{"id":59563,"date":"2022-12-12T09:25:58","date_gmt":"2022-12-12T08:25:58","guid":{"rendered":"https:\/\/mivisalud.com\/blog\/what-is-runners-knee\/"},"modified":"2025-04-03T12:57:01","modified_gmt":"2025-04-03T10:57:01","slug":"what-is-runners-knee","status":"publish","type":"post","link":"https:\/\/mivisalud.com\/en\/blog\/what-is-runners-knee\/","title":{"rendered":"What is &#8220;runner&#8217;s knee&#8221;?"},"content":{"rendered":"&#13;\n<h2 class=\"p1\"><b>What is runner&#8217;s knee or iliotibial band syndrome?<\/b><b><\/b><\/h2>&#13;\n<p class=\"p3 wp-block-paragraph\">Running is a physical activity that has great benefits for people who practice it with greater or lesser intensity: it improves the respiratory and cardiovascular system, strengthens the immune system, tones the lower body muscles, improves the locomotor system, helps reduce stress and improves sleep, among other positive effects.<\/p>&#13;\n<p class=\"p3\">However, it can also have a significant impact on the lower body joints, especially the knees. One of the most frequent injuries in people who practice running or disciplines that involve continuous running on different surfaces is the <span class=\"s1\"><b>iliotibial band syndrome<\/b><\/span>also known as <span class=\"s1\"><b>runner&#8217;s knee<\/b><\/span>. <\/p>&#13;\n<p class=\"p3\">The <span class=\"s1\"><b>iliotibial band<\/b><\/span> is a thick band of fibrous tissue that connects the gluteus maximus muscle and the tensor fascia latae to the tibia, running along the entire outer thigh. This structure plays a key role in the movement of the leg, especially in activities such as running or cycling. Injury occurs when this band becomes <span class=\"s1\"><b>inflamed and irritated<\/b><\/span> due to repetitive <span class=\"s1\"><b>repetitive friction against the bone<\/b><\/span>The injury occurs when this band becomes inflamed and irritated due to repetitive friction against the bone, mainly in two areas: the external part of the <span class=\"s1\"><b>hip<\/b><\/span> or the <span class=\"s1\"><b>knee<\/b><\/span>. The most common rubbing occurs between the webbing and the external femoral condyle <span class=\"s1\"><b>external femoral condyle<\/b><\/span>especially during the initial contact phase of the stride, where an eccentric deceleration contraction is generated.   <\/p>&#13;\n<p class=\"p3\">Pain usually occurs at a specific <span class=\"s1\"><b>specific running distance or time<\/b><\/span>forcing the cessation of the activity. Over time, if not properly treated, the pain begins to manifest itself earlier and earlier, even on shorter runs. It is characteristic that the pain intensifies when running downhill or at slow paces, since in these situations there is a longer contact time between the rib and the epicondyle. In some very aggressive cases, a protrusion or snapping of the tape on the condyle may be noted.   <\/p>&#13;\n<h2 class=\"p1\"><b>Causes of iliotibial band syndrome<\/b><b><\/b><\/h2>&#13;\n<p class=\"p3\">This lesion is of multifactorial <span class=\"s1\"><b>multifactorial in origin<\/b><\/span>There is no single cause that originates it. Among the most frequent factors, the following stand out: <\/p>&#13;\n<p class=\"p4\">&#8211; Cintilla anatomy (tightness or excessive tension).<\/p>&#13;\n<p class=\"p4\">&#8211; Deficit of musculature in the lower body.<\/p>&#13;\n<p class=\"p4\">&#8211; Failure to warm up properly before training.<\/p>&#13;\n<p class=\"p4\">&#8211; Training on uneven or downhill surfaces.<\/p>&#13;\n<p class=\"p4\">&#8211; Running in cold temperatures.<\/p>&#13;\n<p class=\"p4\">&#8211; Excessive training load or overtraining.<\/p>&#13;\n<p class=\"p4\">&#8211; Previous injuries or direct impacts on the area.<\/p>&#13;\n<p class=\"p3\">From the biomechanical point of view, there are predisposing factors that increase the friction of the rib with the femur and favor the development of the syndrome:<\/p>&#13;\n<p class=\"p4\">&#8211; Muscle shortening of the hip flexors and tensor fascia latae.<\/p>&#13;\n<p class=\"p4\">&#8211; Muscle imbalances, especially <span class=\"s1\"><b>weakness of the gluteus medius<\/b><\/span>.<\/p>&#13;\n<p class=\"p4\">&#8211; Genu varum (bowlegged).<\/p>&#13;\n<p class=\"p4\">&#8211; Excessive pronation of the foot or flat feet.<\/p>&#13;\n<p class=\"p4\">&#8211; Dysmetria (difference in leg length).<\/p>&#13;\n<p class=\"p4\">&#8211; Very prominent external femoral epicondyle.<\/p>&#13;\n<p class=\"p4\">&#8211; Capsulo-ligamentous hyperlaxity.<\/p>&#13;\n<p class=\"p3\">In addition, the <span class=\"s1\"><b>use of inappropriate footwear, poor training planning or a sudden increase in load can also trigger this pathology.<\/b><\/span>In addition, poor training planning or a sudden increase in load can also trigger this pathology.<\/p>&#13;\n<h2 class=\"p1\"><b>Symptoms of runner&#8217;s knee<\/b><b><\/b><\/h2>&#13;\n<p class=\"p3\">The main symptom is <span class=\"s1\"><b>pain on the outside of the knee<\/b><\/span>more specifically over the lateral <span class=\"s1\"><b>lateral epicondyle of the femur<\/b><\/span>that can be accompanied by inflammation. This discomfort appears with exercise, especially when running, and usually ceases with rest. When resuming the activity, the pain reappears at the same point of the run or even earlier.  <\/p>&#13;\n<p class=\"p3\">In some cases, there may also be pain in the external area of the hip, or even a sensation of friction or clicking when flexing and extending the knee. In advanced stages, the pain can be continuous and persistent, even when keeping the knee flexed at rest. <\/p>&#13;\n<h2 class=\"p1\"><b>Diagnosis<\/b><b><\/b><\/h2>&#13;\n<p class=\"p3\">The diagnosis of iliotibial band syndrome is usually based on the patient&#8217;s clinical history and the symptoms described. The physical examination may include maneuvers such as the <span class=\"s1\"><b>Ober test<\/b><\/span>test, which evaluates the shortening of the fascia lata, as well as palpation of the external femoral epicondyle to localize the pain. It is common to find <span class=\"s1\"><b>trigger points<\/b><\/span> along the length of the rib.  <\/p>&#13;\n<p class=\"p3\">For a more precise diagnosis, the evaluation can be completed with the following tests <span class=\"s1\"><b>imaging tests<\/b><\/span> such as <span class=\"s1\"><b>magnetic resonance<\/b><\/span> or <span class=\"s1\"><b>ultrasound<\/b><\/span>which make it possible to visualize the state of the affected tissues. Surface electromyography (EMG) <span class=\"s1\"><b>surface electromyography (EMG)<\/b><\/span> can also be used to assess muscle activation during movement. <\/p>&#13;\n<h2 class=\"p1\"><b>Treatment of iliotibial band syndrome<\/b><b><\/b><\/h2>&#13;\n<p class=\"p3\">Treatment will depend on the severity and evolution of the case. The <span class=\"s1\"><b>initial objective<\/b><\/span> is to reduce pain and inflammation, followed by a phase of biomechanical <span class=\"s1\"><b>biomechanical correction<\/b><\/span> and muscular strengthening to avoid relapses. <\/p>&#13;\n<p class=\"p3\">In the initial phases, it is recommended:<\/p>&#13;\n<p class=\"p4\">&#8211; <span class=\"s1\"><b>Application of ice<\/b><\/span> on the inflamed area.<\/p>&#13;\n<p class=\"p4\">&#8211; <span class=\"s1\"><b>Relative rest<\/b><\/span> or modification of the sport activity.<\/p>&#13;\n<p class=\"p5\"><span class=\"s2\">&#8211; <\/span><b>Taking painkillers or anti-inflammatory drugs<\/b><span class=\"s2\">always under medical supervision.<\/span><\/p>&#13;\n<p class=\"p4\">&#8211; Avoid activities that cause pain until functional recovery is achieved.<\/p>&#13;\n<p class=\"p6\"><span class=\"s2\">The <\/span><b>conservative treatment<\/b><span class=\"s2\"> includes:<\/span><\/p>&#13;\n<p class=\"p5\"><span class=\"s2\">&#8211; <\/span><b>Manual therapy<\/b><span class=\"s2\">.<\/span><\/p>&#13;\n<p class=\"p5\"><span class=\"s2\">&#8211; <\/span><b>Personalized therapeutic exercise<\/b><span class=\"s2\">.<\/span><\/p>&#13;\n<p class=\"p5\"><span class=\"s2\">&#8211; <\/span><b>Specific stretches<\/b><span class=\"s2\">.<\/span><\/p>&#13;\n<p class=\"p5\"><span class=\"s2\">&#8211; <\/span><b>Electroanalgesia<\/b><span class=\"s2\">, <\/span><b>magnetotherapy<\/b><span class=\"s2\">, <\/span><b>laser therapy<\/b><span class=\"s2\"> y <\/span><b>cryotherapy<\/b><span class=\"s2\">.<\/span><\/p>&#13;\n<p class=\"p5\"><span class=\"s2\">&#8211; <\/span><b>Re-education of the sporting gesture<\/b><span class=\"s2\">.<\/span><\/p>&#13;\n<p class=\"p4\">&#8211; Review of running technique and training planning.<\/p>&#13;\n<p class=\"p3\">An essential part of the treatment is functional <span class=\"s1\"><b>functional rehabilitation<\/b><\/span>based on an EMG muscle assessment and the development of a strengthening program of the gluteus medius and other stabilizing muscles. <span class=\"s1\"><b>strengthening of the gluteus medius and other stabilizing muscles, to correct erroneous<\/b><\/span>to correct erroneous movement patterns.<\/p>&#13;\n<p class=\"p3\">In the field of <span class=\"s1\"><b>advanced physiotherapy<\/b><\/span>techniques can be applied such as:<\/p>&#13;\n<p class=\"p5\"><span class=\"s2\">&#8211; <\/span><b>PIE (Percutaneous Intratissular Electrolysis)<\/b><span class=\"s2\"> to regenerate injured fibers.<\/span><\/p>&#13;\n<p class=\"p4\">&#8211; <span class=\"s1\"><b>MicroEPI<\/b><\/span> to reduce local inflammation.<\/p>&#13;\n<p class=\"p4\">&#8211; <span class=\"s1\"><b>Neuromodulation<\/b><\/span> to reduce pain and facilitate muscle activation.<\/p>&#13;\n<p class=\"p4\">&#8211; <span class=\"s1\"><b>Radiofrequency<\/b><\/span> o <span class=\"s1\"><b>INDIBA<\/b><\/span> to promote cellular recovery and improve tissue condition.<\/p>&#13;\n<p class=\"p3\">In cases that are more resistant to conservative treatment, corticosteroid infiltration may be considered. <span class=\"s1\"><b>infiltration with corticoids<\/b><\/span> or other anti-inflammatory substances. And if all the above fails, especially when there is a very fibrotic <span class=\"s1\"><b>very fibrous webbing<\/b><\/span>a surgical intervention may be considered. <span class=\"s1\"><b>surgical intervention<\/b><\/span>. <\/p>&#13;\n<p class=\"p3\">Treatment is effective if started early and maintained until complete disappearance of symptoms.<\/p>&#13;\n<p class=\"p1\"><b>At MIVI Salud we are specialists in the treatment of pain.<\/b><b><\/b><\/p>&#13;\n<p class=\"p3\">We approach each case with a holistic and multidisciplinary <span class=\"s1\"><b>holistic and multidisciplinary approach<\/b><\/span>adapting the treatment to the individual needs of each patient. If you have pain in the external area of the knee, do not hesitate to consult with our professional <span class=\"s1\"><b>consult with our professional team<\/b><\/span>. <\/p>&#13;\n<p class=\"p1\"><b>References<\/b><b><\/b><\/p>&#13;\n<p class=\"p4\">&#8211; <i>Iliotibial Band Friction Syndrome<\/i>(n. d.). National Library of Medicine.   https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK542185\/<\/p>&#13;\n<p class=\"p4\">&#8211; <i>Iliotibial Band Syndrome<\/i>(n. d.). Cedars Sinai.   https:\/\/www.cedars-sinai.org\/health-library\/diseases-and-conditions\/i\/iliotibial-band-syndrome.html<\/p>&#13;\n<p>\u00a0<\/p>&#13;\n<p>By <a href=\"https:\/\/www.linkedin.com\/in\/francisco-d-08b5a3150\/\">Francisco Duca<\/a><\/p>&#13;\n<p>Director <a href=\"https:\/\/mivisalud.com\/en\/center\/mivi-sant-cugat-pain-unit\/\">MIVI Sant Cugat<\/a>. and <a href=\"https:\/\/mivisalud.com\/en\/center\/mivi-sabadell-pain-unit\/\">MVII Sabadell<\/a> <\/p>&#13;\n","protected":false},"excerpt":{"rendered":"<p>&#13; What is runner&#8217;s knee or iliotibial band syndrome? &#13; Running is a physical activity that has great&hellip;<\/p>\n","protected":false},"author":3,"featured_media":58982,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1011],"tags":[1013,1015],"class_list":["post-59563","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-knee-pain","tag-chronic-pain","tag-physical-activity"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>\u25b7 What is &quot;runner&#039;s knee&quot;? 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