Active Body Physiotherapy

Runners Knee

Written on the 11 December 2013 by Active Body Physiotherapy

ITB Friction Syndrome, Runner's Knee is the common name for Iliotibial Band Friction Syndrome, a painful overuse condition that affects the outer part of the knee.

The iliotibial band is a tough, thick connective tissue (or fasica) extending from the tensor-fascia-lata 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, getting in more miles than is normal for you. Weakness of the hip abductor muscles – the ones that draw your leg away from the centreline of your body – can also make runners knee more likely. So can over-pronation or leg length discrepancy, which can be either anatomical or caused by running on cambered roads or always in the same direction around the track.

Typical symptoms include pain on the outside of your knee; tightness in your iliotibial band; knee pain thats aggrevated by running, especially downhill; and pain when you bend or straighten your knee, particularly when you press in at the side of the knee over the sore part.

How Do I Avoid It?

There's a lot of action you can take 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 per cent 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 glutes and hip muscles to prevent the iliotibial band becoming tight. Include a regular strength and stability programme in your training. Also, check your bike fit. Badly positioned cleats, a saddle that's too high or pedals without any float (foot movement before your cleats unclip) can all contribute. Finally, listen to your body. If you're in pain, find out why. If you ignore it, things might get worse.

And If I Get It?

If you think you have Runner's Knee, first see a physiotherapist. You may need to back off your training. Take a look at your bike too. Check that your saddle is the right height or get a detailed bike fit from a qualified specialist. 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 free-off restrictions 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 glutes and tensor-fascia-lata 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.

The team at Active Body 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.


Author:Active Body Physiotherapy

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What They Say

Back to the future you

Written on the 5th of September 2014 by Active Body Physiotherapy

Well it's that time of year again. The transition from winter to spring and a time that most individuals come out of hibernation and start throwing themselves back into regular activity and exercise whilst enjoying more modest temperatures rather than the bitter cold of winter.

It's now the time to look at building back into some form of exercise at a steady pace and not throw yourself into something your body cannot handle after a long period off. As an Exercise Physiologist I get to see all too often the end result of someone going "Hell for Leather" into some new regime and not considering if they are physically ready to perform such activity. I'm certainly not saying don't try something new, I am all for that, however start small then build up.

Take the time to look at possible weaknesses you may have, think about where you've come unstuck in the past with previous programs and ultimately your overall goals from your new training program.

Remember that if you start slowly and build up you are more likely to stick to a program, rather than jumping into something that causes injury or excessive muscle or joint damage. Address all facets of training, look at improving your strength, cardiovascular endurance, core stability, and flexibility.

Look at structuring your program to encompass a holistic approach to improving your general fitness; don't neglect the small things either like recovery and nutrition. If all avenues are taken care of then your overall goal is closer than you think.

If you are uncertain about how to start your program or are carrying a niggling injury that refuses to settle, then seek out the assistance of a professional. Let them assess your current situation and find out suitable ways of addressing that reoccurring injury, find a way to best program your training or simply develop a structured program that is "INDIVIDUALISED" for YOU!

Remember, what works for one individual may not be completely suitable for the next. A small adjustment here, or a tweak there may just set you up for the best long-term success you need and want.

Training and building fitness is meant to be fun. Find something fun in each activity you participate in, don't see training as a chore. I understand working out can be hard work, but it should also be something that you enjoy doing. If you take the approach of "wanting to do it" rather than "having to do it" then your success is certainly going to be higher and your results so much more noticeable.

I hope that with the improved weather comes the chance to build a new exercise regime. A chance to get Back to the Future You.

Should you require any information on program design, injury and biomechanical assessments don’t hesitate in contacting our team of professional exercise physiologists at Active Body.

Shannon Codd
Accredited Exercise Physiologist
Strength and Conditioning Specialist

Author:Active Body Physiotherapy
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