Runner’s knee is common terminology for an Iliotibial Band Syndrome. It is a result of the irritation of the Iliotibial Band (ITB) tendon. The ITB is on the outside of the knee and is attached to a muscle in your hip named the Tensor Fascia Latae. The ITB is an important stabilizer of the body when stand on one leg.
When running, there is a moment when only one leg is on the ground, the stance phase. During that phase, the ITB stabilizes the body.

When the ITB gets repeatedly rubbed against the outer part of the knee on the lateral femoral condyle, excessive friction of the tendon occurs. Over time the ITB becomes irritated and worn resulting in localized swelling. The swelling accumulates and irritates the small nerve endings in the band and surrounding tissue and results in pain.

Pain:
There is pain and tenderness on the lateral (outside) aspect of the knee on the lateral femoral condyle. Usually, more severe pain can be felt during activities and there may have diffuse discomfort in the hip and thigh. Pain is felt during running. When the condition becomes severe, pain can be felt during walking and stairs.

Inflammation:
Inflammation will be present although it may not always be visible. It is the result of the irritation of the tendon and the tear of some tendon fibers. In severe cases there will be swelling on the lateral aspect of the knee.

X-Rays:
Usually nothing shows on x-ray.

• Sudden increase in running frequency, time or speed
• Change in shoes to a style that is not suited to your foot mechanics
• Altered mechanics anywhere in your lower extremities from an old injury, for example a fracture or severe sprain
• Always running in the same direction around your route resulting in one leg always being lower on the slope of the road or sidewalk
• Foot biomechanics such as an extremely flat arch or an extremely high arched rigid foot

• Take time off running
• Icing will help decrease the inflammation and the pain
• Consider causes such as training schedule, terrain, shoes etc.
• Maintain aerobic capacity by cycling or swimming, these activities do not demand the same motion from your knee as running does
• When you return to running increase both your mileage and speed gradually and alternate routes
• Stretches, as prescribed by your physiotherapist, to improve flexibility/mobility of restrictive structures that may cause or perpetuate the irritation
• Anti-inflammatories maybe helpful if prescribed by your physician

• Once you find a brand and model of shoes that fits well, stick with them
• Buy new shoes approximately every 400 miles of running, just because they still look good does not mean the inner supports are still adequate
• Make changes to your running route gradually
• Take days off from running each week to rest or participate in another activity (cross-training)
• Maintain flexibility and range of movement of hip, thigh and knee muscles

A physiotherapist will assess your condition and determine the origin of your pain. Your treatment plan will address both the local symptoms such as pain and inflammation as well as the cause of your pain (see causes above).

If you have developed this problem through a specific activity, your physiotherapist can review your technique and make recommendations to avoid injury.

You will also be given an exercise program that will include proper stretching and strengthening exercises, to maintain the flexibility and strength of the hip, knee and ankle muscles. With the help of modalities, your physiotherapist will reduce your symptoms and promote healing.

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