Runner’s knee

Runner’s knee or ITBS (iliotibial band syndrome)

Runner’s knee: What’s that?

In order to avoid our thigh bone from being bent outwards when standing upright and walking, a tendon layer which counters this strain is located on its outer side. This tendon layer, known as the tractus iliotibialis, therefore stabilises the knee joint and the thigh.

The tractus iliotibialis consists of tendons from our hip musculature and runs from the anterior superior iliac spine (spina iliaca anterior superior) to the outer side of the knee joint (Gerdy’s tubercle).

Generally, it is assumed that overburdening phenomena and changes in the tension of the hip musculature play a central role in the emergence of a runner’s knee.

As it is incurred increasingly amongst runners, this ailment is also referred to as runner’s knee.

Causes of runner’s knee

One frequent cause is the overburdening of the anterior hip muscle, the so-called thigh band tensioner (tensor fascie latae), which also forms the tractus iliotibialis tendon layer.

Repeated bending and stretching of the knee joint causes continuous friction of the tractus iliotibialis on the osseous knee joint structures. This is the outer condyle head of the hip/femoral neck (condylus lateralis femoris) in most cases. Therefore, irritations and pain arise on the upper outer side of the knee joint.

Overburdening or shortening of the muscles which form the tendon layer (tractus iliotibialis), primarily the tensor fascie latae, can cause changes to the tension on it. As a result, the friction of the tendon is reinforced on the outer side of the knee joint. Above all, the tendon itself is irritated as well as the bursa (bursa tractus tibialis).

In addition to overburdening, existing malalignment such as the leg axis (varus or valgus malalignment) or the feet (skewfoot) trigger the symptoms of a runner’s knee.

Symptoms of runner’s knee

As irritation is caused by the friction of the tendon layer on the osseous structures, the major symptom is pain. It occurs mostly on the upper outer side of the knee joint and is often perceived as sharp. Frequently, only restricted practising the form of sports is possible and may result in increased pain symptoms.

In addition to the pain, grating may arise from the friction.

Depending on how pronounced the symptoms are, they can already be incurred during brief activity. At the outset of runner’s knee, complaints are normally incurred after longer burdening periods.

Diagnosis of runner’s knee

Normally, a runner’s knee cannot be recognised ad-hoc externally. A trained physician can make the diagnosis based on the symptoms described by the patient (e.g. pain on the upper outer edge of the knee joint).

Moreover, the physician will observe the existence of a possible malalignment in the knee or on the foot joint.

During the physical examination, (palpation), painful swelling on the outer side of the knee and tension changes can be felt in the region of the tractus iliotibialis.

An ultrasound (sonography) or a different imaging procedure such as MRI or CT can be applied to confirm the treating physician’s diagnosis.

Treatment of runner’s knee

It is of considerable importance that the causal factors are eliminated or reduced by the treatment. Normally, this takes place conservatively (without an operation). In some cases, the treating physician can consider operative therapy.

CONSERVATIVE THERAPY:

Targeted strength training and physiotherapy can relax the possibly shortened muscle percentage. Orthopaedic aids such as insoles, knee or hip braces may improve the body and leg statics and contribute to relief of the pain symptoms. Pain and swelling can be countered with medication or cortisone therapy. The use of aids and medication should always take place after consultation with the treating physician.

OPERATIVE THERAPY:

In isolated cases in which conservative treatment does not achieve any improvement, the treating physician can consider operative therapy. Here, the tractus iliotibialis can be “extended” and severe malalignment of the leg axis (in particular a varus) corrected.

How can runner’s knee be prevented?

Prior to sports activity, a shortened musculature can be relaxed via targeted stretching exercises. The thus arising reduction of muscle tension can exercise a positive effect on the friction of the tractus iliotibialis.

Simple strength training can also help to improve the general state of the musculoskeletal system.

Single-sided burdening of the muscle should be avoided.

The compensation of existing malalignment in the knee and foot joints may provide relief to the musculoskeletal system. Appropriate footwear can decisively contribute to the stabilisation or correct positioning of the foot.

How can the BORT CoxaPro hip brace relieve the complaints of a runner’s knee?

The support material of the BORT CoxaPro hip brace consists of elastic compressing material, which stimulates circulation due to its compression effect and can contribute to pain relief.

The trochanter pad specifically relieves the trochanter major region. The recess in the pad relieves the osseous prominence of the trochanter major in a targeted manner. Simultaneously, the pressure is distributed to the surrounding soft tissue, which is massaged by the movement.

This can be effective against muscle dysbalance (e.g. runner’s knee).

The hip joint movement can be stabilised and secured via a side joint splint with flexion and extension control as well as an additional pelvic surround.