Runner's Knee: Causes, Symptoms & Treatment
Runner's knee is a pain syndrome on the outer knee, common in endurance athletes. It is caused by irritation of the iliotibial band. Learn about causes, symptoms, and treatment.
Things worth knowing about "Runner's knee"
Runner's knee is a pain syndrome on the outer knee, common in endurance athletes. It is caused by irritation of the iliotibial band. Learn about causes, symptoms, and treatment.
What is Runner's Knee?
Runner's knee (medically known as iliotibial band syndrome, or ITBS) is a painful overuse injury affecting the outer part of the knee. It occurs when the iliotibial band – a thick band of connective tissue running from the hip to the shinbone – repeatedly rubs over the bony prominence on the outer thigh bone (lateral femoral epicondyle), causing friction and irritation.
Causes
Runner's knee typically develops due to repetitive bending and straightening of the knee, as seen in running, cycling, or hiking. Common contributing factors include:
- Rapid increases in training volume or intensity
- Running on uneven, sloped, or hard surfaces
- Weakness in the hip abductor and gluteal muscles
- Biomechanical issues such as bowlegs or overpronation
- Worn-out or inappropriate footwear
- Insufficient recovery time between training sessions
Symptoms
The hallmark symptom of runner's knee is a sharp or burning pain on the outside of the knee, which typically appears after a certain distance of running and worsens with continued activity. Other common symptoms include:
- Pain when climbing stairs or running downhill
- Tenderness when pressing on the lateral femoral epicondyle
- Occasional mild swelling or warmth on the outer knee
- Symptoms that ease with rest but quickly return upon resuming activity
Diagnosis
Runner's knee is usually diagnosed clinically, based on a physical examination and medical history. Common diagnostic procedures include:
- Noble compression test: Pressure pain at the epicondyle with the knee bent at 30 degrees
- Ober test: Assessment of iliotibial band flexibility and tightness
- MRI (Magnetic Resonance Imaging): Used in unclear cases to rule out other conditions such as meniscus tears or ligament injuries
Treatment
Conservative Management
The majority of runner's knee cases respond well to conservative treatment without surgery. Key treatment components include:
- Reduction or temporary cessation of training: Rest is the most important first step
- Physiotherapy: Targeted stretching and strengthening exercises for the hip, gluteal, and thigh muscles
- Foam rolling: Self-massage techniques to release tension in the iliotibial band
- Anti-inflammatory medication (NSAIDs): Such as ibuprofen for short-term pain relief
- Ice therapy: Application of ice to reduce pain and swelling
- Gait analysis and footwear assessment: Adjustments to stride length and running shoes
Additional Treatment Options
- Corticosteroid injections for persistent symptoms
- Extracorporeal shock wave therapy (ESWT)
- Surgical intervention in rare, treatment-resistant cases
Prevention
Recurrence of runner's knee can be effectively prevented through regular strengthening of the hip and gluteal muscles, gradual increases in training load, adequate rest periods, and choosing appropriate footwear.
References
- Louw, M. & Deary, C. (2014): The biomechanical variables involved in the aetiology of iliotibial band syndrome in distance runners. In: Physical Therapy in Sport, 15(1), 64–75.
- Strauss, E.J. et al. (2011): Iliotibial band syndrome: Evaluation and management. In: Journal of the American Academy of Orthopaedic Surgeons, 19(12), 728–736.
- van der Worp, M.P. et al. (2012): Iliotibial band syndrome in runners: A systematic review. In: Sports Medicine, 42(11), 969–992.
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Related search terms: Runner's knee