Runner's Knee

WHAT IS IT?

• inflammation of the iliotibial band on the outside of the knee
• the iliotibial band is attached to a muscle in your hip (tensor fascia latae) that is VERY important in stabilizing your body when you stand on one leg as occurs each time your foot lands on the ground while running

WHAT HURTS?

• sometimes tenderness is present on the outer aspect of the knee
• running becomes more and more painful, at times runners are only able to run a couple hundred feet before the pain starts
• walking up/down stairs
• in really acute/very inflamed cases the knee may become painful while walking

WHAT CAUSES IT?

• sudden increase in running frequency, time or speed
• always running in the same direction around your route resulting in one leg always being lower on the slope of the road/sidewalk
• change in shoes to a style that is not suited to your foot mechanics
• foot biomechanics such as an extremely flat arch or an extremely high arched rigid foot
• altered mechanics anywhere in your leg(s) from an old injury (fracture or severe sprain

WHY DOES IT HURT?

• the iliotibial band gets repeatedly rubbed against the outer part of the thigh bone (femur)
• over time the band becomes irritated and worn resulting in localized swelling
• the swelling accumulates and irritates the small nerve endings in the band and surrounding tissue and results in - PAIN

WHAT DO I DO?

• take time off running
• ice the area several times daily for SEVERAL days while considering causes such as training schedule, terrain, shoes etc.
• maintain aerobic capacity by cycling or swimming, these activities do not demand the same motion form your knee as running does
• when you return to running increase both your mileage and speed gradually and alternate routes
• discuss possible causes with your physiotherapist because no two people are alike
• stretches as prescribed by your physiotherapist to improve flexibility/mobility of restrictive structures that may cause/perpetuate the irritation
• anti-inflammatories maybe helpful if prescribed by your physician
• ultrasound or interferential current administered by your physiotherapist may help get rid of the inflammation and prevent excessive scar tissue formation
• cortisone injection (only as required in a few cases, rarely done)

HOW DO I PREVENT IT?

• once you find a brand/model of shoes that you like, stick with them
• buy new shoes approximately every 400 miles of running, just because they still look good doesn’t mean the inner supports are still adequate
• make changes to your running route gradually
• take days off from running each week to rest or participate in another activity (cross-training)
• maintain flexibility and range of movement of hip, thigh and knee muscles

WHAT ELSE CAUSES PAIN IN THIS AREA?

• patella femoral joint - the kneecaps and the quadriceps muscles that attach to it can get overused and cause pain
• quadriceps tendonitis
• prepatellar bursitis
• lateral collateral ligament or cartilage of the knee
• superior tibiofibular joint
• biceps femoris tendonitis (outer hamstring muscle)
• arthritic changes in either the knee joint or the joint between the kneecaps and the femur
• irritation of the nerve that supplies this area, this usually occurs in the low back and usually (not always) low back pain is also present

YOUR PHYSIOTHERAPIST CAN HELP YOU WITH THE REST…