“To speak to medical professionals who specialise in sports injury was a breath of fresh air. The experience for me was the best it could be, especially as an athlete with a potentially career-ending injury. Everyone was caring and I was given the hope I so badly needed. It was now possible that... Read More

“Everything was wonderful. I am now completely pain free and absolutely thrilled.”

“Thank you for the excellent operation you did on my knee. It has healed up really well with only a very small scar left. Most of the acute pain is now gone and each week it pains a little less. I am looking forward to the long (pain free) walks I used to do before. So many thanks, you are the... Read More

“Thank you so much for seeing me and treating me so quickly after my skiing accident! I was amazed and impressed that you managed to arrange my surgery so quickly. Mum and I have a nickname for you - GOD!”

“'Thank you' seems inadequate words for the debt of gratitude I owe you all. Your expertise and skills heal body and soul. Your care and kindness humble me.”

“I felt fully engaged from the start and actually found the whole process quite enjoyable! I felt informed without being patronised, well prepared, both by the consultation with Neil, the paperwork and booklets. The outcome has exceeded my expectations and the care was tremendous, as was the pain... Read More

“Neil performed a PCL replacement in my right knee back in 2000. At the time, it was a procedure that few knee surgeons had the skills to perform. He fully informed me of the risks attached to the procedure, the likelihood of success and allowed me to take my time to decide on how I wished to... Read More

“You fitted me with a completely new knee on 20th June. It is absolutely amazing and I'm getting on and off, riding and jumping with ease. It has brought back all the possibilities in retirement that had come to an end with a bad knee. It's not yet four months since the operation.....lets hope the... Read More

“Now that I seem to be well on the road to recovery, I'd like to thank you personally for my new partial knee replacement on 31st July 2017. Having not quite had the courage to watch the full operation on your website, I am nevertheless aware of the enormous skill and expertise required for this... Read More

ITB friction syndrome (runner’s knee)

ITB friction syndrome (runner’s knee)

 

Iliotibial Friction Syndrome is one of the most common causes of what is often referred to as ‘Runner’s Knee’ and can account for up to a quarter of over-use injuries in runners. Being an over-use injury, it is caused by repeated trauma rather than a specific incident.

The iliotibial friction band attaches to the outer border of the tibia or shin bone. It crosses the knee and rubs on the lateral femoral epicondyle. It slides forwards and backwards across this bony point. This repetitive sliding can create excess friction, especially when the knee is bent at 30 degrees, which commonly happens just as your foot touches the ground when running. This region of 30 degrees of knee flexion is called an ‘impingement zone’ or pinching of irritated structures over the outside of the knee, thereby producing ITB Friction Syndrome.

What is the Iliotibial Band?

The iliotibial band is a long, thin band of fibrous tissue that runs down the outside of your thigh. At the top of your thigh it is attached to your Tensor Fascia Latae (TFL) muscle and Gluteus Maximus, and at the bottom it attaches to your tibia (lower leg bone) and femoral condyle on lower outside portion of the thigh bone.

What causes ITB Syndrome?

ITB friction syndrome is caused by altered running biomechanics due to underlying muscular imbalances. Your biomechanics can alter due to a muscle imbalance (weakness or tightness), fatigue and ground impact issues.

The most common causes:

  • Poor biomechanics (running technique); particularly inwards rolling knees and hips
  • Weak hip / gluteal muscles
  • Weak hip rotators
  • Weak inner quadriceps
  • Weak core muscles
  • Poor foot arch control
  • Worn out or unsuitable trainers
  • Sudden increase in mileage for training
  • Excessive hill training (particularly downhill)
  • Endurance running (training for ½. and full marathons, ultra-marathons)

The most common symptom includes, sharp or burning pain just above the outer part of the knee; pain that worsens with continuance of running or other repetitive activities; swelling over the outside of the knee; pain during early knee bending; gradual onset of symptoms which if they persist for greater than 4 weeks can cause major interference for any sport or activity.

How is it treated?

The mainstay for treatment is physiotherapy and podiatry which will address muscle tightness and balance. A steroid injection can speed recovery. Surgery is almost never required.