Runner's knee and how to avoid it

Runner's knee is the common name for iliotibial band friction syndrome, a painful overuse condition that affects the outer part of knee. The iliotibial (IT) band is a long length of tough connective tissue that extends from the tensor fascia latae muscle, located at the side of the pelvis, downwards to the outside of the shinbone (the tibia). The condition arises from repeated friction of this band over the bony prominence at the widest point of the thighbone, known as the lateral femoral epicondyle.

High training volume, weakness of the hip abductor muscles (those responsible for pulling the leg away from the centreline of the body), excessive pronation of the foot (rolling inwards on foot strike), or leg length discrepancy, which can be either anatomical or induced by running continually on cambered roads, can all increase risk of developing runner's knee. Symptoms include;

• pain on the outside of the knee, which may start after completion of a certain distance and then increase to the extent that continuation becomes impossible
• pain felt whilst running downhill of climbing stairs, activities which cause excessive friction of the IT band on the lateral condyle
• pain on bending or straightening the knee, particularly when pressure is applied to the source of pain with the thumb 

​ Development of runner's knee necessitates a reduction in training load and appropriate modification to avoid pain-causing situations such as downhill running or cambered road running. Reduce inflammation by repeated, daily application of ice, and/or prescribed anti-inflammatory medication. Once inflammation is under control, intervention by a qualified physical therapist to reduce restriction in the muscles and tissues of the hip, thigh and knee can help to facilitate recovery. Such professionals can also prescribe appropriate stretching and strengthening exercises, and assess need for corrective orthoses to address possible leg length discrepancy.

Avoidance of runner's knee is facilitated by a number of measures;

• increase training volume and intensity gradually
• stretch the muscles of the glutes and hip throughly after each training session
• incorporate regular strength and stability training into your programme - squatting and lunging actions are ideal for strengthening the hips and glutes 
• wear the correct shoes for your foot type and maintain them in good condition
• address possible differences in leg lenght by consulting a professional who can prescribe appropriate orthotic inserts
• vary the surfaces you run on and if you use a track regularly, alternate the direction you travel in order to evenly distribute load on the legs      

Billy Byrne, Neuromuscular Physical Therapist, provides expertise in the management and treatment of myofascial pain, dysfunction and injury through our healthpro Physical Therapy Clinic. A vastly experienced therapist with over 14 years of clinical practice to date, Billy is nationally recognised as an authority on specialised treatment techniques such as Trigger Point Dry Needling (as featured in our October newsletter) amongst others. Billy works with a diverse client base from athletes to the elderly and is chief physical therapist to the world-renowned dance show, Riverdance.

To book an appointment with Billy, please call +35386 4119222 or email info@healthpro.ie