What is Runners Knee? Runners knee is term sometimes applied to patella pain but is also used to describe Iliotibial band friction syndrome. The Iliotibial band is a sheath of connective tissue attaching from muscles in the gluteal (buttock) region to the lateral (outside) surface of the tibia or shin bone. Its purpose is to extend the knee joint (straightening it) as well as abducting the hip (moving it out sideways). As the ITB passes over the femur bone (thigh bone) at the knee it is prone to friction. It rubs on the lateral epicondyle (bony bit on the outside of the knee). The greatest friction on the ITB occurs when the knee is bent at an angle of approximately 20-30 degrees with is roughly the angle of the knee when the foot strikes the ground when running. In persons who run regularly this may lead to irritation of the ITB commonly known as ilio-tibial band friction syndrome. Signs and Symptoms of Iliotibial Band Syndrome: - Pain on the outside of the knee (at or around the lateral epicondyle of the femur).
- Tightness in the iliotibial band.
- Pain normally aggravated by running, particularly downhill
- Pain during flexion or extension of the knee, particularly when pressing in at the side of the knee over the sore part (this increases the friction on the tendon).
- Weakness in hip abduction
- Tenderness in trigger points in the gluteal area may also be present.
Any treatment for Runners knee must be done in conjunction with stretching of the Iliotibial band. Sports Massage can be particularly helpful for this condition. What can the athlete do to prevent Runners knee - Rest. Avoid painful stimuli, for example lots of downhill running.
- Apply cold therapy or ice to reduce any inflammation as soon as pain is suspected or after very long runs.
- Stretch the Iliotibial band after training.
- Self massage techniques can also be very helpful in correcting excessive ITB tightness
- See a sports injury specialist.
A sports injury specialist or clinician may: - Perform soft tissue or deep friction massage.
- Prescribe anti-inflammatory medication such as NSAID’s e.g. Ibuprofen.
- Myofascial releasing techniques have been shown to be highly effective
- Perform dry-needling techniques
- Outline a rehabilitation strategy which may include stretches and exercises to strengthen the hip abductors.
- Use electrotherapeutic treatment techniques such as TENS, ultrasound and/or interferential to reduce pain and inflammation.
- In acute cases a corticosteroid injection into the site of irritation may provide pain relief.
Ilio-tibial band friction syndrome may require long-term rehabilitation and frequent Iliotibial band stretches are usually needed even when symptoms go.
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