ILIOTIBIAL BAND FRICTION SYNDROME
Iliotibial Band Friction Syndrome refers to inflammation caused rubbing of this band of tissue as it passes over a bony bump on the outside of the knee joint. The iliotibial band is a band of strong connective tissue which runs from the pelvic bone down the outside of the thigh to the top of the shin bone. Wear-and-tear of the band can develop as it flicks over the bony bump.
Symptoms associated with Iliotibial Band Friction Syndrome include:
- pain with activities which involve repeated bending and straightening of the knee such as downhill running and cycling
- dull ache down the side of the knee which appears near the end of a session and dimishes as you stop
- ‘creeky’ knees
There are a number or reasons why the band rubs on the outside of the knee and causes inflammation:
- recent change in training (including frequency, duration, intensity, training surfaces, reduced recovery)
- tight iliotibial band and other muscles
- excessive over-pronation (flatterning of the feet)
- inappropriate footwear
Initially Iliotibial Band Friction Syndrome is treated conservatively by addressing the causes, which put stress on the tendon. This is achieved by stopping the above training errors. Poor foot posture and function are corrected via customized prescription orthoses and appropriate footwear. Tight muscles, most importantly the iliotibial band will be identified and a stretching program will be instituted. Referral to a physiotherapist is necessary so a strengthening and massage program of the Iliotibial band. Conservative treatment is usually very successful, however there are cases where it fails and a corticosteroid injection may be necessary and surgery is always the last resort.
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PATELLOFEMORAL SYNDROME
Patellofemoral Syndrome is an irritation of the knee cap against the underlying bony structure underneath, namely the femur (thigh bone). The amount of irritation can range from mild inflammation to bony changes to the opposing joint surfaces.
Symptoms associated with a patellofemoral syndrome include:
- vague, non-specific pain around the whole knee joint
- pain during squatting and running (more so up and down hill and stairs)
- mild swelling
- occasional creeks, clicks and clunks
Typically, the knee-cap maltracks to the outside of the knee causing it to rub on the edges of the femoral grooves.
There are a number or reasons why the knee-cap constantly irritates the underlying knee joint.
- excessive over-pronation (flatterning of the feet)
- malalignment of the knees (knock knees and bow knees)
- tight and weak muscles around the knee (quadriceps, hamstrings, iliotibial band)
- poor postural stability at hip and pelvis level
- training errors (increased intensity, workload and slope running)
- poor footwear
Initially patellofemoral syndrome is treated conservatively. This is achieved by addressing the causes. Prescription of stretching, stabilization and strengthening of specific tight and weak muscles is usually coordinated by the physiotherapist and podiatrist. The major cause, namely malalignment of lower limb due to feet rolling in too much is controlled via customized orthotic devices and appropriate footwear. In 85% of cases, podiatry and physiotherapy is sufficient to alleviate symptoms. After this, your physiotherapist will coordinate are several other options available for example massage and as a last resort, surgery.
