Runner's Knee: Iliotibial Band Friction Syndrome

Patient

Q: Ok im 32 yrs old and recently starting jogging and working out, and just the other day i went for a mile jog, my knee didnt hurt then but the next morning i could not stand on it, it felt as if my knee was going to give out.. its been 4 dys since it first starting hurting, ive been putting ice on it threw out the day but nothing.. its my left knee and its a lil swollen to the right side of it, and it only hurts in that area.. also dont know if this means anything, but if kinda feels as ifit wants to pop or something could be somewhat serious?

Doctor

A:   Iliotibial band friction syndrome (ITBFS) is a common cause of lateral knee pain, particularly among runners, military personnel, and cyclists. It is considered an overuse syndrome that usually is treated successfully with a conservative measures. Iliotibial band friction syndrome (ITBFS) typically is observed in people who exercise vigorously. The overuse creates stress that the body cannot repair, and soft tissue breakdown occurs. In runners, friction occurs near or just after foot strike during the contact phase of the gait cycle. Downhill running reduces the knee flexion angle and can aggravate ITBFS, while sprinting and fast running increase the knee flexion angle and are less likely to cause the syndrome. Biomechanical and training factors play a large role in the development of ITBFS. The basic principles of treatment include control of inflammation, modification of activity, and correction of underlying problems. Medical therapy: Medical therapy consists of non steroidal anti-inflammatory drugs (“motrin”, “aleve”) with adjunctive physical therapy. These drugs reduce the inflammation in the soft tissue. Analgesics, such as acetaminophen or codeine preparations, can be used in persons with functional disability. Injection of corticosteroid can be used when conservative attempts to control inflammation fail or swelling persists for more than 3 days. Activity modification: Examine recent changes in training, such as duration and intensity of exercise. Curtail activity to a level at which pain is not generated. Local ice massage: Apply to the region of inflammation near lateral femoral condyle for no longer than 15 minutes. Ice compresses or cold packs can be used for 20 minutes. Conservative therapy is successful in most persons with ITBFS. When conservative therapy does not resolve the pain, surgery may be indicated. Conservative therapy should be employed for 3 months before surgery, but most patients for whom surgery is necessary have had symptoms for more than 9 months.
 

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