ITBS vs Runner's Knee: Understanding the Basics

I have seen several posts regarding knee pain so I thought maybe you would all appreciate a little free medical advice. The two most common knee pain/discomfort are IT band and patellofemoral tracking issues.

IT band pain is very common among runners and the pain is found on the outside of the knee. The iliotibial band is a thick band of fascia on the lateral aspect of the knee, extending from the outside of the pelvis, over the hip and knee, and inserting just below the knee. The band is crucial to stabilizing the knee during running, as it moves from behind the femur to the front of the femur during activity. The continual rubbing of the band over the lateral femoral epicondyle, combined with the repeated flexion and extension of the knee during running may cause the area to become inflamed. Pain is usually felt when the foot strikes the ground. Pain can pain be felt during or can intensify after activity or a few days after. For runners specifically, neuromuscular/gait training may be needed for success in muscular training interventions to ensure that those trained muscles are used properly in the mechanics of running. Strength training alone will not result in decrease in pain due to ITBS, however, gait training, on its own can result in running form modification that reduces the prevalence of risk factors.

Patellofemoral tracking aka runners' knees results from problems with the kneecap and femur. Pain may worsen with sitting, excessive use, or climbing and going down the stairs. The most common symptom is diffuse vague pain around the kneecap and localized pain focused behind the kneecap. The pain is usually achy and sometimes sharp. And you could experience the feeling of “giving way of the knee” with this condition as well. When looking at treatment other than rest and ice, we look at strengthening the quad muscle because in many cases it is weak. Specifically the vastus medialis muscles also known as your VMO. There’s an imbalance here between the four muscles that make up the quad which is why a majority of time strengthening the VMO will make the most difference. Other muscles that may aid in correcting the problem are - hip abductor, extensor and external rotator muscles. The final piece to assisting individuals who do suffer with this condition is looking at the biomechanics when running. A majority of individuals who have patellofemoral tracking issues are overpronators. This is where getting fitted properly for sneakers is so important and having customized insoles to help maintain proper balance between the foot/ankle & knee.

I hope everyone finds this information helpful and educational as that’s its purpose. Happy running everyon

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