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Old 07-14-2011, 06:30 AM   #1
Donald Powell
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Lateral Knee Pain

Seems to have been brought on by an increase in squatting. Same side hip flexor is tighter and aches a bit if stressed but never presents during exercise or any other time.

I've been trying to read all I can and the only possibilities I've come across are IT band related. I have put together a regiment of stretching/foam rolling based upon the assumption that the pain is caused by IT band.

Question is...are there any other relatively common causes of lateral knee pain that I should look into to add into my routine?

Thanks
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Old 07-14-2011, 06:39 AM   #2
Donald Powell
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Re: Lateral Knee Pain

As far as squat form, the issue is definitely not valgus. I do tend to go a little wider and feet turned out more than what is used by the majority of CrossFitters, though.
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Old 07-14-2011, 07:24 AM   #3
Aaron Gainer
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Re: Lateral Knee Pain

Roll your gastro, soleus, peroneals, and tibialis anterior. Calves can be a hidden source of knee pain. I assume your already rolling your tfl with a lacrosse ball?
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Old 07-14-2011, 04:32 PM   #4
Steven Low
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Re: Lateral Knee Pain

Where on the knee? What movements hurt?

Tight IT band can sometimes be a culprit as compensation for weak/irritated/etc. hip flexors so that may be an answer.

Could be a bunch of different things though tbh.
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Old 07-18-2011, 08:05 AM   #5
Donald Powell
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Re: Lateral Knee Pain

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Originally Posted by Steven Low View Post
Where on the knee? What movements hurt?

Tight IT band can sometimes be a culprit as compensation for weak/irritated/etc. hip flexors so that may be an answer.

Could be a bunch of different things though tbh.


It's the lateral part of my knee pretty much directly in line with the joint.
Side to side movements cause the most sensation but I'll feel it with enough knee flexion. If I sit in a given position (ie, driving) for long enough when I stand back up it aches. Only other time I notice is if I'm taking off shoes and I use the unaffected foot on the heel of the affected side to pull my foot out of shoe. I feel it throughout my knee with that consistently.
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Old 07-18-2011, 05:45 PM   #6
Steven Low
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Re: Lateral Knee Pain

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Originally Posted by Donald Powell View Post
It's the lateral part of my knee pretty much directly in line with the joint.
Side to side movements cause the most sensation but I'll feel it with enough knee flexion. If I sit in a given position (ie, driving) for long enough when I stand back up it aches. Only other time I notice is if I'm taking off shoes and I use the unaffected foot on the heel of the affected side to pull my foot out of shoe. I feel it throughout my knee with that consistently.
wfs
http://www.eatmoveimprove.com/2009/1...-dysfunctions/

Start doing a lot of the mobility/strengthening work from the page 4... and read the whole thing.

See if that helps
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Old 09-22-2011, 08:04 AM   #7
Donald Powell
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Re: Lateral Knee Pain

Hi,

Thanks for ideas and here is an update.

(1) I regularly do the exercises as in the link provided by Steven in addition to those mandated by a sports medicine doctor. The doctor put me through an array of tests and concluded I had IT Band irritation. He told me I could do anything I wanted, was rather surprised I could do A2G pistols on either leg, and said if the problem got worse I should come see him. He concluded that I shouldn't be surprised if it occasionally flairs up but the exercises provided along with warming up appropriately will help mitigate the problem.

(2) I got a sports massage and one hour of that did exponentially more for me then doing all of the exercises on a daily basis. Afterwards I was 100%. It was incredibly painful and he found multiple knots in my IT band and my lateral quadricep on that side. But, afterwards it was quite literally perfect.


So, that's where I'm at now. It seems every 2 or so weeks it starts tightening up and produces the lateral knee pain. I do my best to foam roll it myself but this does not seem to help. I've been back to the masseuse a total of three times and each time I leave feeling 100%, enjoy several irritation free squatting sessions over a two week or so time period and then it flairs up again.

My understanding of knots in general is that they arise as a protective mechanism. IE, the antagonist is inhibited to a degree and so there is too much strain on the offending muscle(s). Given that premise, I would have to conclude that my hamstrings and a host of more minor muscles are not carrying their weight and my quads are having to compensate. Make sense?

I'm not particularly looking forward to tear-inducing bimonthly $85 sessions with a masseuse as a pre-requisite to irritation free training and life. Am I relegated to continuing to do the exercises I am doing and hoping things catch up?
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Old 09-22-2011, 12:08 PM   #8
Brent Sallee
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Re: Lateral Knee Pain

Donald, there's a lot that your masseuse can't address. He/She's only addressing the soft tissue problems, but there's a lot more that contributes to lateral knee pain, especially if it's recurring even though you've had significant soft tissue work. There's ligamentous structures attached to the kneecap which are frequently tight, bringing the knee cap laterally. In addition to this, the kneecap will automatically track laterally if you're weak in specific musculature at your ankle or hip. It'd be in your best interest to see a physical therapist, who could address all of these issues in one place.

Of course, I'm assuming you're talking about lateral patellofemoral pain, which hasn't been confirmed or denied in this thread.
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Old 09-24-2011, 04:01 AM   #9
Donald Powell
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Re: Lateral Knee Pain

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Originally Posted by Brent Sallee View Post
Donald, there's a lot that your masseuse can't address. He/She's only addressing the soft tissue problems, but there's a lot more that contributes to lateral knee pain, especially if it's recurring even though you've had significant soft tissue work. There's ligamentous structures attached to the kneecap which are frequently tight, bringing the knee cap laterally. In addition to this, the kneecap will automatically track laterally if you're weak in specific musculature at your ankle or hip. It'd be in your best interest to see a physical therapist, who could address all of these issues in one place.

Of course, I'm assuming you're talking about lateral patellofemoral pain, which hasn't been confirmed or denied in this thread.

I had an x-ray and the sports medicine doctor did several tests. He indicated it was not any sort of ligament issue and diagnosed it as IT Band irritation...runner's knee I believe was the other name. So I was assuming it was purely a soft tissue thing.

The issue seems to be at least an inch lateral to the knee cap. If I lay face down, bend the offending knee to 90 degrees, and then reach my hand back and try to move my foot toward the ground, while keeping the same knee angle, I feel it 100% of the time. During deep knee flexion or general knee movement I only feel it sporadically.
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Old 09-24-2011, 10:21 AM   #10
Brent Sallee
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Re: Lateral Knee Pain

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Originally Posted by Donald Powell View Post
I had an x-ray and the sports medicine doctor did several tests. He indicated it was not any sort of ligament issue and diagnosed it as IT Band irritation...runner's knee I believe was the other name. So I was assuming it was purely a soft tissue thing.

The issue seems to be at least an inch lateral to the knee cap. If I lay face down, bend the offending knee to 90 degrees, and then reach my hand back and try to move my foot toward the ground, while keeping the same knee angle, I feel it 100% of the time. During deep knee flexion or general knee movement I only feel it sporadically.
What the doctor was looking for were true knee (tibiofemoral joint) ligaments - ACL, PCL, MCL, LCL, etc. Technically, he can't tell you what ligaments were and weren't intact as an MRI would be required for any good reliability on that. What I'm talking about are lateral patellar retinacular fibers. Most doctors don't even know they exist. They're ligamentous structures attaching your kneecap to your femur and if they're tight on the outside of your knee, they can create ITB syndrome-like problems.

Also, the position you're describing is when the patella engages the most with the femur - it has the most contact. A lot of the time, this is the most irritating point in range for individuals with patellofemoral chondromalacia.

Think of it like this, your kneecap may actually be what's wrong, but it isn't symptomatic. Because of the poor mobility of your kneecap, your ITB has become tight and symptomatic. Sure, you can loosen the ITB, but until you address the patella's immobility, you'll keep regressing. That, or, you may have significant weakness in your hip adductors/external rotators or ankle's posterior tibialis which allows your leg to fall into a position that constantly stretches and irritates the ITB. Either way, if you went to see a physical therapist, they could address each thing. Also, they could tell you for sure if it was a patellar problem or a true knee joint problem.
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