| I can tell you all about runner knee as it is a condition | | | | very clear that you need to have control and stability |
| that I experienced myself. I had this condition when I | | | | for correct alignment. You can try this for yourself |
| ran the Bristol half marathon a couple of years ago | | | | by standing up and turning your foot inwards and |
| and is extremely painful and will stop you from | | | | noticing the muscles on the outside of your leg |
| running all together if not treated properly, believe | | | | tightening. Therefore the treatment should be |
| me I know! | | | | focused on strengthening this muscle. A simple test |
| The medical term for runner's knee is known as | | | | you can do yourself is see how steady you are at |
| Iliotibial band syndrome which will be explained later | | | | standing on one leg. If you are unsteady then |
| on. First let's look at some of the common signs and | | | | probably your gluteus medias is weak. Another test |
| symptoms of runner's knee. | | | | to do is a squat in front of a mirror and see if one |
| - pain on the outside of the knee | | | | leg turns inwards. If it does then this is a suspect |
| - pain or a feeling of tightness on the outside of the | | | | weak gluteus medias. |
| thigh | | | | Other possible Causes |
| - pain on the outside of the thigh when running | | | | There are of course many other possible causes of |
| - referred pain in the buttocks/gluetial muscles | | | | runner knee injuries. In practice it is always best to |
| This condition can also affect cyclists too. There | | | | look at a global picture to identify other muscular |
| many other types of knee pain but today the focus | | | | problems. |
| is pain on the outside of the knee. | | | | - Foot biomechanical problems |
| Anatomy Lesson | | | | - Over pronation |
| To truly understand this condition we must have a | | | | - Tight psoas muscle |
| look at the anatomy of the hip and leg. The Iliotibial | | | | - Ligament damage |
| band is not a muscle so it does not contract and act | | | | - Meniscus tear |
| like a muscle but is a form of connective tissue | | | | - Excess fluid in or around the kneecap causing patella |
| known as fascia. Fascia is everywhere in the body | | | | tracking problems |
| and provides a 3d web of tissue. The easiest | | | | - Rectus femoris over tightening |
| example to think about is your skin. Your skin is a | | | | Correct Treatment |
| form of fascia, now imagine that the fascia tightens | | | | - Stretching tfl and gluteus maximus |
| in your forearm. This will constrict movement in the | | | | - Strengthening gluteus medias |
| forearm, cause flexion in the wrist and cause possible | | | | - GAIT analysis to check feet are not over pronating |
| symptoms that might be associated with carpel | | | | - Correct footwear |
| tunnel syndrome. | | | | - Core stability e.g. Pilates class |
| What commonly happens in runners knee if that the | | | | - Stop running temporally |
| muscles that attach to the iliotibial band tighten | | | | Photo Guide to self treatment see website for |
| causing the fascial band to tighten. The iliotibial band | | | | photos |
| inserts on the tibial condyle/the outside of the | | | | One of the best treatments is to use a foam roller |
| knee.(in the diagram this is labelled as gerdys | | | | to release, massage and lengthen the tensor fascia |
| tubercle). When the band tightens this causes it to | | | | latae. You only want to be using the roller from the |
| rub on the outside of the knee causing pain. One | | | | iliac crest to about a third down the leg. Use your |
| possible treatment strategy then is to focus on | | | | weight and body position to work into the muscle. |
| lengthening the gluteus maximus and tenser fascia | | | | The next foam roller exercise works into the gluteus |
| latae which both attach to the iliotibial band. By | | | | maximus. Again work into the muscle by adjusting |
| lengthening and relaxing these muscles this reduces | | | | the angle of your body position. You can increase the |
| tension in the band allowing it to return to its normal | | | | stretch on the muscle by bringing the raised knee |
| length thus reducing friction on the outside of the | | | | closer to your body. If you feel any tender points |
| knee. I have seen a lot of people treating this | | | | stop and ease into them until you feel a release. |
| condition by using foam rollers on the band. Not only | | | | This is a general exercise to work into the gluets |
| does this cause agonising pain but it's not treating the | | | | (muscles in you buttocks). Use your feet to work |
| problem because the band is long not short so if | | | | the roller up and down whilst your hands support you. |
| anything this may make it worse. | | | | Single leg raises will strengthen the gluteus medias. |
| Other Possible Causes | | | | Start with feet together and raise one leg. When |
| - Overuse. Training too much too quickly | | | | raising the leg do it slowly and using control. Equally |
| - Leg length discrepancies | | | | when lowering the leg do it very slowly |
| - Over pronation | | | | Again this is a single leg raise but the leg starts from |
| - Weak gluteus medius | | | | a 45 degree angle. This makes the leg raise harder |
| - Overtight tfl and gluteus maximus | | | | forcing the muscle to contract more. This can be |
| - Other muscular problems | | | | especially hard for people with it band problems to |
| The main culprit Gluteus medius | | | | do. |
| On average 80% of all running is done on one leg so | | | | Again this is a single leg raise but this time a fitness |
| it makes sense to test the strength of a runner | | | | band is around the legs. This provides resistance to |
| standing on one leg and training should include single | | | | the exercise forcing the gluteus medias to work |
| leg raises and strengthening exercises. | | | | harder. |
| The gluteus medius abducts the leg and helps stabilise | | | | There are other exercises which can be useful For |
| the knee and femur whilst on one leg. It also | | | | example one legged skipping may be useful. There |
| stabilises the pelvis whilst on one leg. If it is weak | | | | are other exercises that I do with clients for example |
| then this will cause the pelvis to drop. Weakness of | | | | getting them to stand on one leg whilst throwing a |
| this muscle causes excessive internal rotation which is | | | | ball at them to catch can be a fun way of strength |
| going to cause tfl and gluteus maximus to tighten to | | | | training. There are also lots of stretches you can do |
| compensate for this movement. If you consider that | | | | with a foam roller so its well worth buying one. I |
| during an average run a leg will strike the ground | | | | hope you have enjoyed the article and that it will |
| somewhere between 80 and 90 times it becomes | | | | help you get back to running. |