Sunday, June 21, 2009

'Why do I have pain in my knee?'

Another occasional series of features I'm starting up: an advice column featuring your questions about common running ailments, with answers from a local expert.


In this case, that local expert is certified chiropractic sports physician Scott Greenapple of Greenapple Chiropractic Sports & Wellness on Park Road (full bio here). I met Dr. Greenapple through the Trenton Guy Sr. Summer Track Series going on this month at Myers Park High School; he's a board member for the Charlotte Track and Triathlon Club, which runs the series.

If you have aches, pains or anything else you're wondering about injury prevention, send me an e-mail and I'll work with him to provide you with some guidance. Meanwhile, let's get to the first question ...

Q. I love running but have been having a problem on the outside of my right knee, maybe an inch down from the knee joint. I've tried different stretches before running but it always seems I get a nasty pain in a very specific spot. It's really put the brakes on my ability to go running. What am I suffering from?

Dr. Greenapple says: Typically, the pain runners get on the outside of the knee is from a condition called Iliotibial Band Syndrome or ITBS. The causes are many. Most people focus on treating the symptom, which is pain on the outside of the knee. They try and stretch it out or take anti-inflammatories. This usually does not work.

The pain is caused by the muscle (where it attaches at the hip) called the Tensor Fascia Latta (TFL) being either too weak or too tight or both, which puts pressure on the insertion at the outside of the knee. Furthermore, another muscle -- the Gluteus Medius -- is typically weak, and the TFL has to work harder, causing an imbalance that leads you to dysfunctional running and then pain.

The ITB is a thick band that really does not stretch (despite what the Internet will tell you); the other muscles can be stretched and worked on if needed to try and help resolve the problem.

There are many other causes of outside knee pain, but this is the most common. The best advice is to have it evaluated by a sports physician who understands the biomechanics of running, and can give you a diagnosis as well as treatment and proper stretches and exercises. Feel free to contact my office for stretching sheets and information on ITB.

For contact info, click here.

3 comments:

Ben Greenfield said...

Another tip...if your knee pain is related to IT Band Friction Syndrome, you should definitely check out the website: http://www.bulletproofknee.com .

Good luck.

Ben

Anonymous said...

Ex Greenapple patient says: I'm an ex patient for a reason. Your problem could also be a meniscus tear. Mine was and required surgery. The good news is I walked out of surgery unassisted.

viagra online said...

The pain is caused by the muscle (where it attaches at the hip) called the Tensor Fascia Latta (TFL) being either too weak or too tight or both, which puts pressure on the insertion at the outside of the knee.