Runner’s Knee (iliotibial band syndrome-ITBS)

Runners knee or Iliotibial band syndrome (ITBS) is a common knee injury that comes through the doors at our Galway City physiotherapy and sports injury clinic. Patients with ITBS usually present with pain and/or tenderness on palpation of the outer aspect of the knee (above the joint line). It is considered a non-traumatic overuse injury and often seen in runners and cyclists.

ITBS is indicative of an underlying weakness of hip abductor muscles. The current theory is that this condition is likely to be caused by compression of the innervated local adipose tissue. Studies have described an ‘impingement zone’ occurring at, or slightly below, 30° of knee flexion during foot strike and the early stance phase of running. During this impingement period in the running cycle, eccentric contraction of the tensor fascia latae muscle and of the gluteus maximus causes the leg to decelerate, generating tension (compression) in the iliotibial band.

Clinically Relevant Anatomy

The iliotibial tract is a thick band of fascia that runs on the outside side of the thigh from the iliac crest (outer hip/pelvis) and inserts on the outside of the knee. It is composed of dense fibrous connective tissue that appears from the muscles of the tensor fasciae latae and gluteus maximus.

ITBS is one of the most common injuries in runners presenting with lateral knee pain. The etiology of ITBS is often multi-factorial. Long distance running is a common cause of ITBS, especially if running on slightly banked ground, as the subtle drop of the outside of the foot stretches the ITB, increasing the risk of injury. Sudden increases in activity levels can also lead to ITBS.

Treatment

The treatment of ITBS is usually non-operative, and physiotherapy should be considered the first and best line of treatment. As part of the treatment process, you can expect some of the following:

  • Activity modification and relative rest.
  • Myofascial release and trigger point therapy of tight and dysfunctional musculature.
  • Use of a foam roller on the tight muscles could also be beneficial.
  • Exercises to strengthen the abductor muscles and stabilise the hip. Since ITBS can often be associated with hip abductor weakness, strengthening and stabilising of the hip will be beneficial in the treatment of ITBS.
  • Gradual return back to sport under your physio’s clinical judgement.
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Runner’s Knee (iliotibial band syndrome-ITBS)

Runner’s Knee (iliotibial band syndrome-ITBS) FAQs

What is Iliotibial Band Syndrome (ITBS), and how does it cause runner’s knee?
Iliotibial Band Syndrome (ITB) is a common overuse injury that affects the iliotibial band, a thick band of tissue that runs along the outside of the thigh from the hip to the knee. When this band becomes tight or irritated, it can also cause runner’s knee, resulting in pain and inflammation on the outside of the knee.

What are the symptoms of Iliotibial Band Syndrome (ITB)?
Symptoms of Iliotibial Band Syndrome include sharp or burning pain on the outside of the knee, especially during activities such as running or cycling. You may also experience tenderness or swelling on the outside of the knee, along with a snapping or popping sensation.

How is Iliotibial Band Syndrome diagnosed?
Iliotibial Band Syndrome is typically diagnosed through a physical examination by a physiotherapist, who will assess your knee for pain, tenderness, and range of motion. In some cases, imaging tests like an MRI may be used to rule out other conditions.

How can West Coast Physio help treat Iliotibial Band Syndrome?
At West Coast Physio, our treatment for Iliotibial Band Syndrome includes manual therapy to release tension in the ITB, stretching exercises to improve flexibility, and strengthening exercises to address muscle imbalances. We also focus on correcting running mechanics and posture to prevent the recurrence of runner’s knee.

How long does it take to recover from Iliotibial Band Syndrome with treatment at West Coast Physio?
Recovery times for Iliotibial Band Syndrome vary depending on the severity of the condition. With treatment at West Coast Physio, many patients experience significant improvement within 6-12 weeks. Chronic cases may take longer to fully resolve, but consistent treatment can speed up recovery and prevent long-term issues.

Can Iliotibial Band Syndrome be prevented?
Yes, Iliotibial Band Syndrome can often be prevented by maintaining strong and flexible hip and thigh muscles, using proper footwear, and gradually increasing running or cycling distances. West Coast Physio can help you develop a personalized exercise program to strengthen the muscles around the hip and knee, improving biomechanics and reducing your risk of injury.

When should I see West Coast Physio for runner’s knee or ITB pain?
If you experience persistent pain on the outside of your knee during physical activities such as running or cycling, it’s essential to seek help from West Coast Physio. Early intervention can prevent further irritation and help you return to your activities pain-free.

At West Coast Physio, we have the tools to fix the most stubborn of ITB syndromes. Give us a call today.

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