There are two types of Runners Knee – IlioTibial Band Sydrome (ITBS) and Patella-Femoral Tracking Syndrome (PFTS). Both may be due to too much twisting of the knee as a result of collapse of the foot arch. Chiropractic orthotics can help to control excessive arch collapse and help this condition to heal.
The iliotibial band (ITB) is a very long tendon extending from the hip dwon to the outside of the knee. The ITB spans the length of the upper leg, crosses the knee and attaches below it. The contraction of this muscle controls the movements of both the hip and the knee, stabilising them during walking and running.
Injury to this tendon is very common in long distance walkers / runners and tennis or squash players. Common triggers of injury include radical changes to the intensity, frequency or duration of activity and/or changes in the surface. And in such cases most people will respond to physiotherapy.
However, if the condition proves does not respond to treatment, or keeps coming back, an underlying biomechanical problem is the likely culprit. Abnormal foot mechanics are often to blame: over-pronation followed by twisting of the tibia causes the ITB to pull away from its attachments on the outside of the tibia, causing strain, irritation and ultimately pain or dysfunction.
Patella-Femoral Tracking Syndrome is a condition that results from the kneecap gliding abnormally between the femoral condyles (a groove at the bottom end of the thigh bone) as the knee bends and straightens
The four major muscles in the thigh (quadriceps) share a common tendon that attaches just below the knee and encases the kneecap. Therefore the contraction of the quadriceps has an impact on how the kneecap glides in this groove. If there is abnormal pulling of the quadriceps on the kneecap, this can cause the kneecap to grind rather than glide in the groove, leading to inflammation and pain.
This condition is common in long distance runners (hence ‘runner’s knee’), particularly in women, who have wider hips than men and are therefore comparatively knock-kneed.
Factors that predispose people to runner’s knee include previous trauma and muscle imbalance, as well as abnormal foot biomechanics. When the foot over-pronates, this creates a twisting, or torsional, force which extends up into the knee, causing the top of the tibia to twist inwards, changing the way the quadriceps pulls against the kneecap, with the painful consequences described above.
Custom Chiropractic orthotics will stabilize the foot and knee to prevent the abnormal movement of the knee cap on the knee and therefore help relieve the pain.