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.