Runner's knee
What is runner's knee?
This diagnosis is also called runner's knee and the medical term for runner's knee is iliotibial band syndrome-ITBS or iliotibial tract tendinitis. The iliotibial tract is a band of connective tissue that runs vertically along the outside of the thigh and passes over the outside of the knee to attach to the outside/front of the shin bone. Where the tendon passes above the knee joint there is a bump (lateral femoral condyle) against which friction can occur when bending and extending the knee repetitively under load, such as when running. This friction can lead to pain from the inside of the tract tendon or from the bursa that is found here and cause pain on the outside of the knee.
Why do people get runner's knee?
This diagnosis is most common in endurance sports, especially running but also cycling. As with so many other ailments, a common cause is that you have increased the training too hard and/or rested the knee too little. Running on one side of a country road where the road surface normally slopes slightly to the side to drain rainwater, can trigger pain on the outside of the knee. A lot of hill training can lead to runner's knee.
Other reasons for getting runner's knee:
High or low arches.
If your pelvis tilts a lot sideways when running.
Wheelbase
Leg length discrepancy
Shoes that are not optimal for your physique.
Symptoms of runner's knee?
Initial pain on the outside of the knee that occurs during the workout and goes away after the activity is over. If you continue running despite the pain, the pain can intensify, become more sharp and start to radiate up the outside of the thigh and sometimes down the lower leg. You start to feel pain even after the activity is over. Pain when standing up after sitting for a long time is common. In some cases, swelling can occur on the outside of the knee. Pain when pressing on the outside of the knee.
Treatment for runner's knee?
Our physiotherapists first try to determine the cause of the problem together with the patient. This is usually followed by a temporary break from the causative activity. We review whether there are purely anatomical causes of the pain (see "why do you get runner's knee"). To strengthen the diagnosis, we can perform an ultrasound examination if runner's knee is suspected. This is often treated with shock wave therapy to speed up healing. If necessary, anatomical shoe inserts are recommended to support any misalignment in the foot or knee. Rehabilitation training is started if necessary to strengthen and improve coordination and mobility. If it is running that the patient wants to return to, a medical running analysis is often performed to optimize the running stride and minimize the risk of relapse.
In difficult cases, the doctor may try injecting cortisone into the affected tendon or bursa. In a few cases, surgery is performed to lengthen the iliotibial tract.
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Prognosis for runner's knee?
The prognosis is very good. An estimated figure is that over 90% of those affected will recover with the help of non-surgical treatment. Depending on how extensive the injury is and how well the patient handles the rehabilitation, we usually cure this diagnosis in between 1-3 months.
Differential diagnoses
External meniscus injury, osteoarthritis of the outer knee, damage to the external collateral ligament, damage to the distal part of the biceps femoris, patellofemoral involvement laterally.
