Runner's knee (iliotibial band friction) syndrome

Runner's knee or iliotibial band (ITB) syndrome is the name given to a condition that causes pain on the outside of the knee in the area of the lateral epicondyle - bony prominence on the outside of the knee. The iliotibial band is a sheath of connective tissue that runs from the gluteal region (buttocks) to the tibia or shin bone. It helps to extend (straighten) the knee joint and abduct (move sideways) the hip. As the ITB passes over the femur (thigh bone) at the knee it rubs against the lateral epicondyle, causing friction. In runners, this may lead to irritation commonly called iliotibial band friction syndrome.

Symptoms of iliotibial band friction syndrome include:

• Pain around the region of the lateral epicondyle.
• Tightness in the iliotibial band.
• Increased pain with running, particularly downhill.
• Pain during bending or straightening the knee.
• Trigger points may be present in the buttocks.

Rest is important. The athlete should especially rest from running downhill. Use ice to decrease pain and inflammation. Stretching and massaging the ITB even after symptoms subside is helpful. Long-term rehabilitation may be required to ease this condition. Your doctor may prescribe anti-inflammatory meds and in some cases may give corticosteroid injection to provide pain relief.

The goals of rehabilitation of runners knee or Iliotibial band syndrome are to:

• Reduce initial pain and inflammation with the use of ice and ultrasound.
• Stretch the Tenser Fascia Latae muscle (a small muscle at the top of the thigh that helps to abduct the hip and the iliotibial band to remove tightness.
• Strengthen the tendon and muscles.
• Gradual return to full fitness.
• Prevent recurrence of the injury.

Myofascial release- manual massage techniques that stretch the fascia (tough connective tissue beneath the skin) to promote pain relief and increase range-of-motion and dry needling are some techniques that have been successfully used in physiotherapy for this condition. Stretching and strengthening exercises also form part of treatment.