The painful iliotibial band syndrome, also called the “windshield wiper syndrome” or "runner's knee", is the expression of the interaction between the foot and knee in movement. This pain syndrome appears mainly during running, hence the English name, the runner's knee. The pain is located on the outer side of the knee where a tendon strip rubs the bony relief of the femur (external condyle) and creates inflammation (bursitis). This friction is done from front to back in flexion and back to front in extension of the knee, hence the name wiper syndrome.

The iliotibial band is so called because of its anatomical appearance, similar to a blind strip 3 to 4 cm wide. It originates from the iliac crest in the pelvis and its distal attachment to the outer plateau of the tibia. This anatomical structure works like a real external stay and stabilizes both the hip and the knee. Certain morphologies can predispose to the syndrome such as X or O legs, natural hyper-laxity (excessive joint flexibility), lack of muscle flexibility or pronounced bone relief. BUT, since this syndrome appears in movement, especially in running or walking downhill, it is natural to find a biomechanical explanation for this condition.

FHL is present in all cases of iliotibial band pain syndrome and plays a major role in the onset of pain. The attack of the step on the outer edge of the heel and the stronger impact puts additional stress on the strap and the frictional forces are greater. The repetition of the movement creates an inflammation of the sliding plane between the tendon and the bone, and leads to a painful bursitis. The cessation of the sporting activity in question most often resolves the symptoms, but they recur if activity is resumed. The pain is sometimes worse the day after exercise and may be accompanied by transient lameness. The conservative treatment proposed for FHL is most often effective. For runners, an analysis of the movement on a treadmill and a dynamic podiatry assessment can prove useful for the continuation of the activity in the best possible conditions.

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Painful iliotibial band syndrome