Iliotibial Band Syndrome (ITBS)

ITB syndrome is an overuse injury that occurs when the iliotibial band near the knee rubs over the bone, epicondyle, on the outside of the knee joint causing friction, pain and inflammation. The cause of iliotibial band syndrome can be anywhere from the hip to the knee with the iliotibial band attached to both the hip and the knee. Certain factors may make you more susceptible to developing iliotibial band syndrome. Weakness in hip abduction (moving the leg out sideways) and hip rotators are common contributors to ITBS. Over pronation, excessive supination, or poor foot biomechanics may also increase the risk of injury. If the foot rolls in or out, the leg rotates increasing the chance of friction on the band. Other factors include tight tissues in your hips or along the side of your leg, poor running form, leg length differences, running on hills especially downhill or on cambered roads, wearing worn-out shoes, running too many track workouts in the same direction, or simply running too many miles. Unlike many overuse injuries, however, IT band pain afflicts seasoned runners almost as much as beginners. The epicentre of iliotibial band pain is always on the outside of the knee. It comes on at a certain time into a run and gradually gets worse until often the runner has to stop. After a period of rest the pain may go away, only to return when running starts again. Pain may be felt when bending and straightening the knee which may be made worse by pressing in at the side of the knee over the sore part. Tender trigger points in the gluteal muscles or buttocks area may also be present.

Here are some steps you can take to prevent iliotibial band syndrome:

  • Decrease your mileage or take a few days off if you feel pain on the outside of your knee.
  • Strengthen, strengthen, strengthen your hip and glute musculature
  • Foam roll your glutes, quads, hamstrings, and IT band
  • Replace your running shoes more frequently than you think
  • When road running, try to run where it is the flattest, but safest.
  • When running on a track, change directions repeatedly.
  • Attain a video gait analysis to determine if your running form is contributing to your pain

Patellofemoral Pain Syndrome (Runner’s Knee)

Patellofemoral pain syndrome is a condition characterized by knee pain ranging from severe to mild discomfort originating from the contact of the back of the patella (kneecap) with the femur (thigh bone). When the muscles around your hip and knee don’t keep your patella aligned properly, the back of the patella can rub on the femur creating pain. It is caused by imbalances in the forces controlling patellar tracking during knee flexion and extension, particularly with overloading of the joint. Typical symptoms can be variable and generalized, but the pain usually dominates around the kneecap and can be uncomfortable while sitting with bent knees or when descending/ascending stairs. Onset can be gradual or the result of a single incident and is often caused by a change in training regime that includes dramatic increases in training time, distance or intensity. It can be compounded by muscle imbalances with tight quads and weak hips, wearing the wrong type of footwear, or poor running form.

Here are some steps you can take to prevent patellofemoral pain syndrome:

  • Stretch your quads and foam roll your quads and IT band
  • Strengthen your hips and glutes
  • Assess your shoe wear and running form with a gait specialist

Achilles Tendonitis (Achilles Tendinopathy or Achilles Tendinosis)

Achilles tendonitis is an overuse injury causing pain, inflammation and or degeneration of the achilles tendon at the back of the ankle. The achilles tendon is a large tendon that connects the big calf muscles at the back of the lower leg to the foot and inserts at the back of the heel or calcaneus bone. It provides the power in the push off phase of running where huge forces are transmitted through the achilles tendon. Symptoms consist of pain and stiffness at the back of the ankle which may have come on gradually over time and often be worse first thing in the morning. It may improve slightly with initial activity, but becomes worse with further activity. Achilles tendonitis can be either acute or chronic. Acute tendonitis is usually more painful and of recent onset. Chronic injuries will have come on gradually and over weeks or may follow an acute injury that is not treated properly. Chronic injuries do not not necessarily prevent activity but can affect performance. Achilles tendinitis occurs most commonly in men and with age. A flat or high arch in your foot with tight calf muscles, running in the wrong shoe for your foot type, on hilly terrain, and in colder weather can increase your risk of achilles tendinitis.

Here are a few tips to prevent achilles tendonitis:

  • Warm up first by running at a slower pace
  • Choose appropriate running shoes for your foot type and terrain
  • Mobilize your calf and foot muscles with a rolling pin and golf ball respectively
  • Stretch your calf muscles with both a straight and bent knee after exercise to maintain flexibility
  • Eccentrically strengthen your calf musculature