Jumpers / Runners Knee

What is a runner's knee?

A runner's knee is a form of overuse injury in which irritation occurs on the outside of the knee. Between the hip and the outside of the knee, two muscles run into a tendon plate that runs along the upper leg to the knee and attaches to the outside of the lower leg with a tendon. Just before the attachment to the outside of the lower leg, the tendon can 'run into' a protruding point on the outside of the knee. If this continues for a long time, irritation can occur at that point, which causes pain. Because this injury often occurs in runners, the name runner's knee has arisen, but this gives a distorted picture, because there are many other sports and causes that can cause this injury. Other names for this are tractus iliotibialis friction syndrome or iliotibial friction syndrome.

Causes of a runner's knee

There are several causes that can lead to runner's knee. First of all, people with so-called bow legs are more likely to develop these complaints, because the tendon has to go around a kind of bend. This puts more tension on the tendon, which increases the chance of friction at the irritation point on the outside of the knee. Shortened muscles on the outside of the thigh can also cause more friction due to an increase in tension in that area. Weakness of the gluteal muscles and thigh muscles on the outside of the knee can lead to less control during the landing phase of running, causing the knee to tend to move inwards a bit more. This also increases the tension in this area. The tractus iliotibialis friction syndrome can also be caused by a difference in leg length or by a deviation in the position of the foot. In addition, worn or bad footwear is also one of the possible causes.

Signs & Symptoms of Runner's Knee

With a runner's knee, knee complaints mainly occur during running and/or climbing stairs, pain complaints on the outside of the knee. This pain complaints can extend to the top of the lower leg. Usually the pain consists of a dull to sharp, stabbing pain. Often the complaints arise during running and progressively increase. In the beginning, one can usually continue running for a relatively long time, but the pain complaints will occur earlier and earlier. The pain can also occur after running or even the next day and one also has problems when climbing stairs, for example.

Iliotibial tract friction syndrome can be divided into three stages:

Stage I: The pain is felt after exertion

Stage II: the pain occurs during exertion

Stage III: The pain is constant and training is no longer possible.

How is runner's knee diagnosed?

Based on an interview, the complaints of a runner's knee may already come to the fore. In addition, the diagnosis can be established with additional physical examination. The pain is also often easy to identify and there are specific tests that can provoke the complaints. If necessary, ultrasound can confirm the diagnosis, but this is often not necessary because of the clear image.

What is the prognosis?

With adequate treatment, the prognosis of a runner's knee is favorable and it can simply recover completely. The earlier one is there, the better the prognosis. In addition, the cause must also be looked at to prevent a recurrence.

Treatment of a runner's knee

The treatment of the tractus iliotibialis friction syndrome depends very much on the stage in which it is present. In the acute phase, it is important to take sufficient rest so that the affected tendon can recover. Often, cooling with ice is also used when there is inflammation. Once this inflammatory phase is over, some form of rest must still be maintained, but this does not mean that nothing at all may be done. Sports within the pain threshold is allowed, but running is not recommended in the beginning. In addition, exercise therapy and a bit of massage/frictions in the tendon area are often discussed.

Overload can also cause so-called trigger points in the muscles, which can cause extra tension in the tendon area. As a result, a part of the treatment can also be trigger point therapy and/or dry needling therapy. As you will notice, the treatment of this injury can be very broad and this will also be necessary to prevent recurring complaints. Often it is not enough to remove the symptoms and only promote the recovery of the tendon and surrounding muscles. The cause of the development of this complaint must be examined further. As a result, the treatment can differ greatly per person and per phase. It is important to contact a physiotherapist to start a good treatment plan.

What are other treatment options?

• Massage/frictions
• Medical taping
• Triggerpointtherapie
• Dry needling
• Information and advice
• Active exercise therapy
• Shockwave therapie
• Stretching exercises