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  • Writer's pictureJonathan Martin

Iliotibial Band Syndrome (Lateral Knee Pain / Pain to outside of knee/ Runner’s Knee)

Sometimes the term Runner’s Knee is used to describe iliotibial band syndrome and sometimes it is used to describe other knee pain.

ITB syndrome

What causes it?

Well running generally triggers it. However it is not simply down to running. It in my experience is most commonly triggered when a lot of running is done on heavily cambered surfaces such as at the edge of a road rather than on the pavement. Or for the locals much of the Clacton-on-Sea lower promenade particularly the section from the pier to the Eastcliffe Café. The repetitive stress of the knee being forced laterally by the camber makes the ITB, TFL and Glute muscles work very hard to stabilize the knee joint. This leads to excessive tension in the ITB and creating friction and inflammation as the tendon passes over the outside of the knee joint (lateral epicondyle). Please note that there are currently some different theories of the exact mechanisms by which the pain is actually caused. However I believe the triggers are the same.

Shoes – it isn’t just surface camber that can trigger this pain. I have seen a small number of cases where shoes have been the cause generally the individual has purchased a new pair of shoes which have had too much stability control for that individuals running style. As the person’s foot tries to pronate naturally the arch support in the shoe prevents this from happening and causes the runner to supinate which farces the tibia laterally in relation to the femur as with the camber.

What action can I take?

Firstly it is a good idea to get the injury assessed by a physiotherapist or sports massage therapist they will normally perform massage on the legs including some rather painful techniques called stripping and trigger pointing to the ITB. At this point you need to think ‘short term pain for long term gain’ and remember this as it will only last a short time and will give you long term relief. You can try to self-treat through foam rolling the ITB and stretching the Glute muscles. Ice the specific point and give it a week’s rest from running, you can swim or cycle in the meantime if you wish.

Now you need to try to eliminate the root cause of the problem. If the pain came on after buying a new pair of shoes within the last month or so, then try running in an old pair. If you are running a lot on cambered surfaces try to run on flatter grass surfaces. If the symptoms return then you may need to work with someone like myself to analyse your movement to look at any other factors behind the reason for your pain. There are also stretches you can do to help prevent the possible return of symptoms. See the picture below.

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