting. The procedure is relatively quick and painless and does not require the use of a tourniquet. Modifications of the technique, such as partial release or Z-plasty, are possible because the technique is easy and affords good visualization of the structures. However, surgeons must perfect the technique using cadaver models and become competent with the use of ultrasonography. We believe ultrasonographic-guided procedures will become the preferred method for iliotibial band release.