Runner's knee is an overuse condition. It causes pain at the front and outer side of the knee, sometimes also around the outer hip, and is one of the most common running injuries. Pain usually develops after several kilometres of running and when running downhill. In most cases, runner's knee means iliotibial band syndrome (ITBS). In a broader sense, it also includes pain in the front of the knee associated with synovial irritation and cartilage damage in the patellofemoral joint.

Runner's knee is the common name for one of the most frequent running injuries.

Appropriate footwear, correct running technique, balanced training and suitable stretching can help prevent runner's knee.

Symptoms

  • pain on the outer side of the knee
  • pain in this area that increases when bending and straightening the knee

Diagnostics

  • Diagnosis is based on the medical history and clinical examination.
  • Provocation tests that reproduce symptoms in specific areas are the main diagnostic tools.
  • An ultrasound examination may sometimes help supplement the orthopaedic examination.

Treatment

  • Immediate treatment aims to resolve inflammation where the iliotibial band is irritated. It uses anti-inflammatory medicines and individually selected physical treatments: shockwave therapy, ultrasound, cryotherapy and iontophoresis.
  • The mainstay of treatment is addressing the cause of ITBS through:
  • for incorrect foot alignment and excessive internal rotation of the tibia: choosing appropriate running shoes, using corrective insoles and improving running technique, avoiding heel-first contact with the ground
  • for weakness of muscles controlling femoral rotation and preventing excessive inward knee alignment during running: strength exercises for the weak muscles and exercises to improve neuromuscular control
  • for reduced band flexibility: stretching and fascial massage techniques
  • for overtraining: reducing running loads or temporarily stopping training, together with stretching and fascial massage techniques

Causes

  • excessive inward knee alignment
  • incorrect foot and tibial alignment, with excessive hindfoot eversion and internal rotation of the tibia
  • excessive external rotation of the femur due to weakness of the muscles responsible for internal rotation: the gluteus minimus, anterior fibres of the gluteus medius and tensor fasciae latae
  • incorrect running technique
  • unsuitable running shoes
  • reduced flexibility of the iliotibial band due to neglecting post-training stretching
  • excessive training load