Windshield wiper syndrome, a sportsman’s nightmare

Sophie, a keen sportswoman, is preparing for the Lisbon marathon in October.
She runs 3 to 4 times a week, but for the past few days she has been suffering from pain on the outside of her knee.

It almost prevents her from walking.

Ola, Dr Joy here!
What if it’s windshield wiper syndrome?

Also known as Iliotibial Band Syndrome, this is a common ailment that affects many athletes, especially those involved in sports such as running, cycling and cross country skiing.

I’ll tell you more in this article.
Vamoooos !

Anatomy and function of the iliotibial band

The iliotibial band is a band of connective tissue that extends from the iliac bone to the tuberosity of the tibia. It plays an important role in stabilising the hip and knee during walking and running. When the leg is extended, the iliotibial band also becomes taut, stabilising the knee and maintaining the alignment of the leg.

However, when the iliotibial band is over-stretched or repeatedly rubbed against the femur bone, it can cause inflammation and pain, known as windshield wiper syndrome.

It is very common in regular sportsmen and women, and is characterised by pain on the outside of the knee, which can be very debilitating and prevent physical activity.

Symptoms and risk factors of windshield wiper syndrome

The most common symptom is a sharp pain on the outside of the knee. It can be felt particularly when the knee is repeatedly bent and extended, such as when running or cycling.

The pain can be felt along the entire length of the iliotibial band, from the knee to the hip. In severe cases, the pain can be so severe that it can prevent physical activity.

Its causes are often multifactorial.
In Sophie’s case, it may be due to overtraining in view of her goal.

However, it could also be due to

  • A poor choice of shoes
  • Morphological disorders of the foot (hollow foot, flat foot or turned inwards)
  • Posture problems (pelvis, lower limbs)
  • Running on a curved road
  • Poor physical preparation
  • A history of trauma (fracture, sprain, etc.)

Treatment and prevention of Windshield Wiper Syndrome

The treatment of wiper syndrome can vary depending on the severity of the condition.

Osteopathy or physiotherapy
The aim is to relieve the tensor fascia lata.
Indeed, the repeated stresses of running can lead to joint and muscle restrictions. The osteopath will be able to improve the removal of these blockages.
As for physiotherapy, it can help to relax and strengthen certain muscle groups (particularly the hip stabilisers and sheathing work).

Corticosteroid injections
In more severe cases, more invasive treatments may be necessary. These injections can be used to reduce inflammation and pain. In addition, physiotherapy can help to strengthen the pelvic muscles and improve flexibility in the area.

Wearing orthopaedic inserts
or running shoes can also help prevent the iliotibial band from rubbing against the femur bone.
Podiatrists are health professionals who specialise in the diagnosis and treatment of foot and ankle conditions and therefore have a key role to play in the treatment of wiper syndrome.

They will assess the posture, gait and function of the foot and ankle.

In addition to correcting posture and gait, the podiatrist may also recommend muscle strengthening exercises for the feet and ankles, which can help improve stability and function of the area.

The treatment is therefore mainly based on correcting stato-dynamic disorders with insoles and gradually resuming the training load.

Preventing wiper syndrome

Prevention of wiper syndrome is also important for athletes and people who engage in regular physical activity.
It is important to warm up properly before starting physical activity and to stretch regularly to maintain flexibility of the iliotibial band and pelvic muscles. Pelvic muscle strengthening exercises can also help prevent injury and improve hip and knee stability.

Sophie now knows what she needs to do, and so do you if you suffer from knee pain. Consult your GP or podiatrist, they will point you in the right direction.

Até jà,
Dr Joy

This information is not a substitute for medical advice.
You must seek the advice of your doctor or another qualified health professional with any questions you may have regarding your health condition.

Sources:
Institut Kinesithérapie Paris — Syndrome de l’essuie-glace : symptômes et traitement

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