Today we discuss one cause of lateral knee pain that is common in runners: Ilio-tibial Band friction syndrome (ITBFS)
What is the ITB? The ITB is a thick band of tissue overlying the muscles on the outside of the thigh. It stretches from the outside of the hip to just below the knee and helps to stabilise the knee particularly during running. In bending and straightening the knee it passes from behind the natural bump (lateral femoral condyle) on outside of knee to in front. When there is increased stress through this tissue the repeated friction caused as it passes over the condyle can lead to lateral knee pain. The ache that develops often appears at the same distance during subsequent runs and can limit an athlete’s ability to increase their distance. Longer runs or courses with a lot of downhill sections tend to aggravate symptoms.
Why does it happen? ITBFS may be due to inappropriate training, muscle weakness/tightness or altered movement patterns. Inappropriate training ranges from progressing your distance too quickly to running on steep downhill or uphill courses. Biomechanically, excessive pronation (inward rolling of the arches of the feet) can lead to increased stress through the ITB, this can be reduced by making sure you have good supportive footwear (ideally running specific). Reduced hip control/stability and weak gluteal muscles may also lead to increased tension which exacerbates the friction caused at the outside of the knee.
Prevention: In a lot of cases it is the end result of doing too much too soon! This is especially true for people who are new to running or are returning from a long break in training. Discuss this with your Chartered Physiotherapist or search well trusted web sources for how to increase your mileage safely.
Treatment: Initially it is essential to reduce your activity to a level that is more tolerable. For some people this may mean stopping running for a period and for others it may simply mean running less frequently and getting more rest. Inflammation around the area may be helped with regular icing or simple anti-inflammatories if indicated* (Discuss with GP or Pharmacist before taking any medication). Your Chartered Physiotherapist will work with you to restore normal strength and length in the muscle groups in the hip and knee. They will educate you around finding a stable level of activity that will enable a return to activity quicker. They will also assess you biomechanically for any lower limb issues that may be causing or exacerbating this condition and may give advice on footwear/orthotics if appropriate. In some cases it may be necessary to assess your running technique to try to pin-point faulty technique or give you a targeted exercise protocol to address any weaknesses.
Conclusion: The good news is that this can be helped and it will get better! Here at Connacht Physio Clinic we will work with you to ensure you have the tools and information to be able to take control of your symptoms and get back doing what you enjoy! Contact us now for an assessment.