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Runner’s knee is common terminology for an Iliotibial
Band Syndrome. It is a result of the irritation of the
Iliotibial Band (ITB) tendon. The ITB is on the outside
of the knee and is attached to a muscle in your hip
named the Tensor Fascia Latae. The ITB is an important
stabilizer of the body when stand on one leg.
When
running, there is a moment when only one leg is on the
ground, the stance phase. During that phase, the ITB
stabilizes the body.
When
the ITB gets repeatedly rubbed against the outer part of the
knee on the lateral femoral condyle, excessive friction of the
tendon occurs. Over time the ITB 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. |
| Pain:
There is pain and tenderness on the lateral (outside)
aspect of the knee on the lateral femoral condyle.
Usually, more severe pain can be felt during
activities and there may have diffuse discomfort in
the hip and thigh. Pain is felt during running. When
the condition becomes severe, pain can be felt during
walking and stairs.
Inflammation:
Inflammation
will be present although it may not always be visible.
It is the result of the irritation of the tendon and
the tear of some tendon fibers. In severe cases there
will be swelling on the lateral aspect of the knee.
X-Rays:
Usually
nothing shows on x-ray.
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- Sudden increase in running
frequency, time or speed.
- Change
in shoes to a style that is not suited to your foot mechanics.
- Altered
mechanics anywhere in your lower extremities from an old injury, for example a fracture or severe sprain.
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- Always running in the same direction around your route
resulting in one leg always being lower on the slope of the road or sidewalk.
- Foot
biomechanics such as an extremely flat arch or an extremely high arched rigid foot.
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- Icing
will
help decrease the inflammation and the pain.
- Consider
causes such as training schedule, terrain, shoes etc.
- Maintain
aerobic capacity by cycling or swimming, these activities do
not demand the same motion from your knee as running does.
- When
you return to running increase both your mileage and speed
gradually and alternate routes.
- Stretches,
as prescribed by your physiotherapist, to improve
flexibility/mobility of restrictive structures that may
cause or perpetuate the irritation.
- Anti-inflammatories
maybe helpful if prescribed by your physician.
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- Once you find a brand and model of shoes that fits well, stick
with them.
- Buy
new shoes approximately every 400 miles of running, just because
they still
look good does not 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.
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Will
Physiotherapy Help Me?
A
physiotherapist will assess your condition and determine the origin of
your pain. Your treatment plan will address both the local symptoms
such as pain and inflammation as well as the cause of your pain (see
causes above).
If
you have developed this problem through a specific activity, your
physiotherapist can review your technique and make recommendations to
avoid injury.
You
will also be given an exercise program that will include proper
stretching and strengthening exercises, to maintain the flexibility
and strength of the hip, knee and ankle muscles. With the help of modalities,
your physiotherapist will reduce your symptoms
and promote healing.
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