A REALISTIC APPROACH TO RUNNERS KNEE
One of the top injuries that affects both runners (22%) and cyclists (15%) is Iliotibial Band Syndrome, also known as ITBS. The Iliotibial Band is a thick band of tissue that runs along the outside of the leg, from the hip to the knee. Together with the quadriceps, the band provides stability to the outside knee joint when you move.
The pain associated with ITBS typically occurs on the outside of the knee, thigh or hip and may be more noticeable when you’re walking down stairs or when you stand up from a sitting position. You may start to feel ITBS pain in the middle or at the end of a run.
As a sports specific chiropractor with a great deal of experience treating running athletes, I can say that it is usually a combination of multiple factors that lead to this frustrating condition. Possible causes of ITBS include:
ITBS is considered an overuse injury that is common among runners who run the same route all the time or the same way around a track. We all have our favorite footpaths to run. However, running paths that are crowned or sloped will force the pelvis to tilt down in favor of the lower side of the path. The same occurs if you perform a lot of work on a track. The outside leg consistently takes a longer stride which also causes the pelvis to drop, stressing the iliotibial band.
Short leg (Unequal leg lengths)
If a runner has one leg shorter than the other, it is reasonable to see that the pelvis will drop on the side of the short leg. In runners more than cyclists, the short leg will also be the side taking a longer stride.
Imagine running with one shoe on and one shoe off, which side is covering the most distance? The one without the shoe. This can be found during a gait assessment performed by your Chiropractor. However, it is possible to visually recognize a leg deficit in runners that have larger calf muscles on one side compared to the other. Usually the leg with larger calf muscles is the short leg side because the athlete is subconsciously running more on their forefoot trying to compensate for the leg deficiency.
Flat feet (Over pronators)
Over pronators (aka flat feet), even in mild cases, occur when the arches drop and feet fall in. This causes the tibia (shin bone) to rotate medially and thereby the thigh bone follows suit. Now our entire lower extremity is rotated inward which twists the IT-Band into a lengthened position, leading to pain and occasionally presents with a snapping sound or feeling at the hip or knee joint.
Weakened glutei and/or quads
Inactive gluteal muscles are almost always present when dealing with this condition. The glutes have many functions, one of which is abduction of the hip. This means raising the leg laterally, away from the body. If the gluteus medius muscle groups are weak or inactivated during running, it will allow the pelvis to drop in relation to the hip rather that abducting the hip itself. Whether from weak glutes, over pronation or a short leg, the side that the hip is dropping on will elevate the contralateral (opposite) hip by default. This is where the increase in tension occurs to the IT-Band (as depicted by the photo).
How do I avoid ITBS?
Here are some tips that may help avoid Iliotibial Band Syndrome:
• Incorporate foam rolling into your routine
• Speak to a qualified Chiropractor and learn how to incorporate proper stretches and strengthening exercises before you go out on a run or cycle
• Have your running or cycling form evaluated by an expert who specializes in biomechanics
• If you’ve been told by an expert that you tend to over pronate when you run, look into custom-made orthotics
Photo courtesy of John Davis via RunnersConnect
I think I have ITBS. What should I do now?
Schedule an appointment with your Chiropractor to discuss your treatment options. Be sure to specify your health and training goals. Also look for a chiropractor who specializes in athletics and extremity work.
The regular consideration for overuse injuries is to stop performing whatever it is that’s causing the irritation. The old adage, “if it hurts, don’t do it” is something that doesn’t bode well with athletes. As an athlete myself, I understand the mental effects of withholding from one’s passions. I try to treat my patients while they continue their activities or at least with minimal down time. There are a variety of natural treatments and therapies I utilize to get my patients back on their feet and out on the road.
Helping you hit the pavement pain free,
—Dr. Kory Johnson, DC, LMT
Dr. Kory Johnson is a Chiropractor at Douglas Chiropractic and Rapid Rehab in Miramar and Lauderhill Florida. He specializes in preventing and treating athletic injuries, auto accidents and personal injury using a variety of non-invasive techniques. You can learn more about Dr. Johnson at www.douglaschiropractic.com or schedule an appointment with him by calling 877.777.8040