Runner’s knee

Synonyms

  • Iliotibial Band Syndrome
  • Tractus Syndrome
  • Tractus scrubbing
  • Tractus iliotibialis syndrome
  • IBS (Iliotibial Band Syndrome)

Definition

A runner’s knee / tractus rubbing is a degenerative change in the tractus iliotibialis, mainly caused by running movements, with associated, sometimes severe, pain in the outer area of the knee joint.

Symptoms

The main symptoms of a runner’s knee are mainly external knee pain, which can occur when running or walking briskly and which can increase in intensity over time. If resting positions are taken, the pain usually subsides again. Swelling or reddening, as with classic inflammation, occurs only rarely.

The pain has a pulling, burning character and in some cases is accompanied by a functional impairment of the knee or lower leg. Usually the first pain in the runner’s knee occurs when going downhill. In advanced stages, however, pain can also occur when going uphill or even when running on a straight line.

Also in advanced stages, pain also occurs when sitting with strongly bent legs. In addition to the pain, a runner’s knee can sometimes also make itself felt acoustically. Due to the great friction of the muscle attachment on the bony prominence, the runner’s knee can sometimes experience a crunching or loud rubbing, which the examiner or the person affected can hear.

In addition to the patient’s medical history, the physical examination is the most important diagnostic factor of the runner’s knee. If patients report the classic pulling, burning or stabbing pain in the corresponding area, especially when going downhill or running, a first suspicion of a runner’s knee can be made. During the physical examination, the examiner will passively move the leg while the patient is lying down and wait to see which movements the patient reports pain.

In addition, the lower leg is rotated to the left and right when the thigh is fixed and the stretched leg is pressed inwards and outwards. In this way, the differential diagnostic causes of the complaints can be ruled out. These are the damage to the external meniscus, where pain would occur primarily during external rotation, and the damage to the external ligament, where pain would occur during external pressure when the leg is stretched.

If the leg or knee joint is swollen and reddened, this would indicate an inflammation. A common inflammation in the knee joint is bursitis. If the kneecap lifts off when the leg is stretched out and rests as if on a carpet of fluid, this so-called “dancing pattela” indicates a joint effusion, which in most cases has an inflammatory cause.

In order to exclude the other causes, imaging can also be performed, which may consist of x-rays of the knee joint or a nuclear spin examination. Here, ligament injuries, meniscus damage or arthrotic changes can be seen or excluded. In addition to the sports mentioned above, such as running, malpositions of the legs are an important risk factor. Long periods of incorrect strain can lead to a runner’s knee much more frequently than legs that are under proper strain. Furthermore, athletes who overdo themselves and especially those who do cold and untrained sports are also more at risk of developing a runner’s knee than trained athletes.