Iliotibial Band Syndrome

Signs and Symptoms:

• Pain/discomfort above the lateral (outside) knee.
• Pain with flexion of the knee at approximately 20 -70 degrees.
• Discomfort at start of run, subsiding during the workout and then returning quickly after stopping.
• Athlete may complain of constant pain throughout daily activities.
• Pain may increase while running on uneven terrain.
• Tenderness to palpation over outside of knee (lateral femoral epicondyle).
• "Snapping" sensation with squat motion.

• Overuse (running long distance)
• Lack of proper stretching
• Tight musculature
• Running in the "shoulder" of the road

• Modification of activity to avoid continued irritation. Complete rest is sometimes indicated.
• Gradual return to activity.
• Ice therapy following activity.
• Heat therapy prior to activity followed by increased stretching.
• Stretching exercises should be done several times per day to help alleviate tight IT Band.
• Anti- inflammatories are helpful in reducing the inflammation of the soft tissue thus reducing irritation. Consult your Doctor for proper dosage.
• Another helpful tool is to apply a strap above the knee with pressure placed just above the site of irritation (above the lateral epicondyle). This band helps dissipate the tension on the tendon.
• To know what is best for you, ask your certified athletic trainer or your physician.
• Physical Therapy. The key to returning to running or cycling activity is to terminate your workout when you sense the knee getting stiff or tight. It is impossible to "run through it" so don't even try!

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Osgood-Schlatter's Disease 

Signs and Symptoms:

• Pain with active movement of the quadriceps (thigh) muscles.
• Point tenderness below the knee at the bony prominence (tibial tuberosity).
• Pain with squatting motion.
• Pain with resistive movement of the quadriceps.
• Swelling and inflammation.
• Weakness of the quadriceps muscle.
• Prominent bony area below the knee at the tibial tuberosity.

• Repetitive stress (jumping/running) on the patellar tendon causing traction at the tibial tuberosity.
• This condition commonly occurs in preadolescent and early adolescent persons, usually during a "growth spurt".
• Predisposing factors such as tight hamstring, tight heel cord (Achilles tendon) and tight quadriceps muscles.

• Activity modification as recommended by your physician.
• Stretching program primarily focusing on hamstring, heel cord, and quadriceps.
• Quadriceps strengthening program with emphasis on vastus medialis obliqus (inner quadriceps muscle).
• Ice following activity. Ice may be used more often as needed to decrease pain and inflammation. Ice cup massage is effective.
• Temporary use of anti-inflammatory medication such as ibuprofen or Aleve. Consult your Doctor for proper dosage.
• Padding may be used for the knee during activity to avoid further trauma to the area.
• A strap may be used to decrease pressure placed on tibial tuberosity (Cho Pat).

CLICK HERE FOR EXERCISES (PDF)
The exercises are in PDF format. To view this file, you need Adobe Acrobat reader. If you don't have access to Adobe acrobat reader, you can go the adobe website and download it for free HERE.

Patellar Tendinitis 

Signs and Symptoms:

• Point tenderness over the patellar tendon (just below the knee).
• Pain after exercise and in later stages during and after exercise.
• Difficulty with jumping or running without discomfort.
• Pain in the tendon region on active, passive and resistive movement.
• Loss of function.
• Swelling (rarely).

• Overuse (usually excessive jumping or bounding activity).
• Quadriceps (thigh muscle) inflexibility.
• Patella alignment may contribute to this condition.
• Sudden increase in exercise intensity or duration.

• Modify or discontinue activity until symptoms subside.
• Stretching program (include quadriceps, hamstring and achilles tendon).
• Quadriceps strengthening program is necessary in order to absorb the strain as well as avoid recurrence of tendinitis.
• Heat therapy along with stretching prior to activity.
• Ice therapy and stretching following activity.
• Anti-inflammatories (i.e. Advil, Motrin, etc.) Consult you Physician for proper dosage.
• When returning to activity, gradually increase activity and participate on surfaces that absorb some of the force. (Concrete and asphalt can cause an increase in symptoms.).
• A patella strap, designed to alleviate stress of the tendon, may benefit

some individuals.

CLICK HERE FOR EXERCISES (PDF)
The exercises are in PDF format. To view this file, you need Adobe Acrobat reader. If you don't have access to Adobe acrobat reader, you can go the adobe website and download it for free HERE.

Patellofemoral Stress Syndrome

Signs and Symptoms:

• Dull and achy pain surrounding the kneecap (may involve one or both knees).
• Pain which worsens during or after activity (particularly activity requiring stair climbing or hill work).
• Stiffness or pain after prolonged sitting (Theatre sign).
• Knee pain occasionally resulting in weakness or feelings of instability.

• Quadriceps weakness (particularly the vastus medialis obliquus).
• Malalignment of the thigh bone (femur), kneecap, and lower leg bone (tibia).
• Overpronation of the mid-foot.
• Training errors including rapid change in activity, intensity, or duration.
• Old or inappropriate shoes.
• Poor flexibility in the hip flexors, hamstrings, and iliotibial band.
• Rapid change in weight or height.

• Avoid activities that exacerbate (worsen) the pain.
• Begin a strengthening and flexibility program with your physical therapist or certified athletic trainer.
• Ice your knee for 15-20 minutes after activity.
• Temporary use of anti-inflammatories, such as ibuprofen or Aleve. Consult your doctor for the proper dosage.
• Buy appropriate footwear and correct biomechanical abnormalities with arch supports or orthotics.
• Dynamic patellar stabilizing brace with lateral supports or McConnell taping may be helpful for some individuals.

CLICK HERE FOR EXERCISES (PDF)
The exercises are in PDF format. To view this file, you need Adobe Acrobat reader. If you don't have access to Adobe acrobat reader, you can go the adobe website and download it for free HERE.

Shin Splints

Signs and Symptoms:

• Pain in the front of leg.
• Loss of normal ankle motion.
• Possible swelling of the front of the leg.
• Abnormal gait (the way in which one walks).
• Pain on active, passive, and resistive dorsiflexion of the ankle.

• Overuse activities.
• Muscle fatigue.
• An anatomic variation such as fallen arches (flat foot) or overpronation.
• Poor running technique.
• Training errors.
• Poor training surfaces.
• Improper footwear.
• Improper stretching to prepare for activity.

• Rest. This may be modification of activity or complete rest for a period of time.
• Correction of anatomic variations such as using an arch support.
• Heat and stretch prior to activity.
• Ice therapy and stretching following activity. (Ice cup massage works great!).
• Stretching should be done several times per day with primary focus on the calf musculature (i.e. calf stretch, toe raises, heel walking).
• Temporary use of anti-inflammatory medication (ibuprofen or Aleve).
• A proper fitting shoe which provides good shock absorption and a firm heel counter.
• Compression sleeve (neoprene sleeve) that is used to provide compression for support and continued warmth to the area.

This condition should not be ignored. Shin splints usually resolve with proper treatment. This treatment is necessary in order to alleviate more severe problems (stress fractures) that could develop.

CLICK HERE FOR EXERCISES (PDF)
The exercises are in PDF format. To view this file, you need Adobe Acrobat reader. If you don't have access to Adobe acrobat reader, you can go the adobe website and download it for free HERE.

Stress Fractures

Signs and Symptoms:

• Point tenderness.
• Loss of function.
• Swelling and inflammation.
• Pain on weight bearing.
• Pain that is increased with activity.

• Repetition of active movement causing repeated loading/stress of the bone over a long period of time.
• Altered stress distribution to bone due to fatigue.
• Changing environment (running surfaces, shoes).
• Returning to sport too soon after injury.
• Changing sports without proper transition time.
• Starting initial training (too much, too soon).
• Anatomic considerations i.e. postural or foot conditions (flat feet).
• Eating disorders can contribute to onset (poor calcium intake).
• Amenorrhea (absence of periods in the female athlete).

 Treatment varies with each individual based on activity, site of injury, and severity. The following is basic treatment and may be altered for individual rehabilitation programs.

• Rest or modification of activity.
• Ice therapy.
• Flexibility and strengthening as directed.
• Anti-inflammatory medication. Consult your physician for proper dosage.
• Return to activity gradually when cleared to do so by your physician or certified athletic trainer.
• Casting is not normally required but may be used for some fractures (metatarsal fracture).