ITBFS- Lateral knee pain

Been training hard in preparation for the upcoming City2Surf or other races in the coming season? Pounding the pavement? Live in a hilly area? Pain on the outside of your knee?

Visit us here at The Forest Podiatry to address any lower limb pain and biomechanical issues you may encounter, or for a City2Surf training assessment on our state of the art Zebris Treadmill. Come and have a chat with me about my racing preparation and race day experiences.

In the meantime, I’d like to talk about a common running injury I treat called Iliotibial Band Friction Syndrome (ITBFS).

The ITB is a thick band of fascia running down the outside of your leg. It extends from the outside of the pelvis, over the hip and knee and inserts just below the knee. Its main function is stabilising the lateral aspect of the knee.

The condition presents as pain on the lateral femoral epicondyle (bony bit on the outside of your upper leg bone) and is intensified at 30 degrees of knee flexion. It is caused by inflammation of the band as it rubs over this bony prominence. Pain is aggravated by downhill running and uneven surfaces. Causes include; a sudden increase in training, including hill running, knocked knees, leg length difference, poor foot mechanics such as over pronation (rolling in of feet) or poor pelvic stability. Any one or a combination of these problems may be responsible for lateral knee pain. Commonly, gluteus medius weakness/fatigue (as seen in the picture below) can cause pelvic drop on one side causing additional stress and ITB lengthening on the opposite side when running.

Conservative treatment involves ice, rest, training modification, gait assessment, glute medius strength program, massage to the ITB, footwear assessment. At home you can self-massage the ITB or use a foam roller, stretch hamstring and quadriceps also. Long term treatment options include cortico-steroid injections or surgical lengthening.

A full biomechanical and gait assessment (pelvic and foot assessment) is advised for runners if conservative treatment has failed.


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