Discomfort on outside of knee

Discussion in 'Strength & Conditioning Discussion' started by Ian Coe, Mar 25, 2008.

  1. Ian Coe

    Ian Coe Silver Belt Professional Fighter

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    Right, short question


    Been doing a decent amount of running. Last sunday I went on a LSD run and did hills sprints at the end. It was the end to a long week (well...I trained the next day and so on so not really a end) and had done 2 sets of hill sprints and a hard 4-5 miler the day before the LSD run.
    I jogged home and started to get some discomfort on the outside of left knee. It wasn't major but walked some of it incase.
    Next day jogged to gym and it started again but a little worse. The leg back I walked.
    I've had since last monday off from running, with complete rest friday-monday.

    Now, it's kinda there still. I'm going to start doing my ass to grass squats again to strenghen the muscles around the area and do some stretching (I current do.....ok, not much lets say), but does anyone have any opinions on what it could be and solutions to fix the problem (because it goes from discomfort to pain).

    I need to get more swimming and rowing in I think (maybe some cycling too, but I don't like cycling for the lack of effect on the lungs).
     
  2. Benji Snap

    Benji Snap <img src="http://img262.imageshack.us/img262/3617/

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    It could be strength difference between the VMO and vastus lateralis... is your VMO well developed?

    The more likely answer is a tight ITB, especially since your knee pain is on the outside. Get a foam roller or any roller and roll along the ground on top of it with the side of your leg. Stretch your ITB too. Something that is better than both of those is a VERY hard massage to your ITB to look for muscle knots and massage them out. Get someone to check the bottom side of your ITB very thoroughly. If you find painful/tender spots its probably a muscle knot. From experience the massage therapists I went to sucked because they are too gentle.
     
  3. Ian Coe

    Ian Coe Silver Belt Professional Fighter

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    Could I get someone to just muscle about in the area around the knee and kneed it to release any knots?


    I was linked to something in runners world I think that was very similar to what you just mentioned (the fact with the pain being on the outside of the knee).


    How would I know if my VMO is well developed?
     
  4. Benji Snap

    Benji Snap <img src="http://img262.imageshack.us/img262/3617/

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    Yeah.. Don't use your whole hands like a "relaxing" massage but very direct pressure with your thumbs or paired fingers looking for sore/tender/crackly spots aswell as muscle knots that can feel like grapes/peas inside the muscle. It's easy to miss them on the underside of the ITB without hard, focused pressure... and if you find them you would need a very high pain tolerance to get them out yourself. It's best to get someone such as a family member that to have a look around. they need a decent level of strength though. A massage therapist would need multiple visits and it's hit and miss because most don't know what they are doing.


    Use a moisturising lotion and search very deep. A deep massage will also breaks up scar tissue and will loosen it up. A tight ITB will pull on your patella causing it to mistrack.

    For your VMO... straighten your leg and have a look at the muscle. it's the teardrop on the inside your thigh. But since your pain is on the outside of your knee its more likely to be caused by a tight ITB.
     
  5. Ian Coe

    Ian Coe Silver Belt Professional Fighter

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    Got ya


    I was considering getting someone else to do it for me, although I think she might be too weak to get in there.
     
  6. Benji Snap

    Benji Snap <img src="http://img262.imageshack.us/img262/3617/

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    I get my sister to do mine... she is pretty strong now lol. I've had a few bad chronic injuries and it turned out they were all caused by muscle knots. I had the same problem you have now with my knee.


    Lie on your side with your knee slightly bent and check the sides of your leg particularly the back of the side almost where your hamstring meets your quad. This is where mine were.
    Check your hip flexors too and your thighs particularly the outer quad. Don't just check around the knee but all the way up your leg.
     
  7. liquid!

    liquid! mens rea

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    Right on Benji! I have a good massage therapist who braces herself against the wall for leverage to apply the pressure needed.

    Foam roll from the outside of your leg from your hips to past your knee

    Make sure not to always run on the same side of a crowned road. Running on a banked surface bends the downhill leg slightly inward.

    As Benji mentioned weak hip abductors are also a culprit.

    I started experiencing IT Bands problems after dropping an arch. Effectively giving me uneven leg lengths and pelvic tilt.
     
  8. MikeMartial

    MikeMartial Black Belt

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    Jackpot. Excellent answer.

    I had a wicked, WICKED case of ITBS syndrome about 10 years back; I couldn't do stairs for weeks. A LOT of ibuprofen daily helped. I wish I had known about foam rolling.
     
  9. Gov

    Gov White Belt

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    I had a case of ITBS a few years back that kept me out of running for a few weeks on end. The above advice is good, but I also recommend that you find a very good sports doctor who'll investigate it thoroughly.

    I still get a little nervous when I think about the ITB massages that I had to endure in order to back to training. Those things are tougher than any workout :)
     
  10. Ian Coe

    Ian Coe Silver Belt Professional Fighter

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    I think I have over compensated with a short run on tuesday, seeing as now my right knee hurts but at the front :icon_cry2


    DAMN YOU HUMAN BODY
     
  11. Gov

    Gov White Belt

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    This may sound obvious Ian, but are you warming up and stretching properly?

    I've had issues with pain both on the side and top of knees, and nothing fixed them better than making sure I'd done ALL of my leg stretches before hand. In particular, stretching out the hip flexors has a huge effect on the knees. You can also stretch the ITB at the hip by crossing over your legs and leaning your hip out on the side of the sore knee. You'll feel the stretch in the hip.
     
  12. Benji Snap

    Benji Snap <img src="http://img262.imageshack.us/img262/3617/

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    damn... Look up patella tendinitis/patella-femoral pain/runners knee/anterior knee pain.

    this is usually the type of injury that won't just go away on it's own... Do single leg squats and strengthen your glutes and hips too. Stretch your quads, particularly your rectus femoris... make sure you don't lean forward at the waist when stretching your quads. The bad thing is there are so many different things that can cause this pain such as muscle weaknesses and tightnesses, over pronation, flat feet, knock knees and more.
     
  13. Ian Coe

    Ian Coe Silver Belt Professional Fighter

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    ^^^

    Cheers mate. I think to be honest I was trying to land heavily on my right leg then my left. It should be ok.

    But I will do some reading and extra stretching.
    I've been missing out my squats for ages (been doing ZDL mainly until I stopped lifting around oct time in prep for fights) so on tuesday I added some in after my fitness work. Some ass to grass ones to try and strengthen the entire region.
    Nothing special, [email protected], [email protected] and [email protected] (kg). We'll see if that helps.


    I've been told to start doing more dynamic work before the run and more static stuff afterwards.
    In all the times I've run since.....like 5 years ago, my warm up has been to jog for 5 or so minutes until my legs, mind and lungs are getting into it then begin to up the pace.
    I've never had a problem doing that and doing some stretches afterwards.

    I'm going to have to start working on the hip though I think. That could be pulling on something
     
  14. pandaman

    pandaman White Belt

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    Sounds like classic ITB, but I'm not a doctor. I just say that because it's exactly how I got mine!

    Thumbs up for the NSAIDs and foam rolling. May I also suggest a rolling pin as a progression from a foam roller, it replicates a massage better because it's a lot harder!

    I also wanted to give you a word of caution - if you're going to try cycling while you've got ITB take it VERY CAREFULLY! I was training for a triathlon last year, had my ITBS flare up exactly the way it did for you (end of a LSD run with some effort intervals, jogging home, felt the discomfort) and I found I couldn't cycle with any intensity or effort. I actually didn't know what the pain was, thought nothing of it and went on a very very hilly ride and that's when I really made it worse. I was able to get bake into very gentle spinning (easy gear and 90 cadence) to keep the legs loose, but nothing more...

    Instead I'd suggest you swim, that should be fine. If kicking hurts, use a pool buoy between your legs, let your arms do the work! Also, anything with knee flexion and extension past a certain point could be painful (stairs, all forms of squatting for example) - just experiment conservatively with what hurts and what doesn't. I found squats were ok, but I couldn't walk up and down stairs without pain for 6 weeks. If that's the case for you, treat yourself and take the elevator!
     
  15. Benji Snap

    Benji Snap <img src="http://img262.imageshack.us/img262/3617/

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    Let us know how it goes...

    Something that I have found that emphasises the VMO is a specific type of squat with lighter weight... probably 40kg would be good for you... and squat in a VERY wide sumo like stance... with your feet pointing very far outwards... almost 180degrees away from each other but not quite. Don't worry about depth for this.

    You can't isolate your VMO 100% but doing this is about the closest you will get.

    Do some single leg squatting too.
    Single leg eccentric squats are great. I bought a solid wooden board for about $10 from a hardware shop and lean it against a 30cm high step to create the slope and do slow 1 legged eccentric squats standing on it. The downard phase is slower.
     
  16. Ian Coe

    Ian Coe Silver Belt Professional Fighter

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    It seems to be going ok for the time being mate.

    I went for a run yesterday and seemed to be ok, I'm thinking about going on a slow run tonight and some sprints tomorrow.

    Its a nice day and I feel couped up at the moment.
     
  17. Ian Coe

    Ian Coe Silver Belt Professional Fighter

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  18. black koala

    black koala Banned Banned

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    Your knee hurts so instead of ice and rest your going to do squats and cycle? Keep us posted.
     
  19. Ian Coe

    Ian Coe Silver Belt Professional Fighter

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    I used the word discomfort on purpose.


    From the tone of my post you can come to the conclusion that the time frames for rest and rehab work and prevention are different



    :rolleyes:
     
  20. Revok

    Revok Brown Belt

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    Let us know how those insoles work. If they're any good they might let me get through the summer without forking out
     

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