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Management of “Runners’ Knee” Runners’ knee or ilio-tibial band (ITB) friction syndrome is an irritation of the connective tissue on the outer aspect of the knee. The ilio-tibial band is a long, thick band of tissue that attaches to tensor fascia lata (TFL) muscle on the outer hip and pelvis and runs down the outer thigh to the side of the tibia or shin bone, just below the knee. These structures jobs include extending or straightening the knee, as well as movement of the hip outward. The primary function of the ITB and TFL during running, by tensing, is to control the inward movement of the thigh. When the knee is bent and straightened repeatedly, as in running, there is potential for friction to occur between this band and a bony prominence on the femur, or thigh bone. For those who may run regularly, this repeated friction can lead to inflammation and pain. Runners’ knee is most often characterized by pain on the outer side of the knee, usually occurring toward the middle or the end of the run. Running downhill or going down stairs may be particularly painful. It may be painful to bend and straighten the knee. Pain may radiate up or down the leg from the knee. Several factors may contribute to the cause of ITB syndrome. Muscular weakness, especially in the outer hip, can create a straining on the ITB. In many cases, the ITB is shortened or tight, increasing the friction as it travels across the femur. Errors in training, such as running on a circular track, running on crowned roads and increasing distances too rapidly can lead to irritation. Excessive pronation of the feet, improper shoe wear and a leg length discrepancy can increase your risk of developing the syndrome. Physical therapy intervention for ITB friction syndrome would include a comprehensive evaluation to identify the cause (s). Modalities and manual techniques, such as massage, may be used to increase circulation to the tissues to decrease inflammation and promote healing. Modalities include such treatments as ultrasound, laser, and electrical stimulation. An individualized exercise program is essential to stretch tight muscles and strengthen areas of weakness. Education on proper shoe wear, training guidelines and self-management strategies would be included in your treatment. Those with excessive pronation or a leg length discrepancy may be given orthotics or a heel lift. Identifying the individual causes in each case is the key to successful management and resolution of the problem. © Family Physical Therapy Services, Inc. 2008

Management of "Runners' Knee"  

Runners’ knee or ilio-tibial band (ITB) friction syndrome is an irritation of the connective tissue on the outer aspect of the knee. Runners...