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"Runners Knee"

Often called runner's knee, Iliotibial Band Friction Syndrome (ITBFS) is a relatively common over-use injury seen frequently with runners, although it can be experienced by other athletes, such as cyclists, soccer players, weight lifters (especially during squats) and skiers. ITBFS is caused by inflammation of the Iliotibial Band, the connective tissue that begins at the hip, providing the attachment site for the Gluteus Maximus and Tensor Fascia Latae (TFL) muscles, and extends down the lateral side of the leg to the outside of the knee, attaching on the lateral tubercle of the tibia, the head of the fibula and the patellar retinaculum.



Affecting beginners and seasoned runners alike, symptoms of ITBFS include pain on the lateral aspect of the knee and may also radiate up the thigh towards the hip. Pain results when a tight ITB rubs across the lateral epicondyle of the femur (the end of the thigh bone).

To better understand ITBFS, is important to understand the mechanics of the ITB. The ITB provides a stabilizing function to the hip and outside of the knee. When standing, the ITB is fairly relaxed; it really starts to engage when the knee is flexed (bent) to about 20 degrees. Studies have shown that the ITB passes over the lateral epicondyle the ITBFS "hot spot" at around 30 degrees of knee flexion. The repeated force of impact during running and the continuous knee flexion required for cycling puts significantly increased demands on the ITB. If the ITB is unusually tight, the rubbing on the femoral epicondyle can eventually lead to microtrauma and inflammation and resulting pain.

Factors contributing to ITBFS include old / improper running shoes; too much activity (too many miles) too soon; excessive running downhill; other biomechanical factors (e.g., weak hip abductors, anterior hip tightness, uneven leg length, over pronation of the foot, etc.)

Treatment strategies may include:

* Rest Decreasing your mileage or taking time off from running or other activities perpetuating the pain.

* Ice Ice over the lateral epicondyle of the femur to reduce inflammation.

* Massage Slow, myofascial release will help loosen the ITB, which in turn decreases the rubbing and friction on the lateral epicondyle.

* Figuring out the cause You may need to consult with a physical therapist or other biomechanical expert to help solve the problem.

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