Do you ‘kneed’ some help?
Do you “kneed” some help understanding your knee pain?!?
Illiotibial band syndrome
Given the closure of many sporting clubs and gyms I noticed an increase in individuals taking up new fitness endeavours. A common one amongst my friends, including the team at PhysioWest, was running. I therefore thought I would join the gang and begin my running journey.
Without having gone for a run in years I jumped straight into it. The first couple of times was went well and I was hitting some good running goals. After a while I started noticing a sharp pain on the outer side of my knee. Initially I only experienced it whilst running, however with increased frequency of running I noticed it became more prominent and present with long distance walking. What I believed to be experiencing was Illiotibial band (ITB) syndrome, more commonly known as ‘runner’s knee’.
Your ITB is a thick band of tissue located on the outer side of your thigh, which runs from your hip to your knee. Associated inflammation of the ITB or its surrounding structures can result/present as this sharp/burning outer knee pain. There is debate about the exact cause and source of this inflammation. Majority attributes it to repetitive knee flexion and extension movements, which cause the ITB to rub repeatedly against local bone structures. This ultimately leads to irritation and inflammation of the ITB itself. These types of movements are frequently seen in cyclists and runners, hence the name. Another proposed cause can be compression of fat and tissues that sit under the ITB, which become inflamed and produce pain.
Multiple risk factors can be considered for the development of ITB syndrome. These include tightness of the ITB, load/distance/frequency of aggravating activity (running or walking) and muscular weakness of supporting lower limb muscles (knee extensors, hip abductors and hip flexors).
In the early stages of rehabilitation, the primary focus is reducing pain and inflammation. Simple modalities which can help towards pain relief include icing, massage/foam rolling (to tight ITB’s) and taping (to offload ITB). Avoiding further aggravation is a key step to the recovery process, this may involve some form of rest or activity modification; however the amount will be driven by the severity of the condition. Modifying the activity intensity/time/distance to a range which is pain-free both during and after the activity is something to consider. It is also important to implement a graded return to activity after a period of rest or activity modification. Exercise prescription is crucial for maintaining mobility and targeting any strength deficits. Stretching exercises which target the ITB, tensor fascia latae and gluteal muscles are encouraged. Research also suggests implementing strengthening exercises targeting the hip abductors (gluteal muscles) to help stabilise the hip.
Experiencing this sort of pain can be somewhat frustrating, especially if it is stopping you from achieving your activity goals. It is important to understand the cause of your knee pain in order to treat it appropriately. The physiotherapists at PhysioWest are trained to assess and treat this sort of knee pain or any other knee troubles you may be having.
So pop into the clinic so we can get on top of your knee pain and get you back to your activity… whether that be running just like me.
Beals, C & Flanigan, D 2013, ‘A review of treatments for Illiotibila band syndrome in the atheletic population’, Journal of Sport Medicine, Vol. NA , pg 1-6.
Goom, T 2012, ‘ITBS’, Running Physio, <https://www.running-physio.com/itbs/>.
Physio-pedia NA, ‘Illiotibial band Syndrome’, Physiopedia, <https://www.physio- pedia.com/Iliotibial_Band_Syndrome>.