{"id":2231,"date":"2020-04-27T12:12:00","date_gmt":"2020-04-27T11:12:00","guid":{"rendered":"https:\/\/movementandwellbeingclinic.co.uk\/?p=2231"},"modified":"2020-07-13T13:20:34","modified_gmt":"2020-07-13T12:20:34","slug":"itb-syndrome-resolve-runners-knee","status":"publish","type":"post","link":"https:\/\/movementandwellbeingclinic.co.uk\/itb-syndrome-resolve-runners-knee\/","title":{"rendered":"ITB Syndrome &#8211; How to resolve runners&#8217; knee"},"content":{"rendered":"\n<figure class=\"wp-block-image size-large is-resized\"><img decoding=\"async\" loading=\"lazy\" src=\"https:\/\/movementandwellbeingclinic.co.uk\/wp-content\/uploads\/2020\/01\/ITB-Knee-Pain-1-768x1024.jpg\" alt=\"ITB Syndrome runners' knee\" class=\"wp-image-2248\" width=\"433\" height=\"577\" srcset=\"https:\/\/movementandwellbeingclinic.co.uk\/wp-content\/uploads\/2020\/01\/ITB-Knee-Pain-1-768x1024.jpg 768w, https:\/\/movementandwellbeingclinic.co.uk\/wp-content\/uploads\/2020\/01\/ITB-Knee-Pain-1-225x300.jpg 225w, https:\/\/movementandwellbeingclinic.co.uk\/wp-content\/uploads\/2020\/01\/ITB-Knee-Pain-1-1152x1536.jpg 1152w, https:\/\/movementandwellbeingclinic.co.uk\/wp-content\/uploads\/2020\/01\/ITB-Knee-Pain-1-1536x2048.jpg 1536w, https:\/\/movementandwellbeingclinic.co.uk\/wp-content\/uploads\/2020\/01\/ITB-Knee-Pain-1-scaled.jpg 1920w\" sizes=\"(max-width: 433px) 100vw, 433px\" \/><\/figure>\n\n\n\n<p><\/p>\n\n\n\n<p>So, after all the mental and physical preparation for your weekend run, you go out planning to do a 10k jog. Halfway through, you feel a sharp pain on the outside of your knee and you suddenly have to stop. Thoughts like \u2018\u2019Just my luck\u2019\u2019 and \u2018\u2019I should have just stayed in\u2019\u2019 enter your head as you hobble back home. You may wonder if you\u2019ve knocked it (but haven\u2019t) or if you\u2019ve been kneeling too much, which only adds to the confusion, but there is another possibility.<\/p>\n\n\n\n<p>As an osteopath, I see a lot of patients with knee issues, and because of the demographics of runners and cyclists that simply want to get fit, I see a lot of frustrated individuals. This is primarily because it is so painful and it greatly affects running, which for a lot of people is a go-to stress reduction activity, but also because it\u2019s an unknown entity. A lot of patients I see have Google\u2019d the issue and believe they may have damaged their cartilage or ligaments, which sounds very serious when you read certain articles. I am here to tell you that it could simply be ITB syndrome, otherwise known as \u2018\u2019runners\u2019 knee\u2019\u2019.<\/p>\n\n\n\n<p>ITB (iliotibial band) syndrome is rife amongst recreational and elite runners and cyclists. It is a source of frustration in 52% of runners, and is responsible for 16% of all running injuries. It\u2019s also the 3<sup>rd<\/sup> most common injury that runners and cyclists suffer (1).<\/p>\n\n\n\n<figure class=\"wp-block-image size-medium is-resized\"><img decoding=\"async\" loading=\"lazy\" src=\"https:\/\/movementandwellbeingclinic.co.uk\/wp-content\/uploads\/2020\/01\/ITB-Syndrome-1-214x300.jpg\" alt=\"iloitibal band syndrome\" class=\"wp-image-2249\" width=\"331\" height=\"464\" srcset=\"https:\/\/movementandwellbeingclinic.co.uk\/wp-content\/uploads\/2020\/01\/ITB-Syndrome-1-214x300.jpg 214w, https:\/\/movementandwellbeingclinic.co.uk\/wp-content\/uploads\/2020\/01\/ITB-Syndrome-1-732x1024.jpg 732w, https:\/\/movementandwellbeingclinic.co.uk\/wp-content\/uploads\/2020\/01\/ITB-Syndrome-1-768x1075.jpg 768w, https:\/\/movementandwellbeingclinic.co.uk\/wp-content\/uploads\/2020\/01\/ITB-Syndrome-1-1097x1536.jpg 1097w, https:\/\/movementandwellbeingclinic.co.uk\/wp-content\/uploads\/2020\/01\/ITB-Syndrome-1-1463x2048.jpg 1463w, https:\/\/movementandwellbeingclinic.co.uk\/wp-content\/uploads\/2020\/01\/ITB-Syndrome-1-scaled.jpg 1829w\" sizes=\"(max-width: 331px) 100vw, 331px\" \/><\/figure>\n\n\n\n<h2>So what is it?<\/h2>\n\n\n\n<p>The ITB is a band of fibrous tissue that connects the hip muscles to the lower leg. When the mechanics of the hip aren\u2019t balanced properly, which is a very common phenomenon. This is especially true in runners and cyclists, the ITB thickens and rubs against the outside of the knee. This is where there is a fat pad. This fat pad is highly pain- sensitive and prone to inflammation, which is what causes the pain.<br><\/p>\n\n\n\n<h2>Why is it occurring?<\/h2>\n\n\n\n<p>The excessive friction can occur for a few reasons:<\/p>\n\n\n\n<ul><li>Rapid change in mileage<\/li><li>Hill sprinting<\/li><li>Running on a tilted surface<\/li><li>Glute weakness<\/li><li>Foot pronation<\/li><li>Allowing the knee to bend inwards<\/li><li>Bow legs (2)<\/li><\/ul>\n\n\n\n<h2>How do you know if you actually have it?<\/h2>\n\n\n\n<p>Usually a patient with ITB syndrome comes to the Clinic with no previous history of trauma. This includes knocks or twists to the knee, but they may have recently increased their running activity. The pain can typically occur a few miles into the run and the pain worsens as they continue, especially at heel strike at around 30 degrees of knee flexion (3). If this sounds like you, please get in contact with an appropriate medical professional.<\/p>\n\n\n\n<p>As <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4458926\/\">80% of the diagnosis<\/a> comes from who the patient is and what they say, ITB syndrome is no different. Furthermore, clinical testing for ITB syndrome is weak and unreliable with only one or two tests that have been subjected to scientific testing.<\/p>\n\n\n\n<p>Regarding the next step if it doesn\u2019t get resolved, scans can help diagnose the inflammation on the fat pad. Most patients won\u2019t require this as the clinical presentation and area of pain is usually enough to confirm ITB syndrome.<br><\/p>\n\n\n\n<h2>How to resolve it<\/h2>\n\n\n\n<p>The obvious treatment would seem to be to reduce the inflammation, so rest and ice and maybe medication. Despite this logical argument, that doesn\u2019t seem to be the most reliable way of resolving the problem. The best interventions usually get to the true source of the issue. This is because the poor hip mechanics contribute to the tightness in the ITB and therefore the compression on the fat pad, good hip strength and conditioning works the best.<\/p>\n\n\n\n<p>Osteopaths, physiotherapists and sports therapists will have to assess which muscles aren\u2019t working before a rehab plan is put in place. However, at the <a href=\"https:\/\/movementandwellbeingclinic.co.uk\/when-and-why-should-you-seek-an-osteopaths-help\/\">Movement and Wellbeing Clinic<\/a> we put a full management plan in place so that you will feel confident about the situation and you are empowered to help yourself to resolve it. Usually the program of exercises will be gluteus medius strengthening and specific knee stability work, but again this depends on the assessment.<\/p>\n\n\n\n<p>In terms of hands-on treatment, it is common to see the problematic knee over-rotate inwards which requires hands-on specific mobilisation. This can be a great tool to combat ITB syndrome and keep it at bay, alongside the exercises.<\/p>\n\n\n\n<h2>Lifestyle advice<\/h2>\n\n\n\n<p>Modifying activity is a big part of resolving ITB syndrome: we have two options depending on the case:<\/p>\n\n\n\n<ul><li>Modify running distance<\/li><li>Modifying running technique<\/li><li>Complete rest for a period of time<\/li><\/ul>\n\n\n\n<p>The three options will be discussed with you and the decision will be made together. Like our philosophy with most musculoskeletal conditions, treatment must make sense to you. For example, we\u2019re not going to tell you to stop running completely if the pain isn\u2019t severe and you have a race planned. Conversely, we\u2019re not going to ask you to carry on through the pain if you\u2019re just doing recreational exercise and there is no obvious benefit in continuing with running in the short term.<\/p>\n\n\n\n<h4>For any further questions, please don\u2019t hesitate to ask:<\/h4>\n\n\n\n<p>0161 209 2980<\/p>\n\n\n\n<p><a href=\"mailto:info@movementandwellbeingclinic.co.uk\">info@movementandwellbeingclinic.co.uk<\/a><\/p>\n\n\n\n<p><strong>Ed Madeley M.Ost<\/strong><br><\/p>\n\n\n\n<p><strong>References<\/strong> <\/p>\n\n\n\n<ol><li>  <a href=\"https:\/\/bestpractice.bmj.com\/topics\/en-gb\/587\/epidemiology#referencePop14\">Noehren B, Davis I, Hamill J. ASB clinical biomechanics award winner 2006 prospective study of the biomechanical factors associated with iliotibial band syndrome. Clin Biomech (Bristol, Avon). 2007 Nov;22(9):951-6. <\/a><\/li><li><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/16778549\"> Fredericson M, Weir A. Practical management of iliotibial band friction syndrome in runners.\u00a0Clin J Sport Med.\u00a02006 May;16(3):261-8  <\/a><\/li><li><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/20118523\">Ferber R, Noehren B, Hamill J, Davis IS. Competitive female runners with a history of iliotibial band syndrome demonstrate atypical hip and knee kinematics.\u00a0J Orthop Sports Phys Ther.\u00a02010 Feb;40(2):52-8 <\/a><\/li><\/ol>\n","protected":false},"excerpt":{"rendered":"<p>So, after all the mental and physical preparation for your weekend run, you go out planning to do a 10k jog. Halfway through, you feel a sharp pain on the outside of your knee and you suddenly have to stop. Thoughts like \u2018\u2019Just my luck\u2019\u2019 and \u2018\u2019I should have just stayed in\u2019\u2019 enter your head as you hobble back home. You may wonder if you\u2019ve knocked it (but haven\u2019t) or if you\u2019ve been kneeling too much, which only adds to the confusion, but there is another possibility. As an osteopath, I see a lot of patients with knee issues, and\u2026<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"inline_featured_image":false,"_uag_custom_page_level_css":""},"categories":[152],"tags":[],"blocksy_meta":{"styles_descriptor":{"styles":{"desktop":"","tablet":"","mobile":""},"google_fonts":[],"version":5}},"acf":{"info_box_title":"Breakdown","info_content":"<b>Summary<\/b>\r\n\r\n<span style=\"font-weight: 400;\">ITB syndrome should be considered if you have:<\/span>\r\n<ul>\r\n \t<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Knee pain during, or after running, specifically during the first 30 degrees bringing the foot off the ground<\/span><\/li>\r\n \t<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Pain on the outside of the knee during activities or lying on it<\/span><\/li>\r\n<\/ul>\r\n<span style=\"font-weight: 400;\">Occurs in 52% of runners, and is present in 16% of all running injuries<\/span>\r\n\r\n<span style=\"font-weight: 400;\">What works:<\/span>\r\n<ul>\r\n \t<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Strengthening the knee\/hip<\/span><\/li>\r\n \t<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Modifying activity<\/span><\/li>\r\n<\/ul>\r\n<span style=\"font-weight: 400;\">What doesn\u2019t work:<\/span>\r\n<ul>\r\n \t<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Stretching<\/span><\/li>\r\n \t<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Massage<\/span><\/li>\r\n<\/ul>\r\n<span style=\"font-weight: 400;\">ITB syndrome typically doesn\u2019t improve with rest<\/span>"},"featured_image_urls":{"full":"","thumbnail":"","medium":"","medium_large":"","large":"","1536x1536":"","2048x2048":""},"post_excerpt_stackable":"<p>So, after all the mental and physical preparation for your weekend run, you go out planning to do a 10k jog. Halfway through, you feel a sharp pain on the outside of your knee and you suddenly have to stop. Thoughts like \u2018\u2019Just my luck\u2019\u2019 and \u2018\u2019I should have just stayed in\u2019\u2019 enter your head as you hobble back home. You may wonder if you\u2019ve knocked it (but haven\u2019t) or if you\u2019ve been kneeling too much, which only adds to the confusion, but there is another possibility. As an osteopath, I see a lot of patients with knee issues, and&hellip;<\/p>\n","category_list":"<a href=\"https:\/\/movementandwellbeingclinic.co.uk\/category\/osteopath\/knee\/\" rel=\"category tag\">Knee<\/a>","author_info":{"name":"Ed Madeley","url":"https:\/\/movementandwellbeingclinic.co.uk\/author\/mrosteo\/"},"comments_num":"0 comments","uagb_featured_image_src":{"full":false,"thumbnail":false,"medium":false,"medium_large":false,"large":false,"1536x1536":false,"2048x2048":false},"uagb_author_info":{"display_name":"Ed Madeley","author_link":"https:\/\/movementandwellbeingclinic.co.uk\/author\/mrosteo\/"},"uagb_comment_info":0,"uagb_excerpt":"So, after all the mental and physical preparation for your weekend run, you go out planning to do a 10k jog. Halfway through, you feel a sharp pain on the outside of your knee and you suddenly have to stop. Thoughts like \u2018\u2019Just my luck\u2019\u2019 and \u2018\u2019I should have just stayed in\u2019\u2019 enter your head&hellip;","_links":{"self":[{"href":"https:\/\/movementandwellbeingclinic.co.uk\/wp-json\/wp\/v2\/posts\/2231"}],"collection":[{"href":"https:\/\/movementandwellbeingclinic.co.uk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/movementandwellbeingclinic.co.uk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/movementandwellbeingclinic.co.uk\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/movementandwellbeingclinic.co.uk\/wp-json\/wp\/v2\/comments?post=2231"}],"version-history":[{"count":0,"href":"https:\/\/movementandwellbeingclinic.co.uk\/wp-json\/wp\/v2\/posts\/2231\/revisions"}],"wp:attachment":[{"href":"https:\/\/movementandwellbeingclinic.co.uk\/wp-json\/wp\/v2\/media?parent=2231"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/movementandwellbeingclinic.co.uk\/wp-json\/wp\/v2\/categories?post=2231"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/movementandwellbeingclinic.co.uk\/wp-json\/wp\/v2\/tags?post=2231"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}