“I am training for a half marathon, but lately I have been experiencing pain on the outside of my knee. After running for half an hour, a very sharp, stabbing pain occurs every time .” If the above sounds familiar, you are likely suffering from a common running injury: iliotibial friction syndrome, or runner’s knee. Sooner or later, every runner seems to experience it.
Illiotibialis band complaints (runner's knee)
How do I recognize illiotibial band complaints, or runner's knee?
The complaint often comes on slowly as a nagging feeling on the outside of your knee. Over time, this feeling becomes increasingly clear. In the beginning, you can still walk through it, but if you do not take the complaint seriously, it will eventually disrupt your training. Walking for longer than 10 minutes becomes increasingly difficult, if not impossible. The sharp stabbing pain on the outside of your knee is the symptom of runner's knee. This complaint often occurs in preparation for a half or full marathon
Anatomy
The iliotibial band is a tendon plate that originates at the edge of the pelvis (ilium) and ends at the upper part of your shinbone (tibia). This band plays a major role in the stability of your leg. The band, also called the tractus iliotibialis, is controlled/tensed by various muscle groups. The gluteal muscles and the tensor faciae latae (leg lifter) ensure sufficient tension on the band, allowing it to do its job as a stabilizer.
On its way to the shinbone, the band runs very close to the protruding bone structures (condyle) of your knee joint. This is where the shoe, or rather the band, pinches. The movement of the knee can irritate the band and bursa in between in certain cases. The irritation causes a slight degree of swelling and this swelling causes you to enter a downward spiral. The band rubs even harder against the joint, and the tension on the band also increases. This causes an inflammatory reaction, and often the bursa in between also becomes inflamed.
At first you can still walk a bit and feel a nagging pain, but after a while this pain becomes more severe. This means you have to stop the activity. A characteristic of the complaint/runner's knee is that walking down stairs is difficult. The knee then bends more than 30 degrees and this causes irritation.
Causes of illiotibial band complaints/runner's knee
The complaint has many causes. It is therefore good to investigate where a possible cause lies. At RunX we can help you with this.
- Worn out shoes
- Foot position deviation (flat feet, hollow feet, hypermobility)
- Poorly cushioned shoes or training too much on hard surfaces
- Shoes that are too corrective
- Training too one-sidedly, e.g. only doing laps on a cinder track or always on a sloping road surface
- Weak gluteal and thigh muscles
- O- or X legs
- Too big steps
- Overpronation
- Lack of flexibility
- Hill training
- Sudden overexertion (poor preparation)
In addition to strength and stretching exercises, the foam roller can be used to relax the plantar fascia.
In the photo above you see a runner with a severe hip drop (indicated by an arrow) probably caused by a lack of core stability and good running training. That this leads to knee complaints does not surprise me. The knee is really being loaded disproportionately here. Would the brace still be necessary with sufficient core stability and targeted running training?
Ruud Vlutters
Trainer/coach B
Sports Podiatrist A/B
co-owner RunX Twente
What are you doing about it?
Find the cause of the complaint/runner's knee! At RunX we can analyze your running style and provide insight into possible causes. We give you advice on how to tackle the complaint and prevent it in the future. It is important that you do not seek out the complaint. It will then gradually worsen.
Check your shoes, and have an expert examine your posture, strength, and gait. In the event of a postural deviation, sports orthotic insoles may be necessary. Reduce the volume of your running training or take a complete break from running. As mentioned earlier, do not seek out the source of the complaint. Perform stretching exercises to make the band more flexible. If necessary, use a foam roller.
Do strength exercises daily to strengthen your gluteal and thigh muscles. Cool the affected area after training with an ice pack if necessary. If the runner's knee is caused by too rapid an increase in training, rest in combination with alternative training will generally work well to get rid of it. An anti-inflammatory such as ibuprofen or diclofenac can suppress the inflammatory response, which will help you recover faster. Discuss this with your GP or visit a sports doctor.
Please note! The tissue needs at least six weeks to recover properly. So build it up gradually. If the given tips yield little or no results, then at least look for a good sports doctor for further diagnosis.
In short: runner's knee is unfortunately a common injury. The cause is often a bad training build-up. Take the complaint seriously and take the right measures, then you can quickly enjoy sports again. At RunX we are happy to give you advice.
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