Given the temporary isolation and restrictions on mobility due to forced self-isolation, it can be assumed that after these restrictions end, the population will be eager to catch up. The most popular and affordable way for the masses to increase their activity is running. So today we’re going to look at one of the most common problems with active lifestyles.

Iliotibial band syndrome is a common pathology of the knee joint that manifests itself during its active loading. It is characterized by pain on the outside of the knee joint. According to statistics, more than 20% of runners face this problem, so in most cases it is called “runner’s knee”.

Anatomical structure

To understand the essence of the problem, let’s first analyze the anatomical structure of this structure.
The iliotibial tract is a tendon that strengthens the longitudinal fascia of the thigh, which runs laterally along the thigh. It begins in two bundles, one attached directly to the iliac crest, the other is a continuation of the tensor fasciae of the broad thigh, and ends with a fan-shaped attachment to the outer edge of the patella, the tibial tuberosity of the tibia, and the tendon of the biceps femoris muscle.
The iliotibial tract, together with the associated muscles, provide movement and stabilization of the knee joint, as well as its abduction and lateral rotation of the hip, limiting excessive inward rotation of the limb.

Causes of the syndrome

Iliotibial tract syndrome is an inflammation of the distal (lower) part of the tract due to frequent friction of the stretched tendon against the external condyle of the femur.

Despite a fairly well-defined pathophysiology, the causes of the syndrome are not entirely clear in only a part of athletes. A number of studies have shown a link between biomechanical factors (flat feet, inward rotation of the tibia, O-shaped curvature of the legs, etc.) and the occurrence of iliotibial pathology.

This pathology is inherent not only in runners (athletes), but also in people with other types of activity associated with frequent bending loads on the knee joint.

• underdevelopment of the thigh muscles due to rare irregular training;
• flat feet;
• prolonged running on hills (especially downhill);
• incorrectly selected sports shoes;
• improper running technique;
• insufficient warm-up, hiccups.

Main symptoms

In most cases, the onset of the syndrome is characterized by the appearance of moderate pain in the outer part of the knee joint. The pain appears two to three minutes after the start of activity, often intensifying during running on an inclined plane. After resting, the pain usually disappears, although in case of neglected injury, it can persist and bother during rest.

Diagnosis

The diagnosis is made by an orthopedic traumatologist after a detailed medical history, specific tests and instrumental diagnostics.

Prevention

As with any other injury, the best treatment for iliotibial band syndrome is prevention.
The following can help with this

• a properly designed training schedule with a gradual increase in exercise;
• compliance with running technique;
• selection of appropriate sports shoes;
• good warm-up and cool-down after the main workout;
• strengthening all muscle groups involved in running.

Treatment.

For the treatment of runner’s knee, the so-called “conservative method” is mainly used, which involves rest, inflammation relief, a complex of physical therapy, massage, strengthening of certain muscle groups with a gradual return to exercise. It is also important to eliminate the factors contributing to the development of the injury.

Depending on the “neglect” of the pathology, training for 2-3 weeks is either stopped altogether or reoriented to those that give minimal stress on the problem area (swimming, for example).

First, you need to relieve the inflammatory process. Rest and activity restriction alone may not be enough, so drug therapy in the form of NSAIDs, mainly external use (paracetamol, diclofenac, ibuprofen, nimesulide) is used. In some cases, ultrasound and phonophoresis are used for physiotherapy. Movement in the knee joint is limited by a semi-rigid orthosis.

At the next stage, physical therapy exercises are used, including both stretching the iliotibial tract itself and strengthening various muscle groups of the leg. Subsequently, if the treatment is effective, light training on a flat, non-rigid surface is used. At first, a compression orthosis can be used, which is worn at the level of the hip condyles to reduce friction of the tract during movement.

Surgical intervention for iliotibial band symptoms is rarely used in particularly severe cases.

I would like to remind you that any physical activity should be introduced into your life gradually in order to prevent the development of injuries and discomfort, both in individual anatomical structures and in the body as a whole. Enjoy your run!