What is ‘runners knee’?
Runners knee, or iliotibial band friction syndrome (ITBS) is when iliotibial band irritates the lateral (outside) of the knee to cause knee pain.
The band is thought to be a type of tissue with little or no elasticity, similar to a tendon, that runs from the hip joints along the femur (thigh bone) and works with the quadriceps (thigh muscles) to provide stability to the outside of the knee joint during movement.
What are the signs and symptoms?
Pain on the outside of the knee, particularly during activity such as running. Pain is likely to get worse until the activity is stopped, only to start again once activity resumes. Running downhill or on banked surface is likely to cause more irritation.
Who gets iliotibial band friction syndrome?
Most common in runners particularly women but can occur in anyone.
Poor posture and/or poor biomechanics such as over-pronation of the foot may increase risk of irritation. Also weak hip flexors and gluteals can increase risk of developing the injury. Overuse, increase of training too fast, returning from injury too soon can all lead to ITBS.
How is iliotibial band friction syndrome treated?
Take a break from running. Try an alternative such as swimming that does not put pressure on the same structures.
• Ice & heat therapy
In the initial stages of inflammation use ice or cold packs for 10-15 minutes every hour until the pain has eased. Then repeat 2-3 times per day or after exercise until the pain does not return. Once the initial inflammation has eased, the muscles around the ITB may require heat to ease tension. Apply a heat pack for 10 minutes a day to keep the joint from stiffening at times of rest.
• Stretching and foam rolling
Stretches to the quadriceps, hip flexors, hamstrings, TFL and gluteals will all help take the pressure off the ITB (see below). Using a foam roller to self massage is always a great way to treat any injury at home.
TIP: rolling directly over the ITB can be quite painful. Try rolling the quadriceps and hamstrings, and then then the hip flexors, just below the front hip bone instead.
• Physical therapy including massage, acupuncture and electrotherapy can be very effective for ITBS
• Strengthening exercises
Strengthening the gluteal muscles and the hip abductors, on the outside of the hips will help take the pressure of the ITB
Heel drops, clam exercise and hip abductions
• Modification to training, footwear and biomechanics
How can massage help?
Massage will help release the tight muscles around the ITB to, in turn, help release the ITB. This may include the muscles that feel weak like the gluteals.
Are there any complications?
Typically there are no long-term complications of iliotibial band syndrome but without taking proper steps to reduce the pain and correct any biomechanical problems, the pain may persist.
How can I avoid getting iliotibial band syndrome?
Running on a flat or soft surface. Wearing arch support and having adequate footwear for training. Adequate warm up and stretching each time you exercise and modifying your training routine will help.
Stretches for ITB
Stretches for runners from “Stretching” by Bob and Jean Anderson
Stretches 3, 4, 5, 7 are recommended for ITBS