Diagnosis
In most cases, the patient survey and physical examination are sufficient to diagnose a runner’s knee. If patients give the typical pain localization especially after running and sports, this is already an indication of a runner’s knee. During the physical examination, the physician has the patient lying down lift the leg.
He himself feels the advance of the tendon and muscle plate above the knee. If the movement causes corresponding pain, a tractus syndrome is as good as proven. The differential diagnosis may still be
- Torn muscle fibers or
- Act on injuries to the tendon or
- Arthroses in the knee joint or also
- Meniscus and ligament damage can lead to similar symptoms.
Therapy
In most cases the conservative therapy is sufficient. This consists of physical protection at first. Furthermore, an adequate pain therapy is reasonable.
The physical pain treatments include cold applications. Patients should put their leg up and cool it with ice packs. If the tractus syndrome is caused by incorrect loading, care should be taken to compensate for these incorrect positions with insoles.
Sporting exercises should be started again slowly as the disease progresses. Overloading should be avoided. In extreme cases, conservative therapy is not sufficient. In this case, the constriction at the knee must be surgically removed to allow the muscle movements to take place unhindered.
- Do not do sports and
- Avoid strenuous movements of the legs.
- The medicinal but also
- Can be physical.
Duration
The duration varies greatly with the progress of the inflammation. Frequently affected are inexperienced athletes who have only recently started a new and intensively practiced sport. After a few, but long training sessions, pain occurs.
If rest is maintained immediately and the inflammation is given time to resolve, the pain can disappear within a few days or weeks. The longer the pain is ignored, the more severe and frequent it becomes.In the case of a severe inflammation, which can already be felt at rest or during light movement, healing takes a correspondingly longer time. In these cases up to 8 weeks of rest may be necessary.
Even after this period, the load should be increased again slowly. If a tractus syndrome is present, stretching exercises are suitable both as a therapeutic and prophylactic measure. They are used to stretch the iliotibial tract directly and to strengthen the pelvic stabilising muscles.
The following stretching exercises are particularly suitable for therapy:The legs must be crossed for the first exercise. If the right leg is in front of the left, the left, stretched arm including the upper body must be inclined to the right. The same is repeated with the other leg forward and a body tilt to the left and stretched out right arm.
The respective position should be maintained for about 15-20 seconds. A second exercise involves standing on one leg and lifting the other leg up. With one hand you grasp the knee and with the other hand the ankle joint, so that it looks like a kind of cross-legged seat.
In this position, the lower leg should now be carefully pulled upwards until you feel a stretch on the thigh up to the buttocks. This stretching position should be held for about 15 seconds. It is important that the back is always straight.
Further exercises are best shown by physiotherapists or watch videos with detailed descriptions of correct execution. If the reason for the tractus syndrome is a weakness of the pelvic muscles, it is essential to train and strengthen them. A simple exercise is suitable for this purpose, the only aid being a staircase.
You stand on the stairs with one leg at the edge of the stairs and the other leg swinging freely. Now the pelvis on the side of the freely suspended leg must be lowered and then lifted again. Depending on your fitness level, the exercise can be repeated 10-15 times per side.
Since the tractus syndrome is a common complaint of runners, it is recommended to prevent it. This can be realized by making the training varied and not only consisting of jogging, but also of strechting units and strength training. This avoids a monotonous and one-sided strain on the muscles, which can ultimately reduce the risk of developing tractus syndrome.
In addition, the use of a so-called “blackroll” is helpful in loosening and making the fascial strand of the tractus iliotibialis supple, so that shortening or hardening becomes less likely. In conclusion, it is important to mention that overloading by the above-mentioned exercises should be avoided. To achieve an optimal healing process, the exercises should be performed in a controlled manner and with moderate stress.
Tapering represents a conservative treatment option for tractus syndrome. The properties of elasticity and self-adhesive function make the tape a functional bandage, which is intended to relieve pain. In addition, the tape stabilizes the area of the iliotibial tract and has a stimulating effect on the muscles and fascia of the tractus.
The tape can usually be left in place for up to 5 days. Showering or swimming is also generally possible, but only reduces the adhesion period if necessary. In general, this can also be done by laymen, but in case of extreme complaints and the need for the effect to occur in any case, it is recommended to leave the taping in the hands of specialists.
The following is a brief explanation of how to apply the tape in the case of tractus syndrome. Patients should lie on their side so that the painful side of the leg is facing upwards. In addition, the knee should be slightly bent so that the foot rests on the lower leg of the lower leg.
A long strip of tape is now applied along the iliotibial tract. The middle part is applied with a slight pull, but the two ends in the area of the hip and the knee are glued on loosely. If patients can localize the pain under a tractus syndrome exactly, it is advisable to fix two additional small tape strips in the appropriate place.
The point of pain should be the point where the two strips cross. It is important that none of the two tapes pulls into the hollow of the knee or sticks to the kneecap, as this can cause irritation when walking.Rather, they should run slightly offset to the first long tape, i.e. slightly oblique to the iliotibial tract. Rubbing the tape improves the adhesion to the skin and at the same time increases the blood circulation in the corresponding area.
