The Treatment of Runners Knee or Iliotibial Band Syndrome

This article is by the phjysiotherapist in Islington at the Angel Sports Injury and Physiotherapy Clinic. The article looks at:

• What is Runners Knee or Iliotibial Band Syndrome

• What are the symptoms of Runners Knee or Iliotibial Band Syndrome

• Treatment of Runners Knee or Iliotibial Band Syndrome

The media love’s to trend topics. You would have to have been on the moon not have heard superinjunctions mentioned and in recent years we have had swine flu and ADHD in the health industry. So what I the latest health trend?

Iliotibial band syndrome or ITB syndrome or maybe the more friendly ‘runners knee’ is beginning to trend, or should I write #runnersknee! It has been around since we started running but since everyone can have a go at running without a major outlay in finances the incidence of runners knee is on the up.

What is Iliotibial Band Syndrome or Runner Knee?

Runners knee is inflammation and irritation of the lower part of the iliotibial band as it rubs against the outside of the knee or lateral femoral condyle of the long bone in the thigh, the femur. This happens during flexion and extension of the knee and this occurs every-time you take a step.

If you are susceptible to runners knee this action will irritate the ITB and the bursa (friction reducing pad separating the bone form the ITB) under the ITB every-time you take a step. The inflammation builds up in the ITB until it causes pain and you have to stop the pain inducing activity.

Do you think you may have Runners knee?

It is possible to have all the symptoms but more likely one persistent symptom may recur after running a certain distance and it is most common in those that have increased their millage or are training for marathons. There is always an increase in the presentation of runners knee in the last six to eight weeks before the London marathon as the novice runners start to run over twenty miles in their training.

• Swelling at the location of discomfort
• A snapping or popping sensation as the knee is bent
• Pain on the outside of the knee joint
• Tightness in the iliotibial band or outside of the thigh

• Pain normally aggravated by running, particularly downhill.
• Pain during flexion or extension of the knee
• Weakness in hip abduction.

Treatment of `Runner Knee’

The problem needs to be looked at in two ways. Firstly, stop running and address soreness and the easiest way to do this by icing the painful area on a regular basis.. secondly, address the tightness in the ITB through stretching and massage by an experienced sporst massage therapist. it is easy to overdo the massage.

Ober’s stretch is good but generally it easiest done with help from a friend or therapist.

Alternatively, foam rollers are terrific and let you work on the ITB yourself but make sure you don’t overdo it. With anything that is inflamed there is a balance to be reached between treating the painful area and aggravating the area. Don’t forget to ice afterwards!


Stretching and icing are a start but the factors that lead to runners knee also need to be addressed.

• Hip flexors – the gluteus medius may be weak
• Trigger points – glutius medius wont work effectively if it is in spasm.
• Training route – is it uphill?
• Leg length inequality
• Pronation of feet.


Other running related articles

Runners knee part 2

These last points need expert assessment and this is where Verity simon our Angel Wellbeing Clinic’s sports physiotherapist and Julie Curran our sports massage therapist can help.

Runners knee is common and it is painful and if you want to get back to training you need it treated properly and you need to monitor your return to training carefully.

To arrange an appointment or a Free Assessment click below.


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