Sock Doc 10: $@#% That Pain in the Knee! How To Heal Your IT Band Syndrome, Chondromalacia Patella and ‘Runner’s Knee’ Issues

July 24, 2020


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Welcome back to another episode featuring Dr. Steve Gangemi, aka The Sock Doc. Steve is a holistic alternative health care doctor who runs a practice in Chapel Hill, North Carolina. Learn more about his practice at and visit his many resources at We’ve included some of his articles and videos that pertain to this show’s topic below in the show notes.

On this episode:

Definition and differentiation of some common conditions:

IT band syndrome – Stress/pain on the outside of the knee.
Patellofemoral pain syndrome – Pain in the front of the knee.
Chondromalacia patellae – Friction or breakdown of cartilage under the kneecap. Also known as “runner’s knee.”

George Harrison asks:

Runner’s knee woes

Hey guys, just recently started listening to your show and have really enjoyed it so far. I’ve got a question for you regarding runner’s knee and how to go about treating it.

A little bit about me: I’m 27 and relatively new to running (a little over 2 years). I’ve done a few half marathons and usually try to run 15-20 miles a week. I had plantar fasciitis issues on my right foot about a year ago, but took some time off and got some insoles and haven’t had any problems since. I started to experience pain on the outer part of my left knee during my last run and even felt it lock up a couple times. I’ve taken about a week off to rest it, but I still have some lingering pain and stiffness on the outside of my knee and knee cap while walking. It happened on a shorter run where I was focused on improving my speed, so I was pushing it harder than I normally would. I was running in some new shoes and did not have the insoles in that I usually use. It was also only a couple weeks after my most recent half, so I might have been doing too much too soon. After looking around on the internet, it appears that my symptoms are pointing towards runners knee or IT band syndrome. I’ve been doing the “rice” treatment method which has helped a little bit, but I was wondering if you guys had any other treatment or prevention methods that may help. Or if you think it may be a different type of injury entirely. I was planning on doing another half in a couple of months, however I really don’t want to hurt myself any further so it may be in my best interest to sit this next race out to be safe. Any tips would be greatly appreciated. Really itching to get back out there!

Also, Peter W. asks:

ITB problems and tugging on the knee

Hi – Thank you so much for the podcast and everything that you do! I am a solid sub-8min MAF runner (32 years old) who typically logs between 35 and 50 miles a week.  I’ve recently developed a bad case of ITB syndrome which pulls on my left knee and inflames my left knee cap between miles 6 through 10 or so.  I’ve gone for a few sessions of active release which helps in the short term but I still get this issue now and again.  Serious sucks!,

Should I look at lungs/weighted step ups and rucking as ways to strengthen and improve this issue? More specific stretches possibly? I realize this is a very general question but would be interested into any insights you all on the podcast might have!

What The Sock Doc says:

  • Potential gait issues
  • Insoles/cushions are okay when it comes to someone healing an issue like plantar fasciitis
  • RICE: rest, ice, compression, elevation.
    • Rest (to a certain degree). Prefer active recovery vs. passive.
    • Icing is usually not recommended anymore; may even delay healing. The exception would be to ice something using the cryokinetic method (i.e., icing the area so you can mobilize it better).
    • Compression is the most beneficial. May compress the affected area or massage around it.
    • Elevation may help with swelling.
  • Sock Doc’s Video: Treatment and Prevention of ITB Syndrome
  • Consider the holistic components (e.g., stress levels outside of running, nutrition, sleep, etc.)

Rory Campbell asks:

First Achilles now Chondromalacia patellae got me

Hi guys, Rory from Scotland here. I hope you’re all staying safe and well? Pretty much all of our events have been cancelled for the foreseeable future so I guess it’s time that we can focus on strength building, staying fit and healthy.

Before covid-19 hit us I was having difficulties with Achilles pain and so I focussed on building strength around the Achilles, my legs, core etc. Stopped running and instead hit the gym. In the process of strength building I managed to hurt my right shoulder (maybe doing rdl’s) which is still bad but more significantly a knee niggle came back to haunt me. I had noticed it occasionally on long runs last year but did not impact on my day to day life or running plans. I had a few big ultras last year that culminated in the transalpine run in September. Plans for this year included an 80mile event and some other interesting bits and bobs. All changed now, of course. So the MRI shows Chondromalacial patellae, I’ve rested but also am conscious of not resting, if that makes sense. I can’t run because it gets aggravated. Cycling also seems to aggravate it unless it’s a very light spin on the turbo for 30-40 minutes. Likewise the cross-trainer (elliptical). My shoulder still hurts so some strength excercises I can’t do. Squats also aggravate it. I’m following a 24hour rule – try something, if it hurts the next day then pull back again. I have it taped up, have taken ibuprofen and have iced it. I am very frustrated as all I want is to head out to the hills close to my house and maintain/grow my fitness again. Everything I have read suggests this will get better with time but I’m not seeing it yet. I feel it in my knee just walking around.

Can you suggest some movement strategies or exercises?

What The Sock Doc says:

  • Possible inflammation from training too hard/often (overtrained), or not recovering properly.
  • Try for a holistic health assessment.
  • You may want to hold off on the 80-mile event for now
  • Focus on getting healthier; think about what is running your body down. You want to be able to run pain-free!
  • Sock Doc’s website includes information on virtual consultations, contact information, etc. if you’d like to work with a professional!


Women in perimenopause and menopause feeling knee soreness and pinch type feelings in the knee that wasn’t there before. Is this a factor of making this hormonal transition?

What The Sock Doc says:

  • Previous podcast episode with the Sock Doc
    • High estrogen or low progesterone in women could cause ligament instability.
  • Hormonal imbalance symptoms are common, but not normal.


For those wanting to run marathon or longer and experiencing knee pain on long runs over 10 miles or so… or if by 18-20 miles the ache is unbearable. What’s going on? Will something like glucosamine help? Fish oil? What other supplements?

What The Sock Doc says:

  • Never take a supplement to try and run through pain!
  • First, you need to figure out why you can’t run!
  • Fish oil can act as an anti-inflammatory.
  • If you take NSAIDs and you feel better, that is pretty much telling you that you have a fatty acid imbalance.

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