ITB Friction Syndrome (Also known as “Runner's Knee”) is a painful overuse condition that affects the outer part of the knee.
The iliotibial band is a tough, thick connective tissue (or fascia) extending from the tensor fascia latae muscle at the side of your pelvis to the outside of your shin bone. Runner's knee results from repeated friction of this band over the bony prominence at the widest point of the thighbone (called the lateral femoral epicondyle).
You're more at risk of this injury if you're in a phase of heavy training or recently getting in more distance than is usual for you. Other causes are pronating feet (rolled arches), a recent growth spurt in teenagers, pelvic malaignment or weak gluteal muscles and/or hip abductor muscles.
Typical symptoms include pain on the outside of your knee; tightness in your iliotibial band; knee pain that's aggravated by running, especially downhill; and pain/clicking when you bend or straighten your knee.
There's a lot that you can do to avoid runner's knee. To start with, make sure you build up your training volume and intensity gradually, increasing each by no more than 10% a week. Also, ensure you have the right shoes for your foot type, and that they are in good condition. A specialist running shop or your physiotherapist will be able to advise about this.
If you have one leg more than 1cm longer than the other, insert a 'build-up' insole on the shorter side (see a physio or podiatrist). Vary the surfaces you run on too, avoid cambered roads, and alternate the direction you run around the track to ensure that one leg doesn't get more stressed.
Make sure you stretch after your runs, especially your gluteals and hip muscles to prevent the iliotibial band becoming tight. Include a regular strength and stability programme in your training. Finally, listen to your body... if you're in pain, find out why. If you ignore it, things might get worse.
If you think you have Runner's Knee, first see a physiotherapist. You may need to back off your training. Deal with any inflammation by applying ice or doing ice massage for 10–15mins, three times per day.
Once the inflammation is under control, you can work on releasing the tension in the muscles and fascia around the knee, thigh and hip. A physiotherapist can do this; self massage and use of a foam roller are other options.
Stretch your thigh and hip muscles, particularly the gluteals and tensor fascia latae muscles, holding each stretch for 30 seconds and repeating three times. As the symptoms ease, begin strength and stability training for the hip muscles. Good options are slow one-legged squats, clam exercises and dips. Then, begin a gradual return to running, initially with fast strides, then slowly increasing distance and volume. This way, you're likely to recover within six weeks.
Danielle Smith at Peak Health Physiotherapy is more than happy to help you with any questions, treatment or rehabilitation you require regarding ITB friction syndrome, or any other concerns or injuries you may currently have.