Why Does the Outside of My Knee Hurt When I Run?
Knee injuries are common in runners.
But that doesn’t mean you just have to deal with it! Working with a physical therapist can help you get to the root of your symptoms and keep you doing what you love– running!
Anatomy of The Knee
The outside of your knee has a few different structures that can cause pain with running.
Your iliotibial band (IT band), lateral collateral ligament (LCL), and lateral portion of your meniscus all live on the outside of your knee.
Any of these structures can be injured, but in this blog I am specifically going to tell you about the IT band.
The IT band is a tendon that connects to the outside of the hip on a muscle called the tensor fasciae latae (TFL), and inserts on the outside of the knee.
What Is IT Band Syndrome
IT band syndrome is when the outside of your knee gets irritated and inflamed from rubbing over the outside of the knee bone when your knee bends and straightens.
This happens from increased tension on the IT band.
Common Causes of Outer Knee Pain in Runners
The IT band is a tendon, which is a dense fascial band of tissue that connects muscles to bone.
Tendons are elastic so they stretch and shorten, but they do not contract so they can’t tighten in the same way muscles do. Something must be acting on the tendon to be causing tension.
Some of those causes include:
A tight TFL muscle at the hip can cause increased pulling at the insertion of the IT band on the outside of the knee.
Tight hip internal rotator muscles turning the leg in, increasing pull along the entire IT band.
Weak hip external rotators and/or abductor muscles allowing for more internal rotation of the hip also causing tension along the IT band.
The cause of a tight IT band is rarely one singular thing. There are often multiple compensations the body is using to be able to perform the task at hand.
Because the entire body is connected, the weaknesses or tension at the knees or hips can cause other domino effects on other parts of the body.
How to Tell If It Is Your IT Band or Something Else
Assessing what movements or positions make the pain better or worse gives us a better idea of where the pain is coming from. Like I mentioned above, multiple structures around the outside of the knee can cause pain.
If there is pain with bending and straightening the knee with a snapping like sensation there is a higher likelihood of your IT band being the problem. Any kind of muscle testing could also irritate the IT band.
But if pain isn’t as affected with engaging muscles, there could be something going on with non contractile/elastic structures like the meniscus or ligaments.
What Happens If You Keep Running Through It
Continuing to run with IT band syndrome without addressing the problem can cause increased irritation and compensation in other parts of your body that can start to hurt as well.
But just resting likely won’t solve all of your pain either.
How to Treat Outer Knee Pain
Just because you have IT band syndrome doesn’t mean that you have to stop running all together!
But working with a PT is important because everyone is unique and responds to treatment differently. A PT will help you determine your body’s load capacity to then be able to program around.
A helpful cue I use with clients is to, “push to the pain, not through the pain.”
We want to load the tissue enough in the right biomechanics for recovery, but not push so much that we continue to irritate the already inflamed tissue.
There is no one program that will solve IT band syndrome for everyone, because every injury and body is different, and the root problem can be coming from different areas for different people.
But there are helpful stretches that can help with your symptoms.
Stretches and Exercises That Can Actually Help
Here are some helpful exercises that stretch and strengthen the areas that are connected to the IT band:
Quad stretching
Hip flexor stretching
TFL stretching
Glute bridges
Squats
When to See a Physical Therapist
If you have tried to manage your IT band syndrome on your own and you aren’t seeing meaningful improvement don’t wait to get into a PT!
The sooner you get things evaluated the sooner you can get back to pain free running!
Not only can a PT help you stay running and get stronger, but they can address your symptoms with soft tissue work, cupping, muscle scraping, and dry needling to get things feeling better faster as you address the root cause of your symptoms.
Where to find Runner-Specific Physical Therapy in the Lakes Region of New Hampshire
If you are a runner local to Meredith, New Hampshire looking for help with your IT band pain, book a discovery call or evaluation! I offer running-specific physical therapy and I love helping runners find exactly what they need to help them get back to pain-free running.
So if that's what you're looking for, I would love to work together!
