Knee discomfort: what if you were a victim of windshield wiper syndrome?

If you are a running enthusiast, you have probably already heard of – or have already suffered from – windshield wiper syndrome. From its scientific name iliotibial band syndrome, this phenomenon particularly affects runners but also concerns certain cyclists and hikers. Here's why.

The windshield wiper syndrome is the consequence of friction of the iliotibial band on the tubercle of the external condyle of the knee (external part of the cartilage of the femur) during each flexion-extension of the knee (800 to 1,000 times per km). The athlete then feels discomfort outside the knee, at the level of the tensor fascia lata (TFL) muscle, hence its other name: fascia lata syndrome. To understand the nickname windshield wiper syndrome , simply visualize the iliotibial band which, in extension of the knee, is located in front of the external part of the cartilage, then is found under the external condyle when the knee is flexed; like a windshield wiper. ¹

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The first consequence of this windshield wiper syndrome is a burning sensation in the outer part of the knee. If the athlete decides to continue his effort, the discomfort increases and even becomes difficult to bear in certain cases. The sensation can even radiate to the hip. This discomfort can persist for 48 to 72 hours and get worse when going up or down stairs. ² The windshield wiper syndrome, however, has the particularity of diminishing or even disappearing as soon as the knee is at rest. Athletes who suffer from it are also surprised not to feel this discomfort when practicing sports involving irregular running (tennis, handball, basketball, etc.) ¹

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Windshield wiper syndrome: it’s treatable!

Different clinical tests allow a doctor to diagnose windshield wiper syndrome. In addition to a questioning to detect the patient's habits and the regularity of his knee problems, it is a question of ruling out serious injuries such as stress fractures, tendinitis or injuries of the external ligament. ¹

Several factors can cause fascia lata syndrome, including pes cavus, an overpronated foot, or simply a poorchoice of running shoes. ^1-2

Depending on the cause, the athlete is followed by a physiotherapist or a podiatrist. The treatment generally involves a little rest (2 to 3 weeks) then can consist of rehabilitation sessions, cryotherapy , the use of plantar prostheses (orthopedic insoles), or even infiltrations in the most complex cases. We very rarely get to the point of surgical operation. ¹

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¹ http://www.medecindusport.fr/HTML/articleiliotibiale.html (Dr Nicolas Bompart, Clinique du Plateau)

² http://www.podologue-paris.com/?p=591 (Daniel Benjamin, podiatrist in Paris)