The Dreaded Runner's Knee

For you runners and future runners, you may have had to endure the dreaded "runner's knee". What is the runner's knee? Runner's knee is technically Iliotibial Band Syndrome (ITBS) and is the primary cause of lateral knee pain in runners. It actually accounts for nearly 12% of all running-related injuries. It feels like severe pain or soreness, when standing or landing and taking off while running, on the outside of the knee.

The IT Band is a thick band of tissue running down the side of your thigh made up of the tensor fascia latae muscle, which partially connects with the gluteus maximus. You may be able to actually feel the lower portion of the IT Band by pressing your fingers into the side of your thigh right above your knee and moving them side to side. If it's really tight it will probably feel like a flat rope. The IT Band's job is to abduct (pull out to the side) the leg and stabilize the pelvis and hip.

What causes ITBS? ITBS is generally a severe inflammation of the IT Band caused by numberous factors such as an increase in running mileage, training on uneven surfaces, hip abductor weakness (the muscles of the hip that pull the leg out to the side), and excessive pronation (feet that rotate down excessively upon impact or flat feet). The weakness of certain muscles is probably the primary cause. Because running is generally a very repetitive forward to back motion of the legs, the side to side muscles are not strengthened, leading to a severe muscle imbalance. The IT Band also has to slide over the knee bones every time you flex and extend the knee. If the IT Band is tight, it won't slide over these bones very easily and will cause inflammation.

What can you do if you are experiencing this knee pain?

First of all, watch your running mechanics. Make sure your legs are not rotating inward or moving knock-kneed with each step. If your feet pronate excessively or are flat, your legs will be more prone to move this way.

Second, it is important that you strengthen the weakened muscles--the muscles on the side of your hip (i.e. gluteus medius & some gluteus maximus). There are several exercises that are great for this: Hip Abduction-Quadruped, Mini Band Lateral Walk, Mini Band External Rotation.

Finally, be sure to stretch and lengthen the IT Band. The foam roll is a great tool for working out the IT Band and for encouraging length. Here is how to do it. Also perform an IT Band stretch.

Consistent implementation of these techniques will elimate your ITBS and hopefully prevent it in the future.