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Common Running Injuries, Part 1: Runner's Knee & Illiotibial (IT) Band Syndrome

7/13/2018

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In a perfect world a runner would be able to run for days without injury. There would never be a calf strain. A race would never by ruined by injury. But once you have run for long enough you know that this simply just isn't true. As runner's sometimes we just push it too hard or just come across some bad luck and in comes injury. There are several common running injuries  that plague runners and keep them off the trail or road. In the first part of our series we will discuss two of the most common knee injuries in runners - runners knee & IT band syndrome. [...]
1. Runners Knee
Runners Knee is a very common issue among runners. It often happens when you do too much too fast and is more technically known as patellofemoral pain syndrome (PFPS), but for simplicity we will just refer to it as runners knee here. Runners knee is an umbrella term used for pain arising from the patellofemoral joint itself, or the surrounding soft tissues. The patellofemoral joint is where the kneecap moves along the groove of the femur or thigh bone. 

What Causes It?: Runners knee can be due to trauma to the knee cap, but it is more frequently due to a combination of several factors. Some of those factors may be overload or overuse of the patellofemoral joint, abnormal biomechanics or anatomy, weakness, dysfunction or imbalance. It can also be caused by knee hyperextension, knees caving in or out, increased Q angle, tightness in the IT band (we will talk more about this below), hamstrings, or gastrocnemius (calf muscle).

The above factors can lead to the knee cap moving abnormally in the groove. This leads to irritated tissues and it can often be difficult to treat. Runners knee pain typically presents as pain going up or down stairs, sitting with knees bent, kneeling, or squatting. 


Runners Knee Treatment?
Runners knee treatment involves hands on treatment from a physical therapist, runners knee exercises, patellar taping, and orthotics. Runners knee exercises may include quad strengthening, glute and core strengthening, proprioceptive training, as well as open and closed chain exercises. Various modalities may also be used. Controlled rest is also an important component and will vary based on the severity of the condition. Each case is different and that is why it is important to consult a local rehab professional. 


2. IT Band Syndrome
Another common knee injury for runners is called IT band syndrome. IT band symptoms often present as pain or tenderness on touching the outside of your knee just above the joint line and below the lateral femoral epicondyle. This can be a nagging injury if not managed properly and runners often find themselves wondering "how long does it band syndrome last?" IT band syndrome is an overuse injury and weak hip abductor muscles are usually always present. Personally, I have never seen a case of IT band syndrome that didn't have some underlying weakness of the hip musculature. Repetitive knee flexion and extension movements seen in running are often the cause of the overuse. This motion causes friction on the IT band as it rubs on surrounding anatomy.  IT band syndrome is one of the most common injuries in runners that have pain on the outside of the knee, with the frequency estimated to be between 5% and 14%. Other research has shown that is responsible for 22% of all lower extremity injuries. 

What Causes IT Band Syndrome?
Just as with runners knee there is a combination of several factors that may cause IT Band Symptoms. Repetitive knee flexion and extension can cause the IT band to rub over and over against the lateral femoral epicondyle. This causes irritation and eventually inflammation of the IT band. Hip abductor weakness is a major contributing factor as it causes internal rotation and adduction of the femur. Chronic inflammation of the IT band bursa and compression of the fat pad and connective tissue have also been proposed causes. 


What Can Be Done For IT Band Syndrome?
Rest and the modification of activity is an important factor, as well as modalities to provide pain relief. The amount of rest needed can vary by a case by case basis, so it's important to seek professional help. IT band syndrome exercises may include quad and glute strengthening, hands on soft tissue work to the IT band, and proprioceptive work. If not managed properly IT band syndrome can be long lasting and persistent. 


In summary, runners knee and IT band syndrome can be very difficult and tricky injuries to overcome. I would highly recommend that you seek professional help. Just CLICK BELOW.
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