Runner’s knee is also known as tractus iliotibialis rubbing syndrome, tract syndrome or iliotibial band syndrome and by the abbreviation ITBS. Runner’s knee is a painful condition on the outside of the knee that can occur in athletes and non-athletes.
What is runner’s knee?
Runner’s knee is caused by improper stress on the knees during running. Overuse can also be the cause of runner’s knee. In runner’s knee, pain occurs at the tractus iliotibialis, a tendon plate that extends on the outside of the body from the thigh to the shin. In the process, this tendon plate rubs against the bones of the knee joint, causing the pain. Tissue becomes inflamed during this rubbing process and this can cause stabbing pain. This pain on the outside of the knee joint first occurs when walking downhill or even when jogging, and eventually can be noticed when walking normally. Most affected by runner’s knee are marathon and long-distance runners, although misalignment can also occur from other causes in non-athletes and result in runner’s knee.
Causes
Among the causes of runner’s knee pain are the well-known mistakes made during running. Skipping the warm-up or not stretching enough will be the first causes of runner’s knee. Often, the causes of runner’s knee also lie in an increase in running training too quickly. The wrong footwear is especially often the cause of runner’s knee, and running on too hard a surface also contributes to runner’s knee. Another cause of runner’s knee is bowlegs and other misalignments of the legs. Here, congenital deformities are also a possible cause of runner’s knee. Since the tractus iliotibialis runs from the pelvis over the outer side of the thigh to the head of the tibia, any incorrect posture during running and also during walking has a long-term effect on the knee joint and can produce runner’s knee if the load is too strong and persistent. Runner’s knee occurs when the tractus iliotibialis is too short and rubs against the bones of the knee. Therefore, the cause of runner’s knee can also be a tendon injury.
Symptoms, complaints, and signs
Runner’s knee, also called iliotibial band syndrome, is characterized by severe knee pain that occurs especially when the knee is strained. It is a stabbing pain localized below the kneecap. Local inflammation of the tissue occurs there when the tendon plate located on the outside of the thigh to the shin rubs over the bones of the knee joint. Initially, the complaints only occur when descending mountains. After a certain time, even minor strains are sufficient to produce the stabbing pain. These then become noticeable even during normal running or walking. In later phases of iliotibial band syndrome, even climbing stairs or bent legs while sitting cause discomfort. Even touching the kneecaps can then cause severe pain. Sometimes bursitis also develops, which is also characterized by persistent severe pain, significant swelling at the knee joint, warmth development and restricted movement. Furthermore, in iliotibial band syndrome, a joint effusion sometimes forms in the knee joint. Another typical symptom is an audible grinding in the knee during movement. In principle, there is a good chance of recovery if the affected knee joints are spared. The symptoms then subside within one to two weeks. However, if the knee joint is subjected to further stress, the cartilage can also be irreparably damaged and lead to chronicity of the symptoms.
Disease progression
The course of the disease in runner’s knee begins with any discomfort associated with running, jogging or walking. If pain occurs at the knee, it should be dealt with in principle quite circumspectly. Since training errors are often the cause, a lot can be done to prevent runner’s knee in its infancy by being mindful of oneself. Taking the training speed seriously, a soft running surface, suitable footwear and proper warm-up training are the best aids for counteracting the progression of the disease in runner’s knee.If the progression of the disease is advanced, bandaging is required and training must be temporarily discontinued. The frequency with which runner’s knee occurs is 28 percent in female runners and 24 percent in males. If the runner’s knee continues to be strained too much or incorrectly despite initial problems and pain, chronic runner’s knee may develop.
Complications
Usually, runner’s knee primarily results in very severe and uncomfortable pain. The pain is stabbing and has a very negative effect on the patient’s quality of life. Furthermore, the pain can also spread to other regions of the body, so that it is not uncommon for knee pain to occur. Especially at night, runner’s knee can lead to sleep problems and depression. It is not uncommon for sufferers to also be irritable and suffer from psychological upsets due to the constant pain. The patient’s extremities are heated by runner’s knee and not infrequently also swollen. It is not uncommon for there to be bruising at the affected joints as well. In general, the patient also experiences movement restrictions, which can significantly complicate the daily life of the affected person. Severe discomfort occurs especially during exertion. As a rule, treatment can be carried out with the help of medication and does not lead to any further complications. Thus, inflammations can be avoided. Furthermore, the affected person is also dependent on therapies or massages to reduce the discomfort due to runner’s knee. The life expectancy of the patient is usually not reduced by runner’s knee. Overweight people also need to reduce their body weight in the process.
When should you see a doctor?
Runner’s knee is a swelling and inflammation in the knee that mostly affects joggers or athletes. Normal movement is very difficult with runner’s knee. Even the slightest strain triggers pain, so a visit to the doctor should not be delayed. Frequently, inflammation of the joints occurs in this context, which is visible to the human eye without any problems. At the first signs of such inflammation should immediately consult an appropriate doctor. Otherwise, there is a risk of an abscess. An abscess is a cavity filled with pus fluid. If this clinical picture remains without medical and medicinal treatment, then there is even the danger of blood poisoning. In case of symptoms of runner’s knee, a doctor should definitely be consulted. Only appropriate treatment can lead to an early cure. Those who completely forgo such treatment expose themselves to a great risk. Permanent consequential damage can occur in the worst case. Relief of the knee should take place so that joints, tendons and muscles are not further damaged.
Treatment and therapy
A runner’s knee is recognizable in its early stages by the pain it causes. Therefore, this pain also determines the therapy from the beginning. Cooling the knee and taking anti-inflammatory medication as well as a stabilizing bandage are the first therapy steps for runner’s knee. This includes an unconditional sparing of the knee. If the symptoms of runner’s knee are particularly severe, the treating physician can also inject anesthetics. Then a break from running may be necessary for up to three months. Physiotherapy and light rehabilitation training and specialist supervision are the next steps. Those who have too much body weight can reduce it. Because a runner’s knee is stressed all the more by too much weight. Therapeutic remedies for runner’s knee also include massage and heat applications.
Outlook and prognosis
The prognosis of runner’s knee depends on the extent of the existing disorders and the cooperation of the affected person. Without the willingness of the patient to contribute something for his own health maintenance, no good prospect of recovery can take place. If the patient is overweight, weight loss is essential for lasting relief of the symptoms. This can be achieved independently by the affected person with or without further medical treatment. In cooperation with a doctor, however, the long-term and permanent success improves. In addition, possible complications are avoided.If the runner’s knee is caused by incorrect loading, freedom from symptoms can be achieved with physiotherapeutic treatment and the affected person’s willingness to change. Movement sequences are optimized in targeted training sessions and must also be implemented in a stable manner outside of therapy. If the cause of the disease is an overload of the knee, recovery can also be achieved if the patient introduces long-term changes in physical load-bearing capacity. Physiotherapeutic exercises and an implementation of the medical education about the functioning of the human organism as well as the joints must be carried out by the patient independently. If this is the case, a good prognosis can often be made. If there are no other injuries or damage to the joint, healing is often achieved within a few weeks or months.
Prevention
The preventive measures for runner’s knee are proper warm-up and stretching, suitable shoes and a soft running surface, and ideal weight. In addition, pay attention to yourself while exercising.
Aftercare
Runner’s knee usually leads to uncomfortable and severe pain for sufferers, which can sometimes last for a long time. That is why it is important for affected individuals to take extensive rest and reduce sports activities to a minimum. Training should only be taken up cautiously in order to avoid a relapse. Insofar as the pain has also spread to surrounding regions of the body and causes additional disturbances, this can have an enormous impact on the psyche. Accompanying insomnia can cause sufferers to be permanently irritable and suffer from fatigue. Depression and other mental illnesses can occur as a result. However, uplifting conversations with friends and family can help sufferers to cope more confidently with their suffering. In addition to any follow-up checks by the attending physician, it is important that sufferers find distraction and enjoyment in their social environment. This may help them better weather the period of inactivity during the recovery process.
Here’s what you can do yourself
In the acute phase of the disease, cooling compresses have a pain-relieving effect; alternatively, pain-relieving ointments from the pharmacy can be applied. Rest of the runner’s knee is necessary for at least two to six weeks, otherwise chronic complaints may develop. Light running training may only be resumed when the symptoms have completely subsided. A bandage stabilizes the knee joint during this time and supports healing. When resuming training, care should be taken to ensure adequate warm-up, with particular attention to the outside of the leg. Good footwear provides the necessary cushioning, and foot malpositions can be compensated for by individually fitted insoles. Too rapid increases in training volume and running on consistently hard surfaces often result in a recurrence of iliotibial band syndrome. Shorter sessions on forest trails are far gentler on the knee than long road runs. If runner’s knee is due to overuse caused by an incorrect running style, expert advice and correction by an experienced running coach is advised. In some cases, it may make sense to replace part of the running training with other endurance sports such as cycling or swimming. In addition, the trunk and hip muscles should be strengthened and stabilized through specific exercises to achieve an optimal range of motion while running.
