Iliotibial Band Syndrome, or simply “runner’s knee”, is a common overuse injury that can become particularly painful on the outside of the knee.The pain is caused when the iliotibial band, a thick layer of connective tissue (fascia) that runs along the outer side of the thigh from the hip to the knee, becomes irritated or inflamed due to friction.
How is it caused?
The syndrome can be caused by any physical activity in which the foot performs repetitive motion, such as running or walking on an incline (eg going down stairs). It is basically a stress injury, such as during an exercise program that is more intense than what we are used to. Improper footwear, distance and sudden changes in running surface (uphill to downhill, soft to hard) all contribute to increased strain.
Therefore, straining during intense sports can be a main factor in causing the Syndrome, but it seems that weak muscles in the hip area and especially weak buttocks also favor its appearance. Also mentioned as predisposing factors are laxity in the knees, stiffness in the hip or waist area, flat feet and other conditions that can compensatingly cause a load on the area. So we understand that it is characterized as a multifactorial syndrome and the clear cause that caused it needs to be investigated by a specialized doctor or physiotherapist.
Symptoms
The main feature of the Syndrome is pain on the outer side of the knee. But there are also additional features:
- The outer side of the knee, which is the focus of the pain, will be especially sensitive, even to slight pressure.
- The syndrome usually occurs suddenly, without warning, during physical exertion. The length of time the pain worsens varies, from a few minutes to an hour or two.
- Chronic patients diagnosed with the Syndrome do not feel pain at rest. But they suffer from sudden bursts of pain when moving the leg after standing still, such as after sitting or getting out of bed in the morning.
- Discomfort is also experienced during running or walking, going down stairs or hills.
- Prevention
The most effective way of prevention is to maintain a regular exercise program. If we want to increase the intensity of the program, we should do it gradually and in a controlled manner. Our aim is to avoid sudden “tightening” of the iliotibial band, which can occur if we suddenly increase the intensity in the exercise program. An experienced trainer can advise on the appropriate exercise program.
In the event of pain or discomfort in the outer area of the knee during exercise, immediate rest and relaxation of the intensity of the physical activity is recommended. By refraining from exercise for a few days, we can even avoid the appearance of the Syndrome.
Alternatively, we can exercise in activities of lower intensity than running, and therefore less stressful for the iliotibial band, such as swimming or cycling.
Treatment
The aim of the treatment is to reduce the symptoms of the Syndrome, to avoid a chronic condition and to return the patient to his daily activities as quickly as possible. The doctor or physical therapist will confirm if the pain you are experiencing is indeed due to the Syndrome or some other condition, will inform you in detail about its special characteristics and will show you exercises suitable to deal with it. At the same time, together with an experienced trainer, they will advise you on which exercises to avoid, which, if performed without professional supervision, may aggravate the problem.
Summary
Tibiotibial Band Syndrome is one of the most common conditions afflicting experienced or novice athletes. The causes of the syndrome are under investigation and its aggravating factors vary. The most effective method of prevention and treatment is always proper information and rehabilitation by professionals and experienced therapists.
