by Mark Rennick – Physiotherapist

Knee pain is one of the most common conditions that we treat in the clinic. Often, the pain is associated with an overuse injury known as IT Band Syndrome (ITBS). The main symptom is pain between the hip and knees that worsens with activity.  It is frequently found in distance runners and cyclists, though it also occurs in weightlifters, skiers, soccer players, hockey players, triathletes, and competitive rowers.

What is the ITB

The ITB is a dense, fibrous connective tissue that runs along the outside of your thigh.  Its primary functions are to provide stability for the outer hip and knee and to limit inward rotation of the knee. It also stores and releases elastic energy to help make walking and running more efficient.

“Runner’s Knee”

ITBS is the most common injury of the outer part of the knee within the sport of running – hence the name Runner’s Knee. It is a non-traumatic overuse injury caused by repeated loading of the knee.

ITBS will usually present as pain or tenderness at the outside of the knee and will feel like a sharp, burning pain when pressure is applied to the tender spot. The pain can be particularly acute when the knee is bent at 30°. This happens because the ITB is compressed against the bony part of the knee. In runners, the ITB helps with deceleration of the leg, which can put increased load through the ITB over time.  Increased hip adduction and internal rotation puts more strain through the ITB, often seen in those with weaker gluteal muscles, which can make running extremely aggravating for those with ITBS.

What can your physio do to help with Runners Knee/ITBS?

Physios can help in the diagnosis and treatment of this condition. Due to the complexity of ITBS a detailed assessment is needed to identify the root cause of the injury. This may include walking and running gait analysis.

  • Education and advice around modifying activities to encourage healing.
  • Load management. This may mean reducing running distances or intensity initially,  then progressively increasing the load by adding in distance and incline into the programme.
  • Massage or mobilisation of the soft tissues connecting to the ITB – including the Glute.
  • Providing a home management program. This may include self trigger-point and muscular release, stretching and self-mobilisation of certain structures.
  • Taping or strapping if required.
  • Strength training. This should be created specifically to target any weak muscles identified during the assessment process. This can be progressed to a gym based program in time.
  • Deceleration training.
  • Strategies to avoid re-injury. Your Physio should provide you with tools to help prevent this injury from reoccurring.
  • Referral to other healthcare professionals if required. For example, podiatry for orthotics.

If you are experiencing knee pain, don’t put up with it, call us to make an appointment with one of our experienced physiotherapists. Call (08) 6389 2947 or click here to book online

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