What’s the cause of your knee pain? By Dr. Stephanie Harris
There is no shortage of runners who present to our clinic with knee pain! This often results in those runners having to alter their routine or stop running completely. Understanding warning signs, being proactive and managing your schedule, may go a long way in keeping avid runners running… and therefore happy (you runners out there know what I mean!).
The knee is a very important and complex joint that has many mechanisms involved in running. The muscles surrounding the knee need to work in combination with cartilage, tendons, and ligaments to keep the knee supported and moving properly In fact, 42% of all over-use injuries to the body occur in the knee. This makes sense because the knees take on a lot of stress throughout the day and even more stress when running (or exercising). With each foot strike, a runner’s knee withstands a force equal to eight times his or her body weight — for a 150 lb. person, that’s about 1,200 lbs. of impact with every step.
Knee pain can be categorized into location and depending on that location (front, back, inside of outside of your knee), it will tell us what structures are involved and what is causing your pain. Lateral (the outside) of your knee is one of the most common areas for runner’s to experience pain. Although there are a few different conditions that can result in pain on the outside of the knee, I want to focus on Iliotibial Band (ITB) Syndrome, something at our clinic we refer to as “runner’s knee”.
The ITB is a strong, thick band of tissue that runs along the outside of the leg, starting from the hip and ending on the outside edge of the shin bone just below the knee joint. The main job of this muscular band is to provide stability to the outside of the knee joint during movement. Because its role as a stabilizer, it can become irritated or inflamed from overuse (running too much, using improper foot wear, increasing mileage too fast/too soon, improper foot mechanics).
So…. how do you know if you suffer from ITB syndrome? Well first you need to ask yourself: where is my pain located? If it’s on the outside of your knee and you are a runner, there is a good chance your iliotibial band is involved. Next, you need to pay attention to when you experience the pain. Do you feel it when you are sitting down watching television, or do you notice the pain when you start running (or shortly after you start your run)? Do you feel the pain when you are descending stairs or upon getting up from a seated position? Those are both indicators that again your ITB could be involved in the cause of your pain. If you are a runner and are experiencing pain, it’s time to get your body checked out. Pain is your body’s way of telling you that something is wrong, so if you are feeling pain, you are already a step behind your body. Stay on top of your health and prevent the pain from starting in the first place.
Here are some tips for those of you who are experience lateral knee pain.
- Preventatively and regularly stretch the ITB, which is best achieved by using a foam roller
- Proper footwear is imperative!! Make sure your shoes have enough support and have not worn done from usage!
- Correct over-pronation. See if you are a candidate for orthotics (Refer to Dr. G’s previous post).
- Avoid over-training. Slowly increase mileage in a safe and controlled environment. Stick to the 10 percent rule, which states that you should increase your weekly mileage by no more than 10 percent over the previous week.
- Cross train. Do other forms of cardio (bike, elliptical) to change things up.
- Get adequate rest and recovery.
- Listen to your body.
- Get assessed to find out what is causing your knee pain. ITB syndrome is one of many issues that can cause these symptoms.
A Proper Diagnosis…is the key to fixing a problem!
Whether it’s via twitter, email, or general conversations, I get a lot of questions from people who are experiencing pain, weakness and/or dysfunction. They’re asking for HELP and suggestions! And as much as I would love to help them out, quite frankly it’s simply not that easy!
Before ANYONE (including me;)) can properly answer questions like: Why am I in pain? What is it? Why did it happen? What do I do to get rid of it? What are my treatment options? What exercises can or can’t I do? What strengthening/stretching exercises can I do to help it? What do I do to keep it from happening again? Etc…. you first MUST know what “IT” is, and to do so you MUST be given a diagnosis. So what does a diagnosis consist of?
First off, “diagnosis” is defined as identifying the nature or cause of something. The important word being “CAUSE”. All too often, people deal with the symptoms and not the cause. If you just treat the symptoms you will at BEST get temporary relief (not sufficient in my world!). But if you treat the cause, you can get rid of the problem and the symptoms.
Therefore, determine the cause of the problem (diagnosis), then, and only then, based on the diagnosis a practitioner can help you develop a plan of action (i.e. treatment options, required rest, exercises, rehab, modification to workout program, etc.).
So now that you understand a diagnosis is needed, it is important that you receive a PROPER diagnosis; here are some simple guidelines that you can follow to help ensure you are being properly diagnosed:
- The diagnosis must be given by someone who is qualified and licensed and specializes in the area of concern (don’t come to me for an eye problem).
- A proper diagnosis can not be given without a proper examination. A proper examination must contain at least 2 things: 1) a thorough history (during which the doctor asks you questions about your injury/condition) and 2) a physical examination (during which the doctor runs you through a series of tests which I refer to as orthopaedic tests which examine muscles, nerves, ligaments and joints to decipher where the problem is coming from and what structures are involved).
Note: In a small percentage of cases (10 percent of the cases that I see in my office) additional tests are required, which may include: x-rays, diagnostic ultrasounds, MRI, or blood tests.
So if you have a problem, and you want to be helped, Step 1 is getting a proper diagnosis! The sooner the better! Find the problem…fix the problem!! Remember, without a diagnosis, its just a guessing game….