Recharged Performance Therapy

View Original

Knee Pain- Outside of the Knee

Paige Hubert

Knee Pain- Outside of the Knee

So you know that knee pain you’ve been suffering? Yeah, the one on the outside of your knee just above the bend of your knee? What if I told you that your knee pain may not in fact be knee pain at all?

Today, I want to talk about knee pain that actually may originate from the hip. Iliotibial tract band syndrome (ITBS) is an often overlooked and commonly misdiagnosed issue because most of the symptoms start and end at the knee – but the anatomy says it all comes from the hip. 

Anatomy

First, it’s important to run through a little bit of the anatomy of the hip and knee. Almost every major muscle that originates at the hip inserts at the knee – and act on both! The structure we’re concerned about is the iliotibial tract band (ITB), a thick band of fascia that runs from the side of the hip down to the top of the knee. If you run your hand down the side of your thigh, you can probably feel it. Now, that ITB only has two points where it inserts, allowing it to move back and forth as we move our leg (e.g., walking, running, standing up). At the top of the hip, it connects into the major glute muscles that help stabilize us when we move around. (This is important to remember in just a minute.)

Who Does It Affect??

ITBS is often considered a repetitive, non-traumatic injury. This means that the ITB becomes overused and rubs along the outside of the knee. Getting ITBS from fall or something like that is very uncommon. This pathology is often seen in long distance runners…But I want to stop you right there. It’s not just runners that get ITBS! Anything that involves repetitive motion at the knee over long periods of time can potentially cause ITBS. This can include activities with a lot of squatting and lifting – like being the primary caretaker for someone.

What Does ITBS Feel Like?

The symptoms of IT band syndrome are at once very specific, but can also be confused with other causes of knee pain. The most common symptoms include:

  • A sharp or burning pain on the outside of the knee

  • Pain with going down stairs, when first standing in the morning, or with running

  • Swelling on the outside of the knee that doesn’t go away with RICE

  • A burning sensation when you put your thumb on the sore spot

  • The feeling of “snapping” when you bend your knee

Okay, So What Do I Do?

If you’ve been suffering these symptoms for any length of time, it is always good to consult a physical therapist about your specific case. 

But in the meantime, there are a few things that you can try at home to get some relief. 

Activity modification: If the symptoms are relatively new, try the RICE method. It is also important to take a break from whatever activities may be causing the flare up in order to let the inflammation calm down. 

Self massage: Foam rolling or using a lacrosse ball for gentle massage along the ITB and the glutes can help during acute flare ups. Because the ITB is a non-contractile muscle, it cannot be stretched easily so soft tissue work is a good bet to help relieve symptoms. 

Hip strengthening: Remember how we said that the ITB connects into most of the major stabilizing muscles at the hip? Well, ITBS is often associated with weak hip muscles. So…once the symptoms are more tolerable, performing exercises to strengthen your hips is super important. Examples include: 

  • Glute bridges with a resistance band

  • Sidelying hip abduction and resisted clam shells

  • Sidesteps with a resistance bands

  • Side planks

These are a few effective basic exercises to get you started. 

Mechanics: Gait mechanics, especially while running, and squatting/stooping can have a significant effect on the ITB.  It can be hard to assess this on your own, so a physical therapist might be a good resource. (They can also give you more specific hip exercises to get you on your way.) 


Bottom Line:

IT band syndrome can be a pesky cause of knee pain. But you don’t have to live with it! By doing some activity modification, strengthening your glutes, and consulting your physical therapist, you can get back to the life you love to live!!

<3 The Recharged Performance Therapy Team

Sources

https://www.hss.edu/condition-list_iliotibial-band-syndrome.asp

https://www.physio-pedia.com/Iliotibial_Band_Syndrome

https://news.harvard.edu/gazette/story/2015/08/understanding-the-it-band/