22 October 2007 11:07
My knees hurt on descent. What gives?
Many hill-walkers suffer from ‘runner’s knee’, ‘downhill knee’ or, to give it its proper moniker, iliotibial band friction syndrome (IBFS). There’s a lot you can do to relieve the symptoms; but ensure you also see your doctor, who may refer you for physiotherapy.
The iliotibial band is a band of tissue that stretches from your pelvis, down your thigh and over your knee, and attaches to your lower leg. It aids flexion of and stabilises your knee (preventing it from over-bending sideways). Every time you bend your knee, this band moves across the side of your knee. Do this repeatedly and the friction against the bone can result in inflammation and pain. Covering a lot of miles can actually shorten the iliotibial band, increasing the friction, and increasing the likelihood of IBFS.
How to know if you have IBFS
If you suffer from these symptoms, see your doctor for diagnosis:
- You feel a pain in the outside of your knee when it’s bent, particularly around an angle of 30 degrees, and particularly when you’ve got all your weight on that leg. The pain could range from a dull ache to a sharp needle.
- This pain frequently occurs when walking or running downhill.
- It gets worse if you continue walking downhill.
- It disappears when you stand upright.
What to do
If you’re suffering from IBFS, rest your leg, ice the painful area and take ibuprofen (and your doctor’s advice). It’s okay to walk as long as it isn’t painful – but avoid hills (bah!) for a few weeks. You must also avoid any exercise that causes pain: this is likely to include running, cycling and knee-flexing gym-bunny moves like squats.
These actions will alleviate the symptoms. But if you want to prevent IBFS flaring up again, you’ll have to embark on a stretching regime. These exercises will all increase the flexibility of your iliotibial band, and therefore reduce the friction. Spend 10 minutes, twice a day, doing them SLOWLY and SMOOTHLY – and don’t stop as soon as the symptoms disappear: these should be a daily mission for the rest of your life…
- Lie on your back and keep your shoulders flat on the floor throughout the exercise. Extend your left arm out to the side, keeping it on the floor.
- Now lift your left leg over your right leg, and hold it in place with your right hand on the base of your right thigh. Straighten your left leg as far as possible: you’ll feel the stretch down the outside of your left leg. Repeat for the other side.
- Sit on the floor with your legs flat on the floor in front of you. Cross your left leg over your right leg, and place your left foot flat on the floor next to your right knee.
- Curl your right elbow around your left knee. Turn your head and upper body a little to the left: you’ll feel the stretch down the outside of your left leg. Repeat for the other side.
- Stand upright and cross your left leg behind your right leg, keeping your body upright.
- Put your right hand on your right hip, and bend from the hips to lean to the right: you’ll feel the stretch in your left hip. Repeat for the other side.