1) ITB syndrome is the only source of lateral knee pain.<\/strong><\/em><\/h2>\n\n\n\n![\"2](\"https:\/\/www.physiotutors.com\/wp-content\/uploads\/2021\/07\/2-1.png\")
<\/figure><\/div>\n\n\n\nFirst of all ITB syndrome is certainly the most prevalent cause of lateral knee pain with a reported incidence as high as 12% of all running-related overuse injuries. There are surely other sources that can cause pain at the lateral knee. Typical signs & symptoms for ITB syndrome are worse pain when running downhill or on narrow trails and a spike in training volume history. If the patient reports pain posterolaterally, you will have to take distal femoral biceps tendinopathy into account. In contrast to ITB syndrome, biceps tendinopathy worsens when running uphill, is worse with higher speeds, but gets better when warmed up.<\/p>\n\n\n\n![\"Image\"](\"https:\/\/www.physiotutors.com\/wp-content\/uploads\/2021\/07\/image.png\")
<\/figure>\n\n\n\nFurthermore, you have to consider patellofemoral pain which is very common in runners. PFPS is usually worse with loaded flexion, walking stairs, or after prolonged sitting \u2013 also called the Cinema sign. At last, lateral meniscus pathology or early osteoarthritis might be a cause of pain in runners regularly running on hard surfaces, who report pain on deep squatting or twisting the knee. This more prevalent in patients above the age of 40. Even some morning stiffness might be present in this group.
To conclude: ITB syndrome is not the only cause of lateral knee pain.<\/a><\/p>\n\n\n\n2) ITB syndrome is caused by friction & Rubbing over the bursa at the lateral epicondyle of the femur.<\/strong><\/em><\/h2>\n\n\n\n![\"Image](\"https:\/\/www.physiotutors.com\/wp-content\/uploads\/2021\/07\/image-1.png\")
Godin et al. (2017)<\/a> – Figure 1. Cadaveric specimen demonstrating the fiber orientation
of the proximal and distal iliotibial band fibers (Kaplan
fibers) in a right knee. FCL, fibular collateral ligament; ITB,
iliotibial band; PLT, popliteus tendon.<\/figcaption><\/figure>\n\n\n\nOriginally, the idea behind ITB syndrome was that the ITB flicks over the lateral epicondyle of the femur. This would occur at around 30 degrees of flexion when the ITB changes its force direction from an extension force at the knee to a flexion force or vice versa. However, Fairclough and colleagues (2006<\/a>) showed that there is actually no native bursa under the Iliotibial band. On top of that, the same authors (2007<\/a>) showed that the Iliotibial band is anchored to the distal femur by fibrous strands making friction at the knee impossible. The sensation of \u201cflicking\u201d that runners report is rather an illusion of movement that is created by changing tension in the ITB\u2019s anterior and posterior fibers during knee flexion. But what is ITBS then? The author’s reason that the band moves medially during knee flexion as a consequence of tibial internal rotation which compresses the fat pad under the ITB against the epicondyle. With extension, the ITB moves laterally again. Excessive compression of the fat pat may trigger an inflammatory response which could be the nociceptive generator in ITBS.<\/p>\n\n\n\n \n\n
<\/figure><\/div>\n\n\n\nFirst of all ITB syndrome is certainly the most prevalent cause of lateral knee pain with a reported incidence as high as 12% of all running-related overuse injuries. There are surely other sources that can cause pain at the lateral knee. Typical signs & symptoms for ITB syndrome are worse pain when running downhill or on narrow trails and a spike in training volume history. If the patient reports pain posterolaterally, you will have to take distal femoral biceps tendinopathy into account. In contrast to ITB syndrome, biceps tendinopathy worsens when running uphill, is worse with higher speeds, but gets better when warmed up.<\/p>\n\n\n\n Furthermore, you have to consider patellofemoral pain which is very common in runners. PFPS is usually worse with loaded flexion, walking stairs, or after prolonged sitting \u2013 also called the Cinema sign. At last, lateral meniscus pathology or early osteoarthritis might be a cause of pain in runners regularly running on hard surfaces, who report pain on deep squatting or twisting the knee. This more prevalent in patients above the age of 40. Even some morning stiffness might be present in this group. Originally, the idea behind ITB syndrome was that the ITB flicks over the lateral epicondyle of the femur. This would occur at around 30 degrees of flexion when the ITB changes its force direction from an extension force at the knee to a flexion force or vice versa. However, Fairclough and colleagues (2006<\/a>) showed that there is actually no native bursa under the Iliotibial band. On top of that, the same authors (2007<\/a>) showed that the Iliotibial band is anchored to the distal femur by fibrous strands making friction at the knee impossible. The sensation of \u201cflicking\u201d that runners report is rather an illusion of movement that is created by changing tension in the ITB\u2019s anterior and posterior fibers during knee flexion. But what is ITBS then? The author’s reason that the band moves medially during knee flexion as a consequence of tibial internal rotation which compresses the fat pad under the ITB against the epicondyle. With extension, the ITB moves laterally again. Excessive compression of the fat pat may trigger an inflammatory response which could be the nociceptive generator in ITBS.<\/p>\n\n\n<\/figure>\n\n\n\n
To conclude: ITB syndrome is not the only cause of lateral knee pain.<\/a><\/p>\n\n\n\n2) ITB syndrome is caused by friction & Rubbing over the bursa at the lateral epicondyle of the femur.<\/strong><\/em><\/h2>\n\n\n\n
of the proximal and distal iliotibial band fibers (Kaplan
fibers) in a right knee. FCL, fibular collateral ligament; ITB,
iliotibial band; PLT, popliteus tendon.<\/figcaption><\/figure>\n\n\n\n