Member Case Study: Right Knee Pain and Road Angle

author : AMSSM

comments : 1

When athletes have an imbalance, either due to core weakness or in this case uneven terrain, this can produce strain anywhere along the IT band, but most commonly along the outside of the knee.

Member Question:
I recently went for a long run of ten miles. Afterward the outside of my right knee hurt considerably. I felt no pain or discomfort during the run nor had I injured the knee anytime prior to the run. I was running on a highway, facing traffic, and the road slanted to the left.

Could it be that the angle, or slant, of the road, over a long run produced the most stress at my inside (right) leg at the knee? The knee continues to bother me even when I run on a flat surface for shorter distances. It usually takes a day or two after a run for the pain to cease.
 

Answer:

The short answer to your question is yes, the slant of the road produced the most stress on your inside (right) knee. Your problem is not an uncommon one. Many distance athletes have problems when it comes to uneven terrain.

The problem that you are describing is most consistent with iliotibial (IT) band syndrome. The iliotibial band is a large band of tissue that runs from your hip, down the outside of your leg, crosses the lateral aspect of the knee and it inserts on the tibia (your lower leg bone).

When athletes have an imbalance, either due to core weakness or in this case uneven terrain, this can produce strain anywhere along the IT band, but most commonly along the outside of the knee. Your problem is not one that requires surgery and generally, doesn’t require a break in training. With this problem, I generally tell my athletes, “you can do what you can do.” In other words, if it is not causing severe pain, you can continue to run.

If you are having significant problems, you may need to spend some more time on the bike or in the pool until it settles down. I suggest that you see a local sports medicine specialist who can do a good analysis of your core strength and IT band. They should be able to direct you to a therapist who can assist you in the appropriate rehab regimen.

Mark Alexander, MD CAQ Sports Medicine
Fairview Hiawatha Clinic
Minneapolis, MN

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date: November 19, 2006