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Cheltenham, Runners and knee pain

Stuart Fossella - Wednesday, March 06, 2013 | Comments (0)
Posted 6 years ago
The Iliotibial Band

The Week in Review-Iliotibial Band Syndrome

This last couple of weeks I have mentioned that there are a fair few runners coming to clinic. Of course it is the time of year when marathon runners are upping mileage and covering serious distances, after all there is only 6 weeks until the Virgin London event kicks off.

With an increase in training I’m noticing a fair few athlete’s coming through with ‘ITB Syndrome.’ Or in simple terms pain felt at the outside of the knee whilst running, cycling or simply walking.

The Iliotibial Band is a thick piece of tissue that runs along the outside edge of the thighbone. It originates at the pelvis and ultimately blends into the Patella or kneecap and shinbone. The ITB indirectly also has a close relationship with the Gluteal muscles, gathering most of the Gluteus Maximus-which we also tend to find to be tight in those suffering with ITB Syndrome.

It’s important to screen a patient thoroughly in a first assessment, as a good assessment will provide the basis for understanding why someone has ended up in the injured state.

At the assessment stage of a consultation a client has generally given you a great understanding as to what the issue is in running, and through clever questioning we will have a better idea why they may be suffering from ITB symptoms.

The causes of ITB syndrome can be categorised as being either Intrinsic and related to the runner: i.e. tight soft tissues, poor flexibility, poor strength, flat feet etc etc.

The other category, extrinsic is related to factors hopefully under the control of the runner: i.e. training volume, training surface, running style and selection of running shoes etc etc

So what are we finding in clinic? Some clients are coming in complaining of pain at the outside of the knee after increasing mileage. In one case after changing running shoes, others because on paper they are over training and under resting.

So what about the client who changed running shoes, increased mileage, is supplementing running with spin, gym work and team based sports...Gait analysis highlighted the clients over pronation or rolling in of the rear foot following heel strike on the affected limb. “So what” I hear you ask. Well…

Remember, running is essentially hopping from one leg to the next in a balanced manner. So over pronation at heel strike in the running gait is not running with good form. This actually causes the shin bone to turn inwards, causing the thigh bone to counter rotate in an outwards direction. This has the knock on effect of causing a torquing, stretching and shearing of the ITB on the bony outside of the thighbone. This understandably might cause inflammation to the ITB during a 15 mile run!

Combine this with tight gluts, thighs, calves and poor hip control in a single leg dip (possibly a symptom or a cause of the ITB syndrome), and you can see how much trouble someone can find himself or herself in trouble and pain.

In order to minimise the risk of developing running injures get over to our buddy Pete and his team at Up & Running and get your natural running style analysed on video so you can be advised which runners are best suited to you Pete and the team.

So…Remember the little ditty you learnt as a kid…The foot bone is connected to the ankle bone, the ankle bone is connected to the leg bone, the leg bones connected to the hip bone…Well it rings true and can be the cause of problems ‘up-stream’ and ‘down-stream’ of your injury and the perceived problem!

Don’t just treat the symptom, treat the cause. Book in now for your Physio assessment and let us get you going again. Straight back to sport, work or just a regular pain free life style Book an appointment.


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