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Iliotibial band friction syndrome (Runner’s knee)

The Iliotibial (IT) band is the thick sheath of connective tissue that runs from the pelvis to along the outside of the thigh and attaches to the top of the shinbone(tibia). It acts to extend (straighten) the leg and abduct the hip (move it sideways). As this band passes over the bony part on the outside of the knee, it causes friction which leads to pain. Iliotibial band syndrome is sometimes referred to as runner’s knee or Iliotibial band friction syndrome which all means the same thing.

Symptoms of Iliotibial band syndrome are:

  • A burning sensation on the outside of the knee or along the entire sheath.
  • Swelling of the knee.
  • Pain worsens when the foot strikes the ground.
  • Pain when running downhill.
  • Weakness in hip abduction.
  • Pain when the knee is extended (straightened).

Causes of this type of injury are:

  • Overpronation (foot rolls inwards)
  • A tight or wide IT band
  • Weak hip muscles
  • Excessive hill running or increasing mileage too quickly
  • Leg-length discrepancy
  • Insufficient warm-up or cool down

A rehabilitation programme and changes to your practice routine can bring about positive results. Avoiding all aggravating factors such as downhill running is the first step to healing. Rehabilitation will consist of therapeutic massage and/or dry needling to relieve tightness in the IT band and get rid of trigger points in the gluteus (hip muscles). Strengthening of the hip abductors (muscles that move the hip outwards) is also critical to relieving this condition. The athlete can rest and apply cold therapy to the knee to reduce pain. Minimising downhill running or eliminating it altogether will also be helpful. Wearing an orthotic support in the shoe to reduce overpronation is often recommended.

IT band syndrome is a condition that takes a long time to heal, sometimes several months. Even after symptoms appear to cease, you still need to continue with prescribed exercises. It is therefore imperative that you consult a physiotherapist to help you get on the road to recovery. We will guide you in the proper way to stretch and perform the right strengthening exercises.


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