Ashe About Sports: Knee pain from overuse

Editor’s Note: In the latest installment of a monthly series on common sports injuries, Dr. Dena Florczyk, from the Arthur Ashe Student Health and Wellness Center, discusses knee pain stemming from overuse. 

BY DENA FLORCZYK

Iliotibial band syndrome is an overuse condition that causes pain to the outside part of the knee. The injury occurs to the iliotibial band, which is a fibrous band of tissue that originates from the hip and extends down the outer thigh, crossing the knee joint and attaching to outer side of the upper shinbone.

While most commonly seen in runners, iliotibial band syndrome can also occur in cyclists or those who participate in activities that involve repetitive bending and straightening of the legs, as when using the elliptical or stair-stepper machines at the gym.

The most common symptom of iliotibial band syndrome is an aching or burning pain on the outside of the knee that occurs with activity. There may also be pain to the outer thigh and hip.

Activity-related pain typically improves with rest but may also occur when rising from a seated position or going up and down stairs. Anatomic factors that may predispose one to developing iliotibial band syndrome include having weak hip muscles, high arches in the feet, bowed knees or a leg length discrepancy.

Training factors, such as running on sloped surfaces, excessive running in the same direction on a track, a rapid increase in exercise volume or mileage or using an improperly fitted bicycle may also contribute to the development of iliotibial band syndrome.

Initial treatment for iliotibial band syndrome includes avoiding activities and movements that make the pain worse, icing the knee for 10 to 20 minutes every four to six hours and using an over-the-counter pain medicine, such as ibuprofen (Motrin, Advil), naproxen (Aleve) or acetaminophen (Tylenol).

During recovery from iliotibial band syndrome, changing your activity to a low-impact activity, such as swimming, may be helpful to avoid worsening pain but still allow exercise.

Strengthening the muscles around the hips and core as well as working on flexibility of the hamstrings, quadriceps and iliotibial band is important. Using a foam roller is an effective way to perform myofascial release of the tissues of the iliotibial band.

Preventive measures for iliotibial band syndrome include maintaining adequate core and hip muscle strength as well as flexibility. Additional training factors that can prevent development of iliotibial band syndrome include running on even surfaces, alternating directions while running on the track, gradually increasing exercise volume and intensity and replacing running shoes at least once a year.

Finally, it may be beneficial to have an expert ensure that you are properly fit for your bicycle or evaluate your running mechanics.

You should see your health care provider if you have any knee swelling, locking or catching; feeling of instability or giving way; if pain on the outer aspect of your knee persists despite the above measures; or if you are unable to return to your previous level of activity.

Florczyk is a sports medicine physician at the Arthur Ashe Student Health and Wellness Center.

 

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