Prevention
First of all, care should be taken early on to adopt a suitable physiological position when running and walking. At a young age, any existing malposition should therefore be compensated by means of orthopedic insoles. Athletes should exercise according to their current level of fitness and, above all, make sure they have a sufficient warm-up phase before starting their sport.
If there are already symptoms of runner’s knees in your own family, you should be rather careful when doing sports that favor a runner’s knee. This is because anatomical conditions can be passed on from generation to generation and thus lead to an increased susceptibility of a runner’s knee. Initially, a distinction is made in the therapy of a runner’s knee between an acute pain phase and a long-term therapy of the cause.
In the acute phase of a runner’s knee, cooling of the affected area as well as anti-inflammatory measures (ointments/medication) are recommended.Even if affected persons of a runner knee (tractus syndrome) do not like to hear it: The first step in the therapy of a runner’s knee is to eliminate the causative factors, in most cases running. If a regular runner has a runner’s knee, he or she must drastically reduce, if not stop running altogether. Instead of this, other sports that are easy on the knee joint should be performed.
These include swimming, cycling, fitness training, etc. Immediately after running, symptomatic therapy should be carried out, consisting mainly of cooling the knee and immobilization. Furthermore, an attempt can be made to reduce the inflammatory component with anti-inflammatory ointments/medication.
Ointments with the active ingredient diclofenac or ibuprofen should be mentioned here. In many cases, runner’s knees are caused by the fact that a lot of movement is performed with a leg whose muscles are hardened or shortened. To overcome this anatomical hurdle, a daily stretching program should be carried out.
If the muscles loosen and the tendons lengthen with regular repetition of the stretching activities, the probability of progression of the runner’s knee decreases. Furthermore, regular physiotherapy should be carried out. The symptoms can be alleviated by stimulation current treatments or cold applications.
In some cases it may also be useful to carry out heat applications on the knee. If it is a runner’s knee / tractus abrasion due to anatomical malpositions, there is the possibility to influence the anatomical position of the ankle and knee joint favourably by choosing the right running shoes and an orthopaedic insole supply. If you suffer from runner’s knee complaints, you will certainly be interested in how you can alleviate and prevent them.
A fairly simple option is stretching exercises, which stretch the iliotibial tract. Here are some exercises, all exercises are written for the right knee, if you have left knee problems, simply swap left and right in the following. For the first exercise you stand upright, feet parallel, with your right hand you can support yourself against a wall.
Now cross your legs, keeping the left foot firmly in place while the right foot is passed behind the left. The right foot is then placed left behind the left foot. Both feet point forward.
Now push with your hip carefully to the right towards the wall. You should now feel a stretching of the outside of the right thigh. Be careful not to tip your upper body to the right.
Hold this position for about 20 seconds. For the second exercise sit on the floor with your legs forward. Now cross your legs by placing your right foot to the left of your left knee.
Now grab your left knee with your left hand. Now you can carefully push your right leg outwards with your left arm and thus stretch the iliotibial tract. In the third exercise you stretch both the iliotibial tract and the muscles at the back of your thigh.
To do this, stand upright and cross your right leg over your left leg. Then bend your hips until you can touch the floor with your hands. Hold this position for at least 15 seconds.
Common mistakes in this exercise are bending your knees. However, the aim of the exercise is to stretch the muscles and not to reach the floor with your hands. Do not worry if you do not reach the floor immediately.
Try to reach the floor as far as you can, if there is some distance, this will improve over time. Another common mistake is to lift your heels off the ground. Try to stand firmly on the ground.
In another, technically very simple exercise, first lie flat on your back. Spread your arms out flat to the side. Now lift your right leg and move it to the left.
Make sure that you do not turn your entire pelvis but only move your right leg. Hold the leg as far to the left as possible for 20 seconds. During this exercise you stretch especially the tractus iliotibialis.
Physiotherapy is an important part of the therapy. Physiotherapy can improve the pain symptoms using a variety of different techniques. One treatment method that is frequently used by some physiotherapists for an existing runner’s knee is the application of a so-called tape bandage.The bandage consists of elastic-stable bandages which are applied using a specific technique and are intended to support and stabilize certain anatomical structures during movement.
Taping of the knee as well as the so-called tractus iliotibialis, which is responsible for the complaints, can thus help to alleviate them. In addition to the correct application of the bandage, the time at which it is applied is also decisive for the success of the therapy. Thus, the bandage should not be used as the sole therapy in the acute phase of the runner’s knee, but should rather be applied during the build-up phase when training is intensified.
Here the bandage can help to support the fascia, which is responsible for the complaints of the knee and thigh, and prevent the recurrence of pain. By stretching certain groups of fascia and muscles and by carrying out massages that promote blood circulation, an improvement in the pain symptoms can often be achieved. Exercises, which are performed independently on a so-called Blackroll, can often achieve the same effect as a physiotherapeutic therapy after professional instruction.
A Blackroll is a hard foam roll which can be used for exercises. Especially exercises that stretch the fasciae and promote the blood circulation of these structures can be performed well with a Blackroll. By frequently doing meaningful exercises with the Blackroll, the recurrence of a runner’s knee can be prevented in many cases.
However, attention should also be paid to other risk factors which can promote the occurrence of the pain syndrome. It is also important to do the exercises on the Blackroll only according to professional instructions so that important and irritated structures are not stressed incorrectly and at an unfavorable time of treatment. A treating physiotherapist or orthopedist can help to use the Blackroll at home.
The main cause of a runner’s knee is overloading (e.g. due to frequent running) of the tendon plate, which extends between the outer side of the hip and the upper outer part of the lower leg. The so-called tractus iliotibialis with M. Iliotibialis runs along almost the entire upper outer surface of the thigh and is mainly responsible for the flexion of the leg in the hip and for the outer rotation in the hip joint. For anatomical reasons, it can happen that the tendons of the muscle begin to rub/chafe at a certain bony protrusion between the lower and upper thigh.
This always occurs when certain movements are performed too often and too intensively and when the anatomical conditions can favour the development of a runner’s knee (bow legs). With repeated movements of the leg, the muscle attachment is always moved over the bony process sometimes strongly and sometimes less strongly. This causes pain.
Persons who do frequent endurance running and often work too long and too intensively are particularly at risk. The movement of the leg typical of cycling can also cause a runner’s knee (tractus syndrome). A distinction is made between acquired causes and congenital causes.
Congenital causes include above all malpositioning of the legs, in which increased pressure or traction is exerted on the tractus iliotibialis. Especially patients with bow legs (Genu-varum) have an increased risk of getting a runner’s knee. The most common causes of acquired reasons for a runner’s knee are mainly incorrect loading of the legs during running.
Acquired causes also include so-called classic running errors in athletes. These include training without sufficient warm-up and overloading, which does not correspond to the actual training condition of the athlete. Furthermore, shoes with pronation support and running on hard surfaces (e.g. asphalt) are frequent causes of runner’s knee.
