The outside of your knee hurts, especially about 10 minutes into your run. Bending seems to irritate it but you can’t figure out what is wrong. There is no bruising, no huge amount of visible inflammation, but it HURTS! What you are most likely feeling is an irritation of your IT band, also known as iliotibial band. The IT band is a thickening of the fascia that runs down the outside of the leg. It attaches to the tensor fascia latae (TFL) at the front of the hip and to part of the glute max at the back of the hip. It then runs down the outside of the leg and attaches to the outside edge of the tibia, the head of the fibula, and the patella. This band of fascia is pretty important and gives the leg some stability. It is best to not irritate it or you will find yourself not only frustrated but unable to run without pain.
IT band syndrome is often defined as localized pain on the outside of the knee when the leg is bent. The pain can be felt on the outside top of the knee or the outside bottom of the knee but is most often localized on the outside top edge of the knee.
IT band pain can be caused by poor running form, overpronation, a leg length difference, wearing worn out shoes, or wearing shoes not meant for the individual’s foot mechanics. Also running on a slanted road can cause more stress on the outside of the leg. Most often though, IT band syndrome is caused by overuse. When we fatigue, our running posture breaks down causing the legs and especially the knees to turn inward. This increases the lateral loading of the knee and the overuse causes friction between the IT band and the thigh resulting in inflammation and irritation.
So now that that is determined, what can you do to make it go away? Ice first. Ice is affordable, without side effects, and does wonders at decreasing inflammation and relieving pain. I recommend freezing water in a styrofoam cup, cut away the top so you have what looks like a popsicle and run it along the entire IT band hip to knee. Next stop is into a specialty running store. Sole Sports will take you along for a foot and gait analysis where we can visually see you run by videotaping your stride and then help you determine a proper shoe for your mechanics. You would be at great benefit to also purchase a foam roller. They can be found at all the Sole Sports stores. Lie on your side with the top of your thigh over the roller. The roller should be perpendicular to your body. Push up onto your elbow and roll the outside of your leg up and down from your hip down to just above your knee. This action will help break up adhesions that have formed and stretch the fascia.
Also beneficial would be to start or continue to do some targeted strength training focusing on hip flexors, abductors, and glutes. These three areas are found to be the weakest among runners and in reality are primary muscles in maintaining good running posture and preventing overuse injuries.
While you are rehabbing it is often ok to swim and bike as long as you don’t have pain with the activity. Regardless you should use the foam roller prior to and after exercising and an additional couple times throughout the day. Make sure to ice after all training and stay below the threshold of further irritation. It is much more sensible to take a week or two off now versus being forced to take months off down the road. Stay patient and remember setbacks are only setups for comebacks!