Runner's Knee: Not Just For Runners

As I start planning my running season and training for the San Francisco Full marathon I can't help but immediately think about my poor IT bands and runner's knees. I went on my first run of the season and my knees killed me!

First, runners' knees can be all sorts of problems form IT band issues to Patellofemoral Pain. Not all "runner's knees" are the same and you DON'T have to be a runner to get runner's knee! As always, make sure you talk to a professional before self-diagnosing yourself and performing vigorous activities.

Most knee pain occurs from lack of proper form, overuse, lack of flexibility and strength or trauma from the knee.

Let's clarify the difference between IT band issues and patellofemoral issues!

The iliotibial band (IT band) runs along the outside thigh, from the pelvis to the tibia, crossing both hip and knee joints. The IT band is important to stabilizing the structure of the lateral part of the knee as the joint flexes and extends. It's no wonder many of us have IT band issues, myself included.

IT band syndrome is an overuse injury of the connective tissues that are located on the outer thigh and knee. IT band issues are one of the most common issues among runners, cyclists, and those who squat frequently. IT issues are common but also pretty stubborn. IT band syndrome will typically cause pain on the side of the knee, especially when going downstairs and hills.

What can cause IT band issues? Inflammation, lack of flexibility and mobility, poor training habits, mechanical imbalances, and frequent use without rest.

Training Tips to Avoid IT Band Syndrome

Cyclists: Make sure your posture on the bike is correct. Make sure your shoe clips are aligned properly with no internal rotated toes. If your toes are facing in you are putting much more weight on the IT bands and it can cause inflammation and eventually give you hip/knee pains.

Runners: Make sure you are switching up your surfaces. If you are running regularly on a road that is higher on the outside edge to allow for water runoff, consider running on the other side of the road every now and then. Basically, avoid leg-length discrepancies. Running too many hills and downhill is very stressful on the IT band as it works to stabilize your knees. I know this first hand.

Other activities that can inflame your IT bands include rowing and squatting. Make sure your form is on point and never lift more than you need to. It's not always worth it!

The Difference with Patellofemoral Pain

Patellofemoral Pain is usually a pain in the front part of the knee unlike the side of the knee with your IT bands. This is more common in females and young adults. the pain and stiffness make it difficult to climb stairs, kneel down, and perform daily activities and you might experience popping or even grinding on the knee.

Patellofemoral pain increases when you run, walk, go up and downstairs, sit for long periods of time, or squat. This type of pain can occur when the muscle around your hip and knee don't keep your kneecap properly aligned. Inward movement of the knee during squats can also be associated with patellofemoral pain. Other causes include previous knee surgery, muscle imbalances, trauma to the knee, and overuse.

Prevention and Care For Knee Pain

• Stretch and work on your flexibility in lower back, hips, knees, and leg muscles to avoid reoccurrence of IT Band issues.

• Good ole' RICE!- Rest, Ice, Compression, and Elevation!!

• Practice good form

• Get fitted for the right sneakers/shoes for your specific sport

• Foam roll

• Gradually increase training

• Stay in shape (if you're overweight it adds more stress on your joints)

• Warm-up properly

• Think about your alignment and technique regularly.

I don't usually recommend friends to take a pain reliever medicine before or during exercise because you won't be able to listen to your body if you are overusing your joints. Pain relievers should be taken on rest days to help with inflammation and pain not during training or on race day!