ITB and Runner’s Knee

ITB and Runner’s Knee

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    PHOTO CREDIT: Diana Swanevelder

    “ITB” and “Runner’s knee” can make any runner shake in their shoes. But if you know where it comes from, you can easily sidestep these injuries.

    Runner’s knee became the nickname for Patellofemoral Pain Syndrome (PFPS) because of its common occurance amongst runners. It is caused when the quadricep muscles are too weak to keep the patella (kneecap) tracking in the grooves of the femur (thigh bone). This malalignment causes friction and can be experienced as a sudden sharp or chronic dull pain. Tight calves and hamstrings, weak buttocks and flat feet also contribute to this painful condition. Pain is often felt at the centre or just below the kneecap.

    Iliotibialband Syndrome (ITBS), on the other hand, causes pain on the lateral (outside) of the knee. The ITB is a tight band that runs from the pelvis to the outside of the knee. During running repetitive bending of the knee causes irritation of the ITB over the lateral femoral condyle. Runners often complain of experiencing pain after a certain distance and running downhill. Causes of this include excessive hill training, insufficient stretching and sudden increase in mileage. Weak hip stabilisers, excessively high or low foot arches can also contribute to ITB pain.

    Stop running at the first sign of painful symptoms. Decrease the workload on the knee, avoid knee-bending activities and try to crosstrain.

    Prevent these conditions by doing knee and hip strengthening a few times per week:

    NOTE: If you have not done the previous article’s exercises, you should not attempt these before doing so. Check out the previous article.


    Lené van Heerden
    As a physiotherapist Lené works with people in all walks of life, taking part in almost any and every type of physical activity. More often than not they find themselves in more pain than what you can ever imagine. Working with these people energizes her, but it is also poses a great challenge. Through this she has learnt a lot about the prevention and management of injuries. Lené will be providing trail runners with valuable tips and techniques to avoid injuries and to enhance their performance on the trails! Trail Running is my ticket to switching off my phone, getting dirty and experiencing nature the way it was intended.