I’ve never felt a pain like it. The searing ache ran across the side of both knees every step I took. In more than a decade of running, I’ve managed to avoid any dreaded knee issues. Until now.
I blame three weeks of inactivity in a quarantine camp. As part of emigrating to Australia, I had to spend time isolating in a hotel room with little ability to exercise. Most of those 336 hours of captivity were spent in a sitting position.
This had cased the perfect storm of tightening hip flexors and weakened glutes. Add that to my over enthusiasm on release – doing two 15k runs back to back – and I’d given myself a serious case of iliotibial band syndrome, aka runners’ knee.
What is iliotibial band (ITB) syndrome?
The IT band runs from your pelvis to just below you knee on the outside of your thigh. When your muscles – either your gluteus medius or hip flexor – get tight or weak it can cause problems with your IT band.
You’ll notice a burning, aching sensation on the outside of your knee, where the tendon crosses the bone. It tends to come on during running or squatting exercises. While the pain might appear around the knee joint, the cause is elsewhere.
Prevention is the best cure, but the sooner you identify the issue and begin to treat it, the easier it is to cure.
The road to recovery.
In my case, I didn’t acknowledge I was developing a problem. I did the typical runner thing of ignoring the pain and trying to train through it. That’s the biggest mistake you can make. A few days rest and treatment early, can save you weeks of trouble later. Act quickly. Continued stress just makes the problem worse and could lead to runner’s knee becoming chronic.
Facing the inevitable, I began a routine of resting, stretching and massage.
Massage: No pain, no gain!
One of the most effective treatments is deep tissue massage of the tight muscles. Grab a hard ball – a cricket, hockey or physio ball will do the trick. You want to lie on the ball, targeting the hip flexor and gluteus medius. Warning: this will feel painful to start with. Spend 15 to 30 minutes a day hitting those tight spots.
This will help break up any stubborn knots. Once you’ve got deep into the muscles, you’re ready to try a few stretches.
Stretching:
I found the most effective treatment was the kneeling hip flexor stretch. Put the injured knee on the floor while placing your other leg in front – foot on the floor, knee bent 90 degrees. From this position you want to gradually drop your hip to stretch your hip flexor.
For added depth or stretch, raise the foot on your injured leg. You might be too tight at first, but as you gradually loosen the muscles, you’ll want to increase the stretch. Grab a towel or resistance band, place it around your foot and you’ll be able to pull a deeper stretch. You can also push your foot away to add isometric resistance for extra benefits.
Another great on is called the 90/90. Cross one leg in front of you, with a 90 degree bend, put your other leg to your sides gain with knee at 90, then try to raise your foot while keeping the knee on the floor. You’ll feel your hip flexor activate. Hold for 15 seconds and repeat five times. Swap legs and repeat.
You should feel a dull ache as you do this, but if you get any sharp pains then stop. Stretching can antagonise rather than alleviate an injury rather if you over do it.
Rehab and strength exercises:
While you’re in the good habit of stretching, don’t forget to add some strengthening drills. A great addition to this routine is using a resistance band to strengthen your gluteus medius.
Sit down, double loop a medium or light band, wrap it around your knees and feet, then drive your knees apart, hold this for a second or two, then relax.
Try 10 reps, time three sets. Repeat while sitting upright, leaning forward and slightly backward. The varying angles will target different areas of your muscle. Don’t underestimate how hard this can be. You should feel a deep burning sensation in your glutes if you’re doing it right.
What to avoid?
As you start to feel better, it can be tempting to get back to some hard training. Don’t! Avoid any intense running or bounding during this phase. Stick to steady, gentle jogs to loosen your legs.
Treat these runs more as a warm up to your physio and stretching activity. If you can run on soft ground – grass or off road – it will be ideal. Gradually increase the volume but not intensity. Soon you’ll find you’re running pain free.
How long did it take to fix?
Regular rest, stretching and strengthening work will soon bear results. Within a few days you should notice an easing of pain around the knee.
You might even be able to go for some gentle jogs. Your aim is to end any activity without pain. Once you’ve done 15 minutes of jogging without soreness, add another five minutes. Keep doing this until you’re back to running free.
As with any injury, try to stay positive and you should come out the other side a stronger and better athlete than before.
