What’s The Difference Between IT Band Syndrome and Runner’s Knee
The two most common injuries that affect runners are IT Band Syndrome and Runner’s Knee (or Patellofemoral Pain). While they’re similar, they are not the same and it’s crucial that you get the right diagnosis before starting a treatment plan.
So, here’s how to tell whether you have IT Band Syndrome or Runner’s Knee.
Where Is The Pain?
The easiest way to distinguish between IT Band Syndrome and Runner’s Knee is by the location of the pain.
Pain at the front of the knee, around or behind the kneecap is typical of Runner’s Knee (patellofemoral pain).
IT Band Syndrome pain, on the other hand, is more lateral, along the outside of the knee and partially up the thigh.
Both IT Band Syndrome and Runner’s Knee are localized to a relatively small area. It’s uncommon for either condition to refer pain elsewhere, such as further down the leg toward the foot, or up towards the groin.
IT Band Syndrome
- Hurts to press around the outside of the knee
- No pain when pressing down or around the kneecap
- Pain gets worse going downstairs and downhill
- Pain improves with rest
- Pain worsens when running but remains local to the outside of the knee
- No clicking, snapping, or creaking when moving the knee
- Hurts to press down and around the kneecap
- No pain when pressing the side of the knee
- Pain gets worse going upstairs and uphill
- Pain increases when doing a deep squat or sitting cross-legged
- Pain worsens when running but remains around the kneecap
- You get some creaking noises when bending the knee (*not in all cases)
What Causes IT Band Syndrome and Runner’s Knee?
The cause of both IT Band Syndrome and Runner’s Knee is overuse – doing too much, too soon, too frequently.
While running isn’t inherently bad for you, it is demanding on your joints, tendons, and ligaments. If your body isn’t strong or conditioned enough to handle the physical stress that comes with long-distance running, you will likely develop an injury.
Knees are a common area of injury for runners because they absorb the greatest amount of force when landing. Long-distance running is also incredibly repetitive so those landing forces go through the knees over and over again with each step. Eventually, if the knees aren’t used to dealing with that amount of repetitive stress, they will develop areas of inflammation – irritated tissues that can no longer handle the strain. Depending on where the greatest amount of stress is or where the weakest points are (either the front or the side of the knee), the tissues under that area will get injured, causing either IT Band Syndrome or Runner’s Knee.
Other than a general lack of conditioning, or preparedness, for that specific amount of long-distance running, muscle weakness is also a significant cause of both IT Band Syndrome and Runner’s Knee.
Weakness around the hips, particularly in the glute medius, glute minimus and TFL muscles are typical in runners with IT Band Syndrome and Runner’s Knee. These muscle weaknesses cause runners to land heavier with less stability, inevitably resulting in an increase in load (stress) throughout the knee joint.
What To Do Next
If you’re having trouble identifying and managing your injury, a Physiotherapist should be your first stop. They will perform a thorough assessment, look at your movement, test your muscles and help you create a plan to fix the injury.
Some people will need to take a complete break from running, while others will be able to just reduce the number of miles they run. This depends on the severity of the injury and for how long it’s been a problem. The purpose of rest (or activity reduction) is to stop aggravating the injured area and allow the inflammation to settle down.
However, the most important thing to address is the root cause of the injury – specifically muscle weaknesses and body conditioning. Anyone dealing with IT Band Syndrome or Runner’s Knee should complete a comprehensive exercise rehabilitation program before resuming an intense running routine.
RELATED: 8-week rehab programs – Physio exercises you can do at home
Brown et al. 2019, Hip Muscle Response To A Fatiguing Run in Females with Iliotibial Band Syndrome, Human Movement Science, 64, pp 181-190
Balachandar et al. 2019, Iliotibial Band Friction Syndrome: A Systemic Review and Meta-Analysis to Evaluate Lower Limb Biomechanics and Conservative Treatment, Muscles, Ligaments and Tendons Journal, 9(2), pp 181-193
Aderem & Louw 2015, Biomechanical Risk Factors Associated with Iliotibial Band Syndrome in Runners: A Systematic Review, BMC Musculoskeletal Disorders, 16(356)
Gulati et al. 2018, Current Clinical Radiological, and Treatment Perspectives of Patellofemoral Pain Syndrome, British Journal of Radiology, 91, p.1086
Dutton et al. 2016, Patellofemoral Pain, Physical Medicine and Rehabilitation Clinics in North America, 27, p. 31-52
Dye. S 2005, The Pathophysiology of Patellofemoral Pain, Clinical Orthopedics and Related Research, 436, p. 100-110
ABOUT ALINA KENNEDY
Alina is an Australian Physiotherapist, Strength & Conditioning Specialist and avid runner. She works exclusively with runners in injury rehabilitation, prevention and performance improvement. Learn More Here