How to prevent and treat runner’s knee (IT Band Syndrome)

Runner’s Knee, or IT Band Syndrome, is one of the most common types of running injury. But what is it, how is it treated, and how can you prevent it?

I was at a work event, about to carry a tray of teas and coffees upstairs when I felt a sharp, shooting pain in my right knee. The pain was so intense I thought my knee was about to give way. I shouted for a colleague to grab the hot drinks, then I hobbled off to call a physio.

I was in a lot of pain. It was mainly my right knee, just below my kneecap, but the left knee was also sore. When I tried to go up and down stairs or hills, the pain was unbearable.

I was worried I’d done some real damage. It certainly felt like it.

A few days later I was diagnosed with Runner’s Knee. Thankfully the physio said that with rehabilitation I could make a full recovery, but it would take time. What surprised me was that my injury was not caused because I was running too much, but because I was weak.

I’d not been running more than a few miles a week. I’d spent the previous 18 months sitting down for long hours at work, sitting down to commute 300-miles a week and sitting down to write my book. I’d not done much exercise at all. That was the problem. I’d lost all my strength and fitness, so when I started to run again my body wasn’t strong enough to cope.

The injury started as a dull ache in my knee. I ignored it. I was far too excited to be back running to think that it was anything other than a niggle. As soon as I got back into full fitness, I told myself, it would disappear, but it didn’t. It got much worse.

It got so bad I was struggling to walk. I couldn’t ignore it any more. I had to face up to the fact that I needed to address the root cause of the injury.

What is Runner’s Knee?

If you have suffered with Runner’s Knee you will know the painful, sharp, shooting pain slightly above or below the kneecap. The pain can intensify when you are walking up or downhill and up and down stairs.

What causes Runner’s Knee?

Overuse is one of the main causes. You can be at risk of Runner’s Knee if you are increasing your mileage and doing too much too soon. It can also be caused by poor running form and poor core strength. Or, like me, a combination of all three.

What to do if you experience knee pain?

Don’t ignore it. Don’t think it will go away with time. See a physiotherapist before the problem gets any worse. By the time I hobbled into the physio clinic I was convinced I’d seriously damaged my knee. Thankfully, I hadn’t but if only I’d seen her sooner, my recovery and rehabilitation would have been quicker. If you experience knee pain, rest. Don’t keep running. Listen to your body and seek professional help.

See a physiotherapist
The first thing my physio did was to check my knees to make sure there was no permanent damage. She then treated the knee injury through mobilisation of the kneecap and massage of the iliotibial (IT) band, which runs from the top of the pelvis to the shin bone. The tightening of this causes the knee pain.

Don’t neglect strength exercises
Doing regular strength exercises will improve your running form and stabilise your body to be able to cope with the running movement. I started with the basic squat and bridge to strengthen my glute muscles. Read my blog post about strength exercises for runners here.

Work on your core strength
Core muscles are so important when you are running. A strong core helps with stability, posture, balance and control during the running movement. A strong core prevents rotation and the wasting of energy, which will help you to run faster. I introduced a weekly Pilates class into my programme and could not believe the difference this made.

After a few weeks of strength work, the knee pain has gone. I’ve also noticed a huge difference in my running. I feel stronger and I’m moving more efficiently.

Don’t be afraid to go back to basics
I wanted to get back to fitness quickly, doing the sessions and amount of training that I used to, but my body couldn’t cope. The injury was a warning that I needed to take things slower. I decided to go back to basics, incorporating a strength training programme with running and spinning. I kept my mileage low. I accepted that I needed to take my time.

Work on your running technique
Think about your posture and technique when you are running. Start introducing drills into your workouts to improve your running action.

Increase your mileage gradually
Doing too much too soon is how many runners get injured. Your body needs time to adapt to the demands you are placing on it.

Don’t neglect stretches
Stretching increases the range of movement, improves flexibility and helps increase mobility in the joints and muscles. Stretch after a session, not before, and incorporate a separate flexibility session into your programme.

Suffering with Runner’s Knee is frustrating, but regular strength work will help alleviate the problem and prevent it from re-occurring. I learned the hard way. Hopefully, you won’t have to.

Here’s the link to the strength blog again Seven strength exercises to improve your running.

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