Running is a popular form of exercise that offers numerous physical and mental health benefits. Its ease of access makes it an easy form of exercise for many people. However, for some runners, the experience is marred by the presence of knee pain. Lateral knee pain, specifically pain on the outer side of the knee, is a common complaint among runners. We will delve into the causes of lateral knee pain when running, explore treatment options, and discuss preventive measures to help runners enjoy a pain-free experience.

Causes of Lateral Knee Pain

The most common cause of lateral knee pain is Iliotibial Band Syndrome (ITBS). It occurs when the iliotibial band, a thick band of tissue that runs down the outside of the thigh, becomes overloaded. The incidence ranges from 1.6% to 12% in runners and other repetitive motion athletes, occurring more in women than men. Oftentimes, trainers and even other medical professionals will refer to it as being inflamed or tight. However, true etiology of the disorder remains controversial, whether it is an irritation of the fat pad or bursa (pocket to fluid) that sits underneath where the ITB attaches to the outside of the knee. What we do know is that repetitive motion of running can lead to overloading of these structures, causing pain and discomfort.

Signs of ITB Syndrome

1. Pain with Downhill Movements: Descending stairs or running downhill can exacerbate the pain associated with ITBS. The increased flexion and bending of the knee in these activities put additional stress on the iliotibial band, especially as the foot strikes the ground.

2. Swelling or Tenderness: In some cases, there may be swelling or tenderness over the outer side of the knee. This can be a result of inflammation caused by the repeated friction between the iliotibial band and the underlying structures.

3. Pain Relief at Rest: The pain associated with ITBS tends to subside when you are at rest or when you stop running. However, it may return when you resume activity.

4. Tightness or Stiffness: ITBS can cause tightness or a feeling of stiffness along the outer thigh, extending towards the hamstrings and up towards the hip. This tightness may extend from the hip down to the knee.

Treatment Options

1. Rest and Recovery: If you're experiencing lateral knee pain, it's important to take a break from running to allow your body time to heal. You’ll know you’re ready to return to running if you can perform single leg squats to parallel without pain as well as being able to go up and down the stairs quickly without pain as well.

2. Icing the knee: While icing will not speed up the rate of recovery, applying ice packs to the affected area for 15-20 minutes at a time can help relieve pain.

3. Stretching and Strengthening Exercises: Regular stretching exercises can help improve flexibility and reduce muscle tightness. Pigeon stretch, which targets the glutes are a great starting point as the glutes attach to the ITB. Relieving tension in this area can also help reduce stress along the ITB. Additionally, incorporating exercises that target the hip and glute muscles, such as clamshells, sidelying leg lifts, side planks, can help address imbalances and provide stability to the knee.

4. Physical Therapy: Should symptoms continue to impact you, even when you’re not running, it is impact to get expert care. Seeking the guidance of a physical therapist can be beneficial for runners experiencing persistent lateral knee pain. They can assess your running form, identify weaknesses, and provide a tailored rehabilitation program to address specific imbalances and promote proper alignment.

Preventive Measures

1. Gradual Progression: Avoid sudden increases in running mileage or intensity. Gradually build up your training volume, allowing your body to adapt to the demands of running. This will reduce the risk of overuse injuries, including lateral knee pain.

2. Cross-training and Strength Training: Incorporate cross-training activities, such as swimming or cycling, into your routine to vary the stress on your joints and muscles. Additionally, regular strength training exercises can help improve overall muscle strength and stability, reducing the risk of knee pain.

3. Proper Running Form: Pay attention to your running form. Maintain an upright posture, engage your core, and ensure your foot strikes the ground in a neutral position. Avoid overstriding, which can increase stress on the knee joint.

Conclusion

Lateral knee pain can significantly impact a runner's performance and enjoyment. By understanding the causes of this pain, implementing appropriate treatment strategies, and adopting preventive measures, runners can reduce the risk of experiencing lateral knee pain and continue to pursue their running goals with confidence.

If you are experiencing persistent or worsening lateral knee pain, it is important to consult with a healthcare professional or a sports medicine specialist. They can provide a thorough evaluation, accurate diagnosis, and develop an individualized treatment plan based on your specific needs. Our trained sports physical therapists have years of experience working with runners with lateral knee pain.

Stay healthy, stay strong, and happy running!

Are you a cyclist as well? See our blog on biking related knee pain.