Running Injuries, IT Band Knee Pain

Mark: Hi, it's Mark from Remarkable Speaking. I'm here with Wil Seto, he's the owner, the chief cook and bottle washer at Insync Physio in Vancouver and in North Burnaby. And today we're going to talk about running injuries, IT band knee pain. What's this all about Wil? 

Wil: Yeah, so the weather is getting really nice here and we're starting to see people running outside and and I'm seeing a lot of more running injuries coming into clinics. A lot of our physios are seeing a lot of runners coming in. So basically what it is, is the IT band is a strong connective tissue that basically connects a lot of the muscles on the outside of the thigh. It starts actually in the hip all the way down to the outside of the knee. And what it does, it actually adds extra stability to your knee. 

Now, the problem with running and especially as you start off, like you're running season, a lot of people were training for things like the Sun Run. That's just happening. It's just coming up here this coming weekend. And just as the running, season's starting to peak here, you know, they start to overload. And so what IT band injuries are usually a more of a repetitive type of injury.

Mark: So that's just overuse training, training too hard, too soon, basically? 

Wil: That's a part of it. Yeah. That's a huge part of it. I mean, it's certainly one of the biggest factors. There's a few other things that also can contribute to it as well. But like as you put on the mileage and if you don't get enough rest and let your body recover, that certainly can lead to the overstretching of the IT band because then the muscle that attaches on to them can really pull them and cause a lot of abnormal movement patterns kind around the knee. And so then you ended up getting this knee pain on the outside of your knee, which can also lead to like a clicking sound that can happen there as well. 

Well, you basically would do a bunch of different tests. You were on obviously, like I said, the IT band is part of the knee that provides stability to the knee. And what you want to do is you want to rule out all the other ligaments and see, you know, how that is. Now if you've had a pre-existing injury then you could have these imbalances happening in your knee too. So the IT band syndrome, there's specific tests for it, for looking at different muscle tightness and how that could be pulling on it abnormally. And so essentially if those tests are positive then you're looking at the pattern of how things are moving in the knee.

Then you can determine that it is IT band syndrome. And a lot of the times you have like a few factors involved. Like I said, if it's an overuse thing, but then you may have sort of inclination with like your body type, if your feet are a little bit more flatter, which is called pronation and if you're running in shoes that are worn out, that can basically provide less support for the running and mechanics of it.

And then the other thing is also you know, the really important aspect of this is, is looking at like, are you running on a lot of flat, versus like Cambridge Services or you're doing a lot of trail running and then it's causing your knee to really buckle. And if you're doing a lot of like hill training, then you're getting your hip flexors really tight. And so then what happens is that those muscles end up being really pulled and it causes pulling out of the IT band, which then can give you the pain that you can experience the knee.

So I think the other aspect to looking at IT band injuries and knee injuries with running is how do you treat it? So one of the big things for treatment is really looking at rebalancing everything around the knee. And so part of that rebalancing is in doing things that are basically going to take the load off of it in terms of mechanics.

First thing you want to do, though, is definitely unload what's causing it to give it pain. And so if it hurts with running, then you want to basically take down your training a little bit more and let it settle down because when it's really bad, you can actually have quite a lot swelling and then you can't even walk. So you want to look at the training load and really decreasing that. And the things we talked about footwear. And then looking at recovery, are you recovering enough?

And then are you getting too much training at a high intensity and then not letting your body recover. And so the other aspect too, is we talked a little bit about if you had a preexisting injury, then you can start to compensate with like your hip flexors and some other muscles.

So then you might want to start to look at, okay, so do I have other deficits or do I have other issues that I want to address. Like, so maybe I have a weak core and I'm compensating with my hip flexors to basically stride and really push through. And that's the other issue is my stride. Am I always overstriding? So then maybe I want to look at that in terms of my running mechanics. 

So we would actually do a running mechanics. We have a treadmill that we can actually look at a bunch of different factors involved in terms of your posture and how you run. And also you know, part of that posture is like making sure that your cadence. So your cadence is like how many steps are you taking per minute? And then they've done research studies and they showed that if you're under a certain amount of steps per minute, you're actually more prone to the injuries. And so that's another factor.

Mark: If you need help with any kind of running injury, knee, or anything related to your running program, see the expert trained sports physios at Insync Physiotherapy. You can book your appointment at Or you can call the Vancouver office. They're on Cambie and King Edward. You can reach them at (604) 566-9716. Or the North Burnaby office they're on Hastings near Willingdon, at (604) 298-4878. Insync Physio. Get feeling better. Get moving right and running. Enjoy this beautiful summer we've got coming.