Sports Injury Focus – Runners’ Knee ( ITB Friction Syndrome)

Signs and Symptoms:

Signs & Symptoms of Runners’ Knee include burning sensation/pain that comes on gradually on the outside of the knee. Common in cyclists and runners. Often confusing as there is no major incident or trauma, yet the pain and or burning comes on gradually and appears to get worse. 

* Week 1 

Ice is vital. As is rest. 

Walking is fine and swimming is great too. With this kind of injury, maintaining flexibility and core strength, is important. 

From a Physio point of view – I’d be working on deep tissue massage of the tensioners of the IT Band(The muscles at the top of the hip) as well as stretching the band, quads and hip region. 

It’s also possible that the Athlete’s “back” will have stiffened so I’d be working to loosen that area too. It’s really important for the Athlete to be working on strength work of the Gluteal muscles and the core stability muscles. 

* Week 2 

Continue with ice and rest from cycling or running. 

Swimming is encouraged and the rower is also possible and unlikely to reproduce any pain on the out-side of the band. If it does, stop. 

Continue with gluteal and core exercises and stretching in the gym. 

From a Physio point of view – deep therapeutic massage of the whole leg is vital and will continue x3 daily, immediately followed by passive and active stretching. 

* Week 3 

Cycling and or running will be able to be introduced in this phase, providing the athlete has followed the treatment plan noted above. 

Gentle, half pace jogging is introduced and cycling (both on the flat). Athlete should not be expecting to feel any burning sensation. Fatigue and stiffness is okay. 

From a Physio point of view – deep therapeutic massage continues as does stretching. Increase gluteal and core exercise and begin re-introduction to 3/4 level activity and or practice. Ice remains important after every session (use heat before). 

* Week 4 

Athlete steps up to training. Sneakers are checked and or orthotics applied to footwear to re-correct the position of the foot. 

From a Physio point of view – massage and stretching continue for at least 2-3 weeks and athlete continues working on core stability and gluteal strength and control exercises. More functional baed exercises are included as well as good hip and knee control against gravity.

Review of recovery: 

Complete rest needed early on – just until the pain settles

Stretch and massaging is pivotal to the successful recovery. As is doing the right core, gluteal exercises and functional rehab exercises. Most times the issues are related to biomechanics and this must be corrected or you’ll just be putting a band aid on the problem.

Secret Tip(s): 

Check your sneakers and change them every 3 months, consider custom foot orthotics and ice packs are the best thing that you can be doing to help your self.  Remember your compliance with your home exercises!

Let your Physiotherapist do everything else. 

Do not be fooled by the absence of pain when you rest. The IT Band is only painful in a weight-bearing situation (such as running) or cycling due to excessive over use. 

If you’d like more info on this, and some further easy, actionable tips on other sports injuries too. We have a free guide that we can send you. Connect with us on 01344 489398 or email us on bracknell@applephysio.com and tell us what’s going on. 

A member of the team can take your details and we can email you a copy.

About the Author: Leslie Abrahams and the Apple Physio team


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Leslie is a Physio, Pilates Educator and Rehab Specialist who has a special interest in Spinal Treatments, lower limb injuries, and has vast experience dealing with patients post injury or surgery. Every week, for over 20 years, 100’s of people aged 30-64+ have consulted the Apple Physio team looking for answers to concerning questions about, and for, a fast end to their health worries and physical pains and stiffness.

 Leslie is a Master Trainer for the world renowned Australian Physiotherapy and Pilates Institute(APPI). He is regular key note speaker at conferences and travels internationally to present on modified exercise for rehabilitation. Leslie is the Director of Apple Physio Clinics situated in Bracknell and Windsor. Berkshire’s Specialist Private Physiotherapy Practice for People in their 30’s. 40’s, 50’s and 60’s and above, who want to keep healthy and active.

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