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People
who exercise religiously are undoubtedly more healthy than their
sedentary counterparts and runners seem to be the poster boys
and girls for the fitness revolution.
Although people who run long distances will undoubtedly
be more fit in a number of ways, they can suffer from a variety
of injuries that may eventually cramp their healthy lifestyle.
An
overuse injury that primarily effects runners is called
iliotibial band friction syndrome (for the purposes of this
column, we’ll just call it IBFS).
This condition is fairly common in people who run long
distances for long periods of time.
But it should be remembered that everyone, not just
athletes, can suffer from overuse injuries.
Statistically,
men are more likely than women to suffer from IBFS and the most
common ages are from 20-40.
Also, people who train on stairs or hills routinely seem
to be more at risk for developing IBFS.
A
brief survey of the relevant anatomy will help to explain the
disorder. The
iliotibial band is a thickened strip of fascia that attaches
some of the hip and gluteal muscles the lower leg bone known as
the tibia. As the
band courses from the hip and buttock region down to the top of
the tibia, it must cross over part of the large leg bone called
the femur. Thus, when the knee is repeatedly flexed and extended, the
iliotibial band migrates across part of the femur called the
lateral femoral condyle. This
produces friction and, subsequently, inflammation.
Symptoms
of IBFS include pain along the outside of the knee and often a
limp. The symptoms
frequently appear after a long run or hike and generally
increases with increasing distance.
People have also speculated that activities that call for
increased stride length may increase the friction created by the
iliotibial band across the lateral femoral condyle.
Patients
can sometimes reproduce the pain
by supporting their whole bodyweight on the affected leg
with the knee held in about 30 degrees of flexion and gradually
rocking over the top of the weight bearing leg.
Sometimes
a “creak” is felt while feeling the outside of the knee
while it flexes and extends.
X-rays are almost always normal in people with IBFS.
Treatment
for IBFS generally involves scaling back running or climbing
activities. Oral
anti-inflammatory medications can also be helpful.
In some cases, your sports doctor may choose to place a
steroid injection into the affected area.
Surgery is almost never indicated in the treatment of
IBFS.
Another
disorder common in track athletes is commonly called “jumpers
knee”. As the
name implies, the condition is common in athletes who
participate in sports that involve jumping.
This especially includes volleyball players, jumpers and
basketball players.
The
medical name of jumpers knee is patellar tendonitis. The patella or knee cap is a bone imbedded in a tendon.
The inflammation of the patellar tendon may be present at
the bottom or inferior aspect of the patella where the tendon
attaches or at the tendon’s tibial insertion, with the former
being more common.
Although
the inflammation is usually caused by a repeated stress from a
job or sporting activity, the condition may be aggravated by
day-to-day activities such as climbing stairs.
If untreated, the inflammation may progress to the point
where the pain is present even at rest and is aggravated by even
the most benign activities.
The
diagnosis of patellar tendonitis, like IBFS, is entirely a
clinical one. Patients
with a history of repetitive motion activity and pain at one of
the sites described above are typically diagnosed with patellar
tendonitis. X-rays
are usually normal and other imaging studies are typically not
necessary.
Like
IBFS, the treatment for patellar tendonitis is partial or
complete rest from physical activity, depending on the severity
of the inflammation and the circumstances of the sport.
Oral anti-inflammatory medicines as well as physical
modalities such as heat, cold and electric stimulation may also
be helpful.
In
some cases, patients report symptomatic relief of patellar
tendonitis by using a brace called a Chopat strap.
This serves to take some of the stress off of the
bone-tendon junction and repositions it in the midsubstance of
the tendon.
Surgery
is rarely if ever indicated in the treatment of patellar
tendonitis.
If
you believe that you’re suffering from an overuse injury, it
is very important to see a sports medicine doctor as early as
possible. Early intervention is almost always more effective than
treating the long term problems associated with overuse
injuries.
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