Knee pain when you run?

what's that pain?

IT Band Syndrome results from movements that cause the band to become irritated or swollen. What is an IT band? Well, if you jog for exercise then you know it’s not an all-boy pop vocal group. Different pop. Different vocals.

Iliotibial Band Syndrome (ITBS) is an injury I frequently treat in my practice. I treat a lot of people who run for exercise. Some even compete in major races and marathons. As the weather warms, they train more. Thus, I see more cases of ITBS.

a quick anatomy lesson

The “IT band” is a ligament that originates at the hip and travels down the lateral part of the leg and inserts at the shin. The problem occurs from overuse and usually presents with pain on the side of the knee. Runners are prime candidates for this condition. IT Band syndrome results from movements that cause the leg to turn inward repeatedly. From running downhill to running on banked surfaces to just plain running too many miles.

As the IT band travels down the leg toward the shin it becomes more narrow. The narrow part rubs against the tibia bone. Over time, this friction can cause irritation and inflammation. And, if if left untreated, the symptoms can become chronic.

Another interesting observation is that ITBS can affect beginning runners as well as seasoned professionals. It also seems that I see a lot more women with the problem. Maybe it’s an anatomical thing, since women have thigh bones that turn in more, and a wider pelvis.

Because of the nature of the symptoms (pain and swelling), you might think you messed up your knee. A quick self-diagnosis is to bend your knee at the 45-degree angle, and if you have pain on the outside of your knee you may have a problem. The best way to be sure is to go in for an MRI. The MRI can reveal any thickening of the IT band. Thickness indicates swelling and, therefore, a problem. Don’t waste any time or money on an X-ray, as the indication won’t show up.

a rare case

In my practice, I’ve had the occasion to see a patient present with pain right at the top of the thigh or top of the femur on the side of the leg. Feel it for yourself. That boney area is the trochanter. It can rub the IT band at that point, too, which may or may not cause you to have pain on the side of your knee. While you’re searching for that trochanter, if you find that area to be sore, go ahead and massage it out. This doesn’t mean you have a problem though. A little self massage is just a good thing.

treating ITBS

Treatment options are relatively easy. The best treatment is prevention. Run fewer miles and take days off if you feel pain. Warm up by walking for 15 minutes before you run. Avoid running on concrete. If you run on the street, try to be where it is flattest (be safe and use caution). Check with a podiatrist to see if you need orthotics. Buy better running shoes if you notice excessive wear on the outside of your current pair. Pushing through pain is an antiquated way of thinking, in my opinion. If you want to get your cardiovascular groove on, I suggest swimming, rowing, cycling and an elliptical machine or a dance class. Stair climbing is a bad idea.

Stretching that area is important. There are all kinds of side stretch exercises and yoga poses that can help. I know a lot of people who swear by the foam roller. I’m on the fence about it, but if it works for you, go for it. Myofascia release techniques, specific for that problem, yield incredibly good results.

For chronic or more severe pain see your doctor and get into a rehabilitation program. Therapies like ultrasound or electrical stimulation have positive results. A last resort treatment should be steroid injections and/or surgery. Your particular situation will determine that.

Until next time, be safe and have fun!

peace and love
chuck.