Knee pain in runners

Knee pain due to the IT band in runners

As a keen runner myself, I enjoy the challenge of hill running and trail running around the Central Coast.  On the Central Coast, we have some of Australia’s best National parks and beaches to run through. These types of runs can be extremely satisfying for a runner, but the uneven surfaces and hills can lead to the development of knee pain.  One of the most common problems is outer (lateral) knee pain caused by IT band friction syndrome. 

The IT band is a large collagen structure, which is like a large ligament that runs from the upper part of the hip down to the outer aspect of the knee cap and fibular bone below the knee. The IT band assists with stability in the lower leg and stabilises the patella. When the runner has poor technique on uneven surfaces the band is subjected to friction/compression leading to inflammation and pain.

Runners with IT band friction syndrome will describe pain on the outside of their knee.  The typical presentation is for the pain to develop later in a run as they become tired.  The pain may increase with downhill running or stairs. The pain will often resolve at rest and return once running is restarted.

From a physiology perspective, research suggests that the IT band compress against the bony aspect of the femur.  A layer of fat and connective tissue between the bone and band develops pain.  Compression forces increase in long distance and hill running making this condition more common in endurance runners.

Running physiotherapists can assist with the treatment of this injury through massage of soft tissue around the hip and knee. This can be complemented with dry needling, stretching and foam rolling. 

The key to successful long-term treatment is strengthening of the hip gluteal muscles.  Strengthening around the hip ensures that the knee does not internally rotate or cross the midline which increases the compression on the IT band. A focused strength program of the gluteal muscles will relieve the pressure on the knee and improve your running. Your physiotherapist will provide advice and education on your running technique.

Here’s to happy running and enjoying the Coast’s beautiful trails and beachside runs but ensure that you have a program to keep your hips and knee strong.