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Runner’s Knee / Illiotibial Band Syndrome
By
Dominic McKinley, MD, CAQ and Joe Mullins,
M. Ed., LAT, ATC
 According
to an article published in the Journal of
the American Academy of Orthopedic Surgeons,
one in five runners will experience a yearly
knee injury ('Running
Injuries to the Knee,' Journal of the
American Academy of Orthopedic Surgeons,
vol. 3, pp. 309-318, 1995). Internet
searches for the incidence rate of
illiotibial band (ITB) syndrome reveals that
this malady accounts for an approximate 12%
of knee injuries in running. Therefore, if
you are an avid runner, you have a very high
chance of experiencing lateral (outside)
knee pain at some point in your running
life.
What is Runner’s Knee/ITB
Syndrome?
The ITB runs along the
outside of the thigh and attaches to the
outside part of the knee.
Runner’s knee is an
irritation of the ITB at or near its
attachment to the knee. This irritation is
caused by friction that is built up during
each repetition of the running cycle. The
greatest amount of friction occurs between a
20 and 30 degree knee angle. Since this
angle is assumed with great repetition
during the running cylce of long distance
runners, the ITB can succomb to these
mechanical stresses and result in an
inflammatory response. Additionally, weak
hip abductors can also result in increase
stress on the ITB.
Common Signs and Symptoms
of Runner’s Knee
Tenderness along the outside of the knee
with the following presentation:
-
Pain starts as minor discomfort, but
worsens
-
Discomfort initially relieved by rest
-
Pain with running downhill
-
Pain with running on uneven surfaces
Treatment of
Runner’s Knee
Treatment of runner’s knee coincides with
the three stages of tissue healing:
-
Anti-inflammatory medication (NSAID’s)
to prevent the inflammatory stage of
tissue healing from being prolonged
-
Soft tissue mobilization and stretching
during the regeneration phase of tissue
healing
-
Continued stretching along with hip
strengthening/stabilization exercises
for the abductors, adductors, external
rotators and extensors during the
remodeling phase of tissue healing
-
Decrease running distance until pain
free or nearly pain free
-
Decrease hill and stair workouts until
pain free or nearly pain free
Prevention of
Runner’s Knee
Athletes can be proactive in preventing
runner’s knee by incorporating the
following:
-
Undergo a Performance Based Functional
Assessment to identify any underlying
physical imbalances that may be
predisposing the athlete to injury
-
Initiate a preventative flexibility
program
-
Initiate a post-running regeneration
program that includes stretching and
self massage techniques
-
Evaluate running shoes for excess wear
-
Avoid downhill and uneven terrain
running until pain free
Bottom Line
As with many overuse type injuries, runner’s
knee can be largely prevented through a
proactive approach. However, in the event
that you begin experiencing the above
symptoms, seeking appropriate and expedient
assistance from a sports medicine
professional can help you get back to
running quicker.
Dominic McKinley, MD, CAQ is a primary care
sports medicine physician with Guilford
Orthopaedic and Sports Medicine Center in
Greensboro. He serves as team physician for
N. C. A&T State University and Bishop
McGuiness High School. He enjoys running.
Dr. McKinley can be contacted at
336-275-3325. More information about Dr.
McKinley and the services he provides can be
found at
www.guilfordortho.com.
Joe Mullins, M. Ed., LAT, ATC is Founder and
Director of Athletic Training &
Conditioning, Inc. He specializes in
functional orthopedic evaluations and works
with athletes from middle school, high
school, and college to professional and
Olympic athletes. He can be contacted at
joe.mullins@athletictrainingandconditioning.com.
More information about Joe Mullins and the
services he provides can be found at
www.athletictrainingandconditioning.com.
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