Just because you run doesn’t mean that you will get runners knee (iliotibial band syndrome), its not something you achieve through running a certain distance like a T-shirt or a medal after completing a marathon to know that you are now officially a runner “YES! I have runners knee, I’m officially a professional runner!”. Runners knee is when the Iliotibial band (IT band) that runs (excuse the pun) from your hip to the outside portion of your knee starts to pull and rub onto the attachment site. Runners knee usually occurs when there is repetitive flexion and extension of the hip and knee, this in turn causes friction, micro-trauma and inflammation. As you may know already when there’s these three nasty combinations it makes a great recipe for pain and that in this case is usually found about 5 – 10cm above the lateral (towards the outside of the body) portion of the knee.

If the IT band is tight (which it sort of has to be due to its purpose) you can also feel pain all the way to the hip along the band. Other symptoms can be present such as a reduction In pain with exercise, pain when putting weight through the leg and going up or down stairs. However, runners knee usually occurs when there is a lack of strength, flexibility and overuse of the surrounding area.
The IT band attached onto something called your TFL, no not Transport For London, it’s called your Tensor Fascia Latae. Even though that might sound like a coffee you could well be experimenting in the yuppie cafes of London it’s actually a muscle that plays a major role in Abducting (taking away from the midline of the body) the hip. If the TFL becomes tight then this can pull through the IT band and eventually onto the knee, If the TFL is tight then that means there could be weakness in the Glutes, if there’s a weakness in the glutes then there could be an issue of surrounding tissues such as the pelvis, the lower back or even a nerve supply problem. This is where Osteopathy comes in and looks at the whole body as a functional unit. Its always worth having an examination and getting your biomechanics tested as it could be a problem that has begun from your feet that has effected the way you walk or exercise that could have a knock on affect to your knee and your hip.

So what can you do other than see an Osteopath?

• Ice areas of pain – repeating 10 minutes on and 10 minutes for 1 – 2 hours for 2 – 3 days. This will help reduce any inflammation and reduce the pain.
• Rest – if you don’t want to completely rest, vary your activity and cross-train – coming off weight-bearing exercise for a 2 week period minimum.
• Check your footwear – change your trainers reasonably regularly, especially if you are running a lot. If you see a podiatrist they will examine your Gait and footwear.
• Runners – run on softer ground with less of a gradient (reduce hill intervals) until the inflammation has reduced and don’t return to running too soon.
• Cyclists – check that your bike is set up correctly for you.
• Stretch the quads (front of the thigh).
• Stretch the gluteal muscles.
• Strengthen and stabilise by performing half single-leg squats in front of the mirror so you can check that the pelvis remains level as you dip and the knee on the squatting leg does not dip over the midline. Repeat 15 x 2 each side.
• If a single leg squat is too hard then regress it to a normal squat or a box squat to a height that suits you then you can progress it to a single leg or a lower box.
• Make sure your knees are stable when performing exercises and are not deviating inwards or outwards too much.
• If you are in doubt about your exercises then please contact us or a coach/trainer to examine or adapt your movements.

Don’t foam roll your IT band you will probably make it worse and it really hurts. You wont stretch your IT band by foam rolling it or doing “IT band stretches”. A study in 2008 determined the amount of force it would take to lengthen the IT band was essentially superhuman. They found out that it would take ~2,000 lbs of force to lengthen your IT-band 1%, that’s about two grand pianos.

If your pain persists in the areas described, come in for a full assessment and examination. We will check your biomechanics such as gait, leg length difference, muscles imbalances and joint restrictions before discussing any findings and treating as appropriate.