Pain on outside of knee after 2/3 miles. Not convinced it's ITB.

are you running outside on concrete ?

If so I suggest the treadmill for a bit and see how it feels

Sounds like a strength and flexibiliy issue to me. Recommend you stretch you quads, hamstrings, calves, hips and add run specific strength training at least 3 times a week. Squads, lunges, pistol squats, glute bridges, hamstring curls, VMO squeeze, leg lifts, prone planks, and side planks are some good example exercises to get started without the need to go to a gym.

ETA: I also recommend you see a good sports chiropractor to check if you have any skeletal imbalances that need correcting.

Edited by kloofyroland 2018-01-15 4:33 PM

Any chance your shoes are getting old and broken down, and therefore you are landing just a little differently? If you've been running that strongly for that long, it has to be that something has changed.

You are obviously an experienced triathlete/runner, so I assume that you have some sort of stretching/recovery type protocol, but it is not listed.

I happen to have experience with ALL of the overuse injuries, but have been injury free for a few years now. I would contribute this mostly to the foam roller and "stick". Even though I hate doing it, I religiously foam/stick roll the soleus, calves, IT band, and quads. I even stick roll the front lateral portion of my lower legs in a diagonal pattern just under that bump on the outside of the knee. I specifically implemented this in response to lateral knee pain I was getting while on the bicycle that I assumed was IT band related (even though it was on the bicycle...)

In short, I would recommend foam rolling and not just "rest". It definitely sounds like an overuse injury, and there are only so many possibilities for that location. If it does not hurt to run 1-2 miles, I would do that and start rolling.

Hi Karl,

I am a muscular therapist and for the past 29 years I've been working with endurance athletes. I've seen knee problems that are caused by many structural situations, and most of the time it's because muscles are so tight they are putting a strain on the bones.

I suggest you do a self-treatment for the muscles that are on the outside of your hip. The tensor fascia lata muscle merges into your ITB and inserts into your lateral knee. Every step you take causes this muscle to contract, if fact, if you put your hands onto the outside of your hips and then stand on one leg, you'll feel the muscle contract. When you are running, especially the number of miles you are putting on each week, the muscle gets repetitively strained. As it shortens it will pull up on your ITB and you'll feel the pain in your lateral knee.

Try putting a tennis ball directly on the muscle - right between your hip bone and the top of your thigh bone. Then lie down on the floor so your weight is pressing the muscle into the tennis ball. If it's very painful you can start out by leaning into a wall, and then move to the floor as the tension starts to release.

If you go onto my Instagram site (PainFreeDrugFree) you'll find free self-treatments that will help you. Look for the picture of an athlete with a red shirt on, who is lying on a pink ball. That's the treatment for the tensor fascia lata.

I've just become an advertiser on this website. I wrote a book titled "The Pain-Free Athlete," which is an updated and revised book based on my original book titled "The Pain-Free Triathlete." :-)

Wishing you well,
Julie

The odds are this problem is caused by your pelvis being rotated by several muscles that originate/insert into your pelvis and knee.

The muscles are the psoas, iliacus (front of your pelvis), quadratus lumborum (back of your pelvis), and rectus femoris (thigh). You can do a Google search to see exactly where each of these muscles are located. It's way to long a story to explain here, but basically these muscles all shorten when you sit, ride a bike, sleep with your legs bent, or climb stairs. As they shorten they cause your pelvis to rotate, which causes a muscle on the outside of your hip to torque.

The muscle is the tensor fascia lata, which is the one that merges into your ITB. It pulls up on the ITB and that puts pressure on your lateral knee. It's worth the time to treat this muscle. Take a tennis ball, put it on the tensor fascia lata on outside of your hip, (at the muscular section that is above your thigh bone and below the bony part of your hip). Then lie down on the floor and lie on top of the ball. It's going to hurt, and if it's too much, ease into the ball. Your intention is to be able to lie totally on top of the ball and it not hurt.

You can see a picture of this treatment by going to my Instagram page (@JulstroMethod), and you can learn a LOT more by going to my websites.

Wishing you well,
Julie Donnelly

YOU are your own Best Therapist! Visit www.FlexibleAthlete.com and www.JulstroMethod.com to discover logical solutions to chronic pain and sports injuries.