Runner's Syndrome: What It Is and How to Cure It

Runner’s knee syndrome, also called iliotibial band syndrome or runner’s knee, is an inflammation of the iliotibial band caused by repetitive friction of the tensor fasciae latae tendon against the outer part of the knee.

This injury causes pain, burning, and inflammation during running that increases depending on the distance covered, which is why the main patients affected are athletes, specifically long-distance runners.

Causes of runner’s knee

One way to classify the causes of an injury is by discussing intrinsic factors (related to the body) or extrinsic factors (external to the body). In the case of runner’s knee, most causes are intrinsic:

• Repetitive friction of the iliotibial band against the outer condyle of the knee.
• Muscle overload.
• Iliotibial band wider or narrower than anatomically normal.
• Hypotonia (lack of muscle tone) in the external rotator and knee stabilizer muscles (gluteus medius, gluteus maximus, tensor fasciae latae, etc.).
• Overpronation of the foot.
• Flat feet.
• Leg length discrepancy.
• Frequently running downhill.
• Running on uneven terrain.
• Inappropriate footwear.
• Poor running technique.
• Etc…

How can I tell if I have runner’s knee?

As mentioned earlier, the main symptom is pain on the outer part of the knee that increases as the impacts of our feet on the ground continue. Additionally, the pain worsens when running downhill because the tension in the tensor fasciae latae muscle is greater during this movement. Once we finish training or have to stop due to the pain caused by this injury, the discomfort usually subsides.

However, there are several conditions with similar symptoms. To differentiate them, we can perform two tests that can help identify runner’s knee and avoid confusing it with another injury:

• Renne Test

  We stand on the injured leg. Then, we bend the knee 30–40° and hold this position for a few seconds. If pain appears, it indicates iliotibial band syndrome.

• Ober Test

  We lie on our side with the injured leg on top (contralateral lateral decubitus) with hips and knees bent. Next, we perform hip extension plus adduction (bringing the knee inward). If the adduction movement is limited, it indicates shortening of the iliotibial band.

What should I do to improve iliotibial band syndrome?

The most important thing, as with any injury, is to act as quickly as possible because the more kilometers we run with a “slight discomfort,” the sooner it will become an injury.

First, it is advisable to reduce sports activity (which does not mean stopping) as this will decrease tendon inflammation. This effect can also be achieved with cryotherapy (applying ice) to the painful area. Likewise, we should perform strengthening exercises for the gluteus medius, gluteus maximus, and tensor fasciae latae to prevent the knee from collapsing inward (knee valgus) during the support phase of running and thus avoid overload on the outer part of the knee. Additionally, using pressotherapy will help reduce muscle fatigue, which, as we have seen, is one of the factors causing iliotibial band syndrome.

If the above advice does not improve your pain or the improvement is insufficient to continue your usual sports practice, you should see a physiotherapist so you can return to training without pain and, most importantly, avoid relapse.

How to prevent runner’s knee?

Next, we will give you a series of tips to help prevent runner’s knee and thus avoid interruptions in your training that could affect your performance in future competitions:

• Prevent muscle fatigue with regular leg recovery sessions using the Sizen machine. Thanks to our pressotherapy, you will help your muscles recover quickly as it promotes the elimination of lactic acid. It also helps reduce the chances of certain discomforts and fluid buildup. Among the four modes the machine offers, modes three and four are the most optimal for preventing sports injuries. Specifically, mode three applies a pulse massage, similar to a manual massage, facilitating a deep, complete, and rapid muscle recovery. Mode four provides a full and more intense session through compression and decompression.
• Visit a physiotherapist regularly.
• Strengthen the external hip rotator muscles such as the gluteus medius, gluteus maximus, and tensor fasciae latae.
• Have proper running technique and appropriate footwear.
• Avoid running most kilometers downhill.
• Follow a progressive training plan.
• Respect rest days.

Author

Alicia Vicario, physiotherapist and creator of Fisiovik (IG: @fisiovik).

I studied Sports Science and Physical Activity and specialized in the Health branch. I worked in a physiotherapy clinic for years as a sports rehabilitation specialist until I finally decided to pursue physiotherapy.