Physical Therapy for Running Injuries - Part II
By Helene Mitchell, Physical Therapist Assistant
Iliotibial Band Friction Syndrome (ITBS) is the most common cause of lateral knee pain in runners and occurs in as many as 23% of the running population. It is more common in women than men.
Symptoms:
• Dull, achy, sharp, burning pain on the outside of the knee
• “Snapping” is heard or felt on the outside of the knee cap (patella)
• Does not always hurt at the start of a run but hurts after running a certain distance
• Symptoms are often worse after a run and it is more painful to run slow than fast
• Pain with squatting
• Pain after sitting for long periods
Causes:
• Excessive increase in running mileage or intensity
• Tight hip musculature
• Weak gluteal muscles
• Running on uneven surfaces or in same direction on a track
• Excessive downhill running
• Excessive foot supination
• “Bow legged”
Conservative Treatment:
Acute (less than 2 weeks):
• Ice massage
• Anti-inflammatory drugs
• Myofascial release
• Avoid downhill running or running in one direction on a track
• Stop running completely if pain begins immediately
Subacute (weeks 2 – 6)
• Gentle stretching
• Massage
• Foam roller exercises
• Hip strengthening
• Address footwear/orthotics
• Active rest and mild running every other day (if without pain)
Chronic: (6+ weeks)
• Hip strengthening
• Balance activities
• Return to running every other day then every day as symptoms subside
Complete cessation of symptoms takes 6 – 8 weeks. Gradually increase distance and frequency over a 4-6 week period. Faster running will cause less pain so start with strides initially.