Runners Knee

Iliotibial Band Syndrome (IT Band Syndrome / Runners Knee)

By Darren Macfarlane, Sports Injury and Rehabilitation Specialist

Iliotibial band syndrome is very common among runners so much so, that it is known as, runner’s knee. It affects up to 10% of all runners at some stage. Iliotibial band syndrome is a painful overuse knee injury that affects the outer part of the knee.
The Iliotibial band is a sheath of thick, fibrous connective tissue which attaches to the tensor fascia latae muscle. It then runs down the outside of the thigh and inserts into the outer surface of the Tibia (shin bone) just below the knee joint. The IT band acts as a stabilizer of the pelvis and to extend the knee joint (straighten it) as well as to abduct the hip (move it out sideways).

As the ITB passes over the lateral epicondyle of the femur (bony part on the outside of the knee) it is prone to friction. At an angle of approximately 20-30 degrees the IT band flicks across the lateral epicondyle. When the knee is being straightened it flicks in front of the epicondyle and when it is bent, it flicks back behind.
Iliotibial band syndrome is common in runners as 20-30 degrees is the approximate angle at the knee when the foot strikes the ground during running. IT band syndrome is an overuse condition that is aggravated by excessive training which causes the band to tighten which then rubs off the knee bone causing pain and inflammation on the outside aspect of the knee and is often more intense when descending stairs, or getting up from a seated position.

Signs and Symptoms of Iliotibial Band Syndrome:

• Sharp or stabbing pain located on the outer side of the knee joint.

• Pain aggravated by running, especially running downhill or climbing stairs.
• Pain will usually worsen as activity continues
Causes of Iliotibial band Syndrome:
• Athletes who fail to perform adequate stretching exercises to quadriceps and lateral thigh.
• Overtraining and overuse
• Running on a cambered road surface. Because most roads slope off to sides, running in the same direction leads to the outside foot being lower than the inside foot. This in turn causes the pelvis to tilt to one side and stress the it band.
• Biomechanical abnormalities that can lead to it band include, excessive pronation of the foot, leg length discrepancy, lateral pelvic tilt and bowed legs.
• Weak hip muscles i.e. gluteus medius.
• Naturally wide and tight it band.

Prevention and Treatment of Iliotibial band Syndrome:

• Rest from any activity that causes pain and inflammation. No one likes to be told to rest but movements like running will aggravate the pain. Rest will allow inflammation to decrease and area to heal. Start with at least five days of complete rest from training.
• Apply ice. This will reduce inflammation. Apply ice at least three times a day. Wrap ice in cloth to prevent burns.
• Try swimming or cycling if pain free or work on upper body strength during recovery period. Rest and low impact cross training can lead to a faster recovery.
• Stretch the Iliotibial band, quadriceps and piriformis muscles if tight after training.
• Avoid overtraining
• Make sure running shoes are in good condition. Many it band injuries are as a result of worn out shoes.
• Foam rollers are useful way to self massage the it band and help stretch out tight and painful areas.
• Strengthening the gluteus medius, if weak it overloads the it band and it has to do all the work and tightens up.
• Increase weekly mileage and training time gradually.
• Get regular sports massage; this will eliminate any tightness or adhesions that cause the IT band to tighten up and turning into pain and leading to time off training.
• Attend a physical therapist to get a full biomechanical assessment to determine the underlining cause of the IT band pain. They will assess your posture and lower limb alignment and correct any dysfunction with a corrective exercise rehabilitation programme and with soft tissue techniques.

Don’t Suffer with IT Band Pain! For a Sports Massage Treatment or to Have a Biomechanical Functional Assessment .Give me a call at the Galway Clinic for an Appointment on 086 1957378

www.sportsinjurytherapy.ie