Lateral Knee Pain:
Typical Treatment
Many clinicians wonder why their patients don’t trust them to fix their problems. Why??
Unfortunately, lateral knee pain is typically treated in a way that does little to fix the origin of the problem. This is a mechanical issue, not a pain issue. Sure we need to decrease pain to make training tolerable for the athlete. But, the main thing to keep in mind is that our overall goal is decrease their pain and problems going forward. This doesn’t happen with localized treatments.
At MTS, we believe that evaluating globally, then acting locally and finally acting globally is the key to treating athletes. It must go in that order. If you skip over a step or never make it to the final global step, you will never get your athletes to where they need to go. Unfortunately, many clinicians get the part correct about acting locally, but it stops there.
Our experience says that most lateral knee pain patients are treated with one or more of the following treatments:
- Modalities such as ultrasound or electric stimulation
- Massaging the IT Band
- Stretching the IT Band
- Taping the knee
So, what’s wrong with the Typical Treatments? This is why they don’t work…
- Modalities: Research is showing that modalities can assist with pain in certain situations, but the overwhelming evidence is showing that for the most part, traditional modalities such as ultrasound and electric stimulation is little more than an expensive babysitter for the athlete. Ultrasound doesn’t penetrate deep enough into the tissue to make any real metabolic changes and very few of these cases have pain which is specific enough to really make an impact on their pain with e-stim.
- Massage: This can help a lot of athletes when done correctly. Unfortunately, most clinicians aren’t doing it correctly. As we look at the IT Band, it often becomes adhered to the Vastus Lateralis underneath it. These adhesions will cause pain, and more importantly, dysfunction to the quad. So, performing myofascial release through massage can make a huge impact in lateral knee pain patients. The entire IT Band needs to be addressed. To many people want to simply massage the distal portion, near their pain. But, if the entire IT Band is not working correctly, they will continue to have dysfunction. If you are going to address their dysfunction with massage or some other form of myofascial release (and you should), make sure you address the entire IT Band.
- Stretching: This is baffling. If you understand flexibility training (if you don’t, click here), you know that by performing flexibility training, you are simply trying to increase “stretch tolerance.” This is done by overloading the nervous system repetitively until muscle tolerates the stretching sensation, allowing a greater range of motion. There are no muscle spindles in the the IT Band. It is fascia. It cannot be stretched. You can stretch the muscles that attach to it, but if you think you are going to make a difference in the extensibility or stretch tolerance of the IT Band itself, you might as well go bang your head against a brick wall for a few days. It will do as much good for your athlete.
- Taping: This could include McConnell taping and/or Kinesio Taping. These techniques have some application for the very initial phase of treatment (acting locally), but it doesn’t do anything to fix the problem and will only serve to mask the actual issue.
Learn more about Lateral Knee Pain:
Proximal Tibiofibular Joint
The Cause of the Problem
The Solution
Looking for more help? Schedule a consultation today!
Left knee out side. First real problem years ago climbing high ladders; most recent a few years ago riding bike to work 11.1 miles to work for several days, very sore, and the most recent sore from walking 2 miles a day 6 days a week, cut way down to about a quarter still sore, swim sore. Sitting at desk and driving also left butox while driving hurting down to foot. work out now is a few prep movements, dumbell lifts and strething. Hurts the worst sitting at desk but not the left buttox.