Sports Medicine

Runner's knee

When endurance running becomes constant pain – Runner’s knee

Many long-distance runners, as well as cyclists, complain of pain on the outside of their knee joints. Initially, only mild pain occurs during physical exertion. If left untreated, the pain from runner's knee can become so severe that it makes running impossible and even severely impedes normal walking and climbing stairs.

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Runner's knee is a widespread pain syndrome caused by overuse of the musculoskeletal system, particularly in runners. It is triggered by a broad ligament that runs along the outer thigh from the pelvis to below the knee joint (iliotibial tract). With every movement of the knee joint, this ligament rubs against the outer bulge of the knee joint—similar to a rope rubbing against the edge of a rock. Under normal stress, this is not a problem. However, especially in long-distance runners, this friction can lead to overload and irritation of the periosteum and bursae. Pain results.

An experienced physician will make the correct diagnosis simply by questioning the patient and examining the patient. An ultrasound examination usually confirms the initial diagnosis.

Once the diagnosis has been made, a number of accompanying circumstances that influence the rubbing phenomenon in the knee joint must be clarified.

Possible triggers of iliotibial tract syndrome - runner's knee:

  • Bow legs
  • Tract shortening
  • Leg length discrepancies
  • Pelvic tilting
  • Foot deformities
  • muscular imbalances
  • muscular weaknesses

These accompanying circumstances must be clarified as precisely as possible to achieve successful treatment. In addition to the clinical examination, additional special tests may be necessary to detect minor misalignments.

The biomechanics analysis

Minor muscular imbalances, pelvic tilts, or misalignments are often invisible to the naked eye during movement. In these cases, a biomechanics test allows us to draw more accurate conclusions about the cause of the symptoms. In these tests, the patient is recorded in motion with high-speed cameras. Computer analysis then records even the smallest incorrect movements in slow motion.

These sensitive tests can be carried out in our sports laboratory at the Institute for Biomechanics and Performance Diagnostics.

The therapy

In addition to ice treatments, ointments and physical therapy, stretching exercises, muscle strengthening and insoles can lead to success.

Gymnastics for tractus stretching

To alleviate the chafing caused by the iliotibial band (the band on the outer thigh), targeted stretching is helpful. We have compiled a list of proven exercises for specifically stretching the band. Please note that these exercises should be performed slowly and with control.

Stand upright. Cross your legs. The leg you're exercising is behind you (scissor step). Make sure the knee of your back leg is tucked in. In our illustration, the left ligament is stretched. If you find yourself off balance while performing the exercise, you can also lightly support yourself with your buttocks on a wall.

Tilt your upper body toward the side you're not exercising (to the right in our illustration). You should lean to the side until you feel tension above the hip on the leg you're exercising. To increase body tension, stretch the arm on the affected side in the direction you're leaning. Hold this tension for about 10 seconds.

To further enhance the stretching effect, bend your upper body slightly forward. This will increase the tension and stretch on the iliotibial band. Hold this position for about 10 seconds.

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Lie on your side on the floor, with the side you're exercising facing down.
Place a firm roll under the leg you're exercising, about a hand's width from your hip. Alternatively, you can use a towel rolled into a roll.
Support your upper body with your hands.
Cross the leg you're not exercising and place it on the floor in front of the other leg.

Now lower your upper body toward the floor and move your upper body toward your head so that the roller is closer to your knees.
Then push your upper body toward your feet so that the roller is closer to your hips.
Roll back and forth on your tractus (lateral thigh) several times.

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Strengthening the gluteus medius - the pelvic stabilizer

Weakness of the pelvic stabilizing muscles is a common cause of iliotibial band syndrome. With this simple exercise, you can specifically strengthen the gluteus medius muscle. It is one of the most important stabilizers of the pelvis when walking.

Stand with the leg you're exercising on a step or a solid object. The leg on the side you're not exercising should be able to hang freely. For better stability, hold onto something with one hand.

Lower your pelvis on the side of the free-hanging leg, keeping both knees straight if possible.

Now lift your pelvis again. Repeat the exercise 15 times, preferably several times a day.