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GUIDE: RUNNER'S KNEE - Symptoms and treatment

GUIDE: RUNNER'S KNEE - Symptoms and treatment

Se Laura Nijhuis' profil
 By Laura Nijhuis

  

Injuries are a runner´s worst nightmare. If you experience sharp pain in your knee, it might be related to runner´s knee. Runner´s knee is usually caused by running, playing football or doing other sports which involves running. This article focuses on runner´s knee and provides great advice on how to treat it yourself. 

 

Runner´s knee (iliotibial band syndrome) typically cause pain on the outside of the knee joint. The pain usually stems from running but if its not treated, it can also gradually cause pain when you are walking. Runner´s knee is usually caused by intensifying your training intensity or exposing your body to increased physical activity in other ways. Fortunately its often possible to treat the injury by training muscle and tissue. 

 

This article includes the following chapters. Click on one of the headlines to proceed to the chapter you want to read. 

- HOW TO TREAT RUNNER´S KNEE YOURSELF

- MYOFASCIAL MASSAGE FOR RUNNER´S KNEE

- MOBILIZATION AND STRETCHING EXERCISES FOR RUNNER´S KNEE

- ACTIVATION AND STRENGTH TRAINING EXERCISES FOR RUNNER´S KNEE

- WHAT IS RUNNER´S KNEE?

- WHAT ARE THE SYMPTOMS OF RUNNER´S KNEE?

- WHAT CAUSES RUNNER´S KNEE?

- HOW LONG DOES RUNNER´S KNEE TAKE TO HEEL?

- HOW LONG SHOULD YOU REST/TAKE A BREAK?

- HOW TO PREVENT RUNNER´S KNEE

 

HOW TO TREAT RUNNER´S KNEE YOURSELF? 

So far there is nothing to indicate that the iliotibial band - a thick band of connecting tissue from the outside of your hip to the outside of the knee gets inflamed. Consequently anti-inflammatory drugs or painkillers won´t have any effect. Fortunately you can get rid of the pain through targeted exercises. 

You need to relax your buttocks and the muscles on the backside of your thighs as these are often overstretched. In addition you need to relax your hip flexors to help your hips return to their correct and natural position. 

In order to have a healthy running style and stay free of injury, its important that you control the stabilizing muscles in your back and core.

 

MYOFASCIAL MASSAGE FOR RUNNER´S KNEE

Myofascial massage can loosen tension on the outside of your legs. Lack of mobility/movement in your hips can cause increased weight on your knee. In order to loosen the thigh muscles by means of exercise, it will also be benefitial to work with muscles and tissue in the area around the hip. 

 

Runner´s knee - massage exercise #1:

Loosens the outer thigh 

runner's knee exercise

 

1. Lay on your side with your forearms supporting you. 

2. Lean with the outside of your thigh on a foam roller. The foam roller should be placed centrally below the outer thigh.

3. Push and pull yourself back and forth using the opposite leg and your arms. In that way the foam roller will roll along the iliotibial band and the muscles on the outside of your thigh. 

4. Make sure you lean slightly forward so you also massage the muscles during the transition between the outer and upper thigh. 

 

Time: 2-3 minutes pr. side

Set: 1

Tip: You should massage the entire length of the thigh from the knee to the pelvis. This exercise will relax the outside of your thighs. 

 

 

Runner´s knee - massage exercise #2:

Loosens the hip flexor 

runner's knee exercise

  

1. Lie on your stomach and support your upper body with your elbows. If you want, you can rest your head on the back of your hands. 

2. Place the BLACKROLL BALL 12 just above the groin between the straight abs and the upper part of your hip.

3. Slowly lower your weight on the BLACKROLL BALL 12.

4. Breathe deeply and calmly, and sink gradually into the tissue at every breath. It will loosen several sore spots along your hip flexors. 

5. Repeat this exercise a couple of times.

 

Time: 1-2 minutes pr. side

Set: 1

 

 

Runner´s knee  - massage exercise #3:

Loosens your buttocks 

runner's knee exercise

  

1. Put the BLACKROLL BALL 12 on the floor and sit with one part of your bottom on the ball.

2. Place the leg, whose bottom lays on the ball, on the thigh of the other leg.  
3. Make small movements on the ball and notice the spots where you are sore. 

4. Use around 15 seconds on the spots where you are most sore and breathe calmly and deeply. 

5. Include the sides of your bottom by moving from side to side. 

 

Time: 1-2 minutes pr. side

Set: 1

Tip: When you do the exercise, its important that you push your chest forward and the shoulders back. In this way you simultaneously train your stability in your shoulder joints and shoulder blades. If the exercise is too hard to do, you can use a foam roller instead of a ball. 

 

 

MOBILIZATION - STRETCHING EXERCISES FOR RUNNER´S KNEE 

Once you have loosened your muscles and tissue in the outer thighs, hip flexors and buttocks, you need to start working on the mobility of your muscles. You do this by means of mobility - and stretching exercises. The following exercises mobilize the connecting tissue, relax the joints and increase the blood flow in the related areas. This will make the tissue more smooth and resistant. 

 

Runner´s knee – stretching exercise #1:

Stretching the ililotibial band

runner's knee exercise

 

1. Stand up.

2. Place the BLACKROLL SUPER BAND around your foot

3. Hold on to the other end of the elastic with both hands. 

4. Slowly lie down on your back and place both legs on the floor. 

5. Use the BLACKROLL SUPER BAND to lift your leg as far up as you can. Lower your leg diagonally across your body. 

6. Use the training elastic to pull your leg deeper into the stretch and remain in this position. 

 

Time: 1-2 minutes pr. side

Set: 1

Tip: You can further mobilze the iliotibial band by making circular movements with your leg when the leg is in the end position (obliguely across the body) as well as bending and stretching the knee. 

 

Runner´s knee – stretching exercise #2:

Improves hip mobility 

runner's knee exercise

 

1. Lie on all fours.

2. Place the BLACKROLL SUPER BAND around the inside of one thigh.

3. Place the training elastic as close to your hip as possible. 

4. Place the leg with the elastic in front of you with the knee bent at an angle of 45° til 90° - depending on what feels good for you. 

5. Stretch the other leg backwards and press your pelvis (on the side of the stretched leg) down to the floor. 

Time: 1-2 minutes pr. side.

Set: 1

Tip: You can vary the exercise by changing the position of the upper body. If you lean your upper body forward, you increase the stretch on your hip. 

 

ACTIVATION - AND STRENGTH TRAINING EXERCISES FOR RUNNER´S KNEE 

An unstable pelvis causes greater strain on the iliotibial band on the outside of the thigh. Therefore its recommended that you also do targeted activation exercises in addition to classical exercises like squats and lunges. 

 

Runner´s knee - activation exercise #1:

Activates the outward rotators of the hip joint 

runner's knee exercise

 

1. Place the BLACKROLL LOOP BAND around your thighs (right above your knees).

2. Lay on your side and bend your knees to 45°. 

3. Lift the upper thigh and rotate it outward. 

4. Keep your thigh raised in up to 6 seconds and return to the starting point. 

4. Lift you buttocks up and push your hips up/forward, so your thighs and torso are in a straight line. 

5. Tighten your buttocks and keep the position for 5 seconds. 

6. Slowly lower your buttocks towards the floor again. 

7. Repeat the exercise without letting your buttocks rest on the floor. 

 

Repetitions: 10-15 

Set: 3

Tip: The hip stretch should come from your buttocks - not the lower back or your thighs. Therefore, make sure you tighten your abs. 

  

Runner´s knee – activation exercise#2: 

Activates your buttocks

runner's knee exercise

 

1. Lie on the floor

2. Place the BLACKROLL LOOP BAND around your thighs (right above the knees).

3. Bend your arms and let your arms rest along the side. 

4. Lift your buttocks up and push your hips up/forward, so your thighs and torso are in a straight line. 

5. Tighten your buttocks and keep the position for 5 seconds. 

6. Slowly lower your buttocks towards the floor again. 

7. Repeat the exercise without letting your buttocks rest on the floor. 

 

Repetitions: 10-15 

Set: 3

Tip: The hip stretch should come from your buttocks - not the lower back or your thighs. Therefore, make sure you tighten your abs. 

 

In the previous chapter we have referred to the following training tools which you can use to treat runner´s knee.  

- BLACKROLL STANDARD FOAM ROLLER

- BLACKROLL BALL 12

- BLACKROLL SUPER BAND

- BLACKROLL LOOP BAND

 

WHAT IS RUNNER´S KNEE?

The iliotibial band which is a wide and tough band of fibrous tissue runs runs from the outside of your hip to the outside of your knee  The iliotibial band stabilizes your hip and your knees and plays an important role during running.

The band goes from the top of your pelvis and runs along the outside of your thigh, across the outside of the knee and is attached to the upper part of your calf. 

The iliotibial band also connects the gluteal muscles with the hip flexor muscle, the tensor fasciae latae.

The muscles work together to stabilize the position of your legs.

If the way these muscles interact is disturbed, these physical capacities become unbalanced which can cause problems. If you have runner´s knee, it means that there is an inappropriate weight around the prominent bone point of the femur on the outside, just above the knee. This causes pain on the outside of the knee and is called "runner´s knee". 

 

WHAT ARE SYMPTOMS OF RUNNER´S KNEE? 

The symptoms are characteristic and described as sharp pains on the outside of the knee. 

Often the pain occurs after a certain number of miles. Its a sign that your knee is overloaded and that you should avoid activity to provoke the pain - at least until you have gained control over the cause of the pain. 

You might think that it will just go away if you keep running. But in terms of overload injuries, like runner´s knee, pain is a decisive alarm signal which you should take seriously.

 

NOTICE! We recommend that you consult your own doctor to be certain that there is no damage to the cartilage or other damage to the musculoskeletal system (includes bones and joints).

 

The doctor should check for: 

- Swelling

- Pain during light exertion and rest 

- Redness and heat in the affected area 

- Sharp pain when you start an activity 

 

WHAT CAUSES RUNNER´S KNEE?

Runner´s knee is more than anything a sign of overload. You have simply exposed body tissue to a load it couldn´t tolerate. Reinforcing risk factors in the development of this injury are myofascial shortenings, limited mobility, lack of strength and the lack of balance which these deficiencies cause. 

 

The following factors are frequent risk factors in relation to runner´s knee. 

- Limited mobility in the hamstring 

The gluteal muscles as well as one of the hip flexor muscles extend into the ililotibial band and provides the tension which the band needs to create stability. If the hip flexor muscle creates too much tension (e.g. due to sedentary work) the thigh will rotate inward and you will put more strain on the hip than normal. 

In addition it increases the tension on the entire illlotibial band and causes greater friction on the outside of the knee. Imagine it as a piece of string which constantly rubs against the edge of a sharp rock. Sooner or later it will cause irritation.

 

- Lack of activity as well as weakness in your buttocks 

The primary function of the gluteal muscles is to stretch the hip. Your body is completely vertical and your thighs, your pelvis and your upper body are all in a vertical line. Our gluteal muscles suffer from the fact that we sit down a lot during the day. Constant compression of the gluteal muscles (during constant seating) limits the mobilty and neuromuscular activity of the muscles. 

If the gluteal muscles are already slack, they won´t be able to maintain adequate balance with the the hip flexor muscle. 

 

Overpronation 

The movement from landing to take-off - is the foundation of a healthy running style. The "inward-roll" of the ankle in your landing/take-off is called pronation. If your feet tip excessively inward (overpronation), it can cause a chain reaction:

Your lower legs, knees and thighs will follow this inward rotating motion. The iliotibial band on the outside of your thigh will react by creating greater tension in an effort to stabilize the movement and compensate for overpronation. 

 

Bad pelvis stability

You often see people run with their lower legs strongly tilted inward. A slight inward deviation is natural and normally cause no problems. But! If your lower legs lean excessively inward it may be a sign that the muscles stabilizing your pelvis are too weak. That means the muscles are not strong enough to keep the outer thighs in a stable position. This increases pulling on the outside of the thigh and can lead to runner´s knee. 

 

HOW LONG TIME DOES RUNNER´S KNEE TAKE TO HEEL? 

With a targeted treatment you can ease pain relatively fast. You should be aware that it could take up to 6-12 months for tendons, tissue and ligaments to heal completely. Therefore its important to limit the extent of the injury as early as possible to limit the healing time. Its also important that once you start running again, you only gradually increase the intensiy and number of miles - even if don´t feel any pain anymore. 

Recovery, exercises and great running shoes are keywords during and after your rehabilitation of your runner´s knee. 

 

HOW LONG SHOULD YOU REST/TAKE A BREAK?

The length of the break is very individual. But its very important that you rest your body during the period where you are rehabilitating from the injury. If you keep irritating the area, you can delay the healing unnecessarily and you risk not getting the result from the time and energy you have put into the rehabilitation. Instead, give your body time to regain the right balance, so your runner´s knee won´t become a chronical problem. 

 

HOW TO PREVENT A RUNNER´S KNEE 

- Work on optimizing your running style.

 

- Make sure you have the right running shoes.

Its difficult to provide a solid answer to the question of which running shoes you should choose when you have a runner´s knee. Your choice of running shoes depend on a number of factors, among those the biomechanics of your body, your running style and and the amount of exercise. It might be a good idea to switch between different pairs of running shoes to vary the load you expose your body to during running. 

Read if necessary more here.

 

- Recovery. 

Listen to your body and rest it when it needs it. 

 

Exercises.

Generally the best treatment of runner´s knee is to do exercises. This applies before, during and after the injury. Exercises can prevent genes from developing into an injury, treat the injury and make the body more robust and resistant to future injuries. 

 

Is a knee brace a good idea for a runner´s knee? 

A knee brace can support the knee, help to stabilize it and relieve it. However, sometimes the pressure from a knee brace can aggravate the pain. So you have to try on different knee braces and decide which one works for you. 

NOTICE! A knee brace can only support the knee - it cannot take away pain caused by a runner´s knee. 

   

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