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What do I do if I have Runner’s Knee?

What is the ITB, and what does it do?

The ITB is actually a long tendon. (Tendons connect muscles to bone.) It attaches to a short muscle at the top of the pelvis called the tensor fascia lata. The ITB runs down the side of the thigh and connects to the outside edge of the tibia (shinbone) just below the middle of the knee joint. You can feel the tendon on the outside of your thigh when you tighten your leg muscles. The ITB crosses over the side of the knee joint, giving added stability to the knee.

The lower end of the ITB passes over the outer edge of the lateral femoral condyle, the area where the lower part of the femur (thighbone) bulges out above the knee joint. When the knee is bent and straightened, the tendon glides across the edge of the femoral condyle.

The picture at the top of the page is most accurate of how the ITB is distributed along the side of the leg. Pain is often felt at the outside of the knee but the problem originates at the hip of the same leg.

Iliotibial band (ITB) syndrome is an overuse problem that is often seen in bicyclists, runners, and long-distance walkers. It causes pain on the outside of the knee just above the joint. It rarely gets so bad that it requires surgery, but it can be very bothersome. The discomfort may keep athletes and other active people from participating in the activities they enjoy.

Why does this occur?

When talking to runner’s, usually it is training error that is what caused this type of knee pain. Typically found in novice runner’s, because they are the group that finds themselves increasing running distance more than those with a consistent base of fitness. Although we do not have a lot of research on the 10% rule (limiting the amount of increase in running distance to no more than 10% per week), we do know that people who get this type of injury are increasing their training mileage to greater than 30% per week. This would also be true about being undertrained for a long distance race and still participating. Following that race, or during, you can develop pain over that knee and moving up towards the hip.

What should you do?

Clam Shell Exercise with band around your knees: 3 sets of 10 to both sides

Standing hip abduction with band around your ankles: 3 sets of 10 to both sides

Lateral plank: hold 10 seconds for 5 sets on both sides.

Prone hip Extension: 3 sets of 10 to both legs

You should also limit your running to a distance that does not increase the pain at the side of the knee or the hip. Do not run through pain with this one. Good luck with your training!

Mike the PT

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