Runner’s Knee

Runner’s knee is a common injury for runners (funnily enough). One of the causes of pain is located on the outside of the knee can be irritation of the iliotibial band. The iliotibial band (ITB) is a band of fascia attaching from the tensor fasciae latae (TFL) and glutes to the shin bone. Runner’s knee/IT band syndrome is an overuse injury generally due to friction at the lateral epicondyle of the femur (the outside bony bit) through 30 degrees of flexion, or compression of fat pads and/or bursa at the same location as the knee flexes.

Usually, there is a gradual onset of symptoms, rather than a sudden burst of pain. The lateral side of the knee will be painful and may radiate both up or down. The pain here will be aggravated by continued activity, especially movements like running downhill or climbing stairs.

There are a number of reasons why someone may experience Runner’s knee. Structurally, we can put this down to poor biomechanics (especially when running), weak muscles (e.g. hip/glutes/inner quads/core) or poor foot arch control. On top of this, it can be caused by overuse or repetitive knee flexion and extension, workout/old running shoes, a sudden increase in mileage or intensity of training, excessive hill training (especially downhill) or endurance running. 

How can I help myself? You may be wondering. 

There are a few ways that you can help yourself to relieve some discomfort. Firstly, something as simple as buying a new pair of running shoes can make a huge difference in the pain you will be experiencing. Applying ice to the area for about 5-10 minutes at a time 3-5 times a day will help to relieve some of the discomfort (make sure you are wrapping the ice in a towel to prevent ice burns). It is also important that you are resting, whether this is not running at all or just a bit less than beforehand, it is important to give yourself a break as if you don’t do this, the condition can become chronic. Lastly, manual therapy will be your best friend in helping to relieve the discomfort caused by this condition.

In terms of treatment, there are a few different things we could try to help to reduce the pain. One way will be to strengthen the muscles that may be a bit weaker (e.g. hip/glutes/inner quads/core). Trigger points in these muscles can be responsible for weakness, treating these through massage will in turn, help to increase strength. Also, a strengthening programme for these muscles will be beneficial. It may also be necessary to look at the biomechanics of your running and be more aware of the way that you are moving as this will massively affect the pain and discomfort.

Much to popular belief, the IT band itself cannot be stretched. As explained above, it is a band of fascia (a sheet of connective tissue). Therefore, trying to stretch it or foam roll it may feel as though it is helping to ease the pain, in the long term, it will not do this. It can actually cause more damage to the IT band as it will not stretch, it will just tear. You can, however, stretch the muscles around the structure which will help to relieve the pain.