Pain on the outside of your knee is often Iliotibial band syndrome. Iliotibial band syndrome (ITBS) is one of the most common knee injuries. It is caused by friction between the iliotibial band (band on side of hip) and the lateral epicondyle of the femur (bony bump on the outside of the knee). The pain is most intense when the knee is at 30 degrees of flexion.
The syndrome often appears with endurance sports such as cycling and long-distance running or hiking. Weight training with heavy weights may also bring on the pain.
The thought process used to be that the IT band had tightened up, causing increased friction at the knee. However, the more common belief now is that weakness in the Gluteus Medius and Maximus results in the leg internally rotating, causing the knee to draw inward. This deviation overworks the IT band, causing pain.
The two primary muscles that attach to the iliotibial band are the Tensor Fascia Lata and the Gluteus Maximus. However, other muscles also have attachments to it, including the Gluteus Medius. So, our goal is to strengthen the Gluteus Medius and Maximus and restore the proper biomechanics.
In addition, we recommend mobilizing the Tensor Fascia Lata muscle. You cannot stretch the Iliotibial band. It is too thick (you could tow a car with it). However, by foam rolling the IT band, you may be breaking up adhesions that lie underneath.
Suggested Strengthening:
1. Strengthening of the Gluteus Medius
a. Lie on your side, painful leg side up
b. Stack your legs with the knees straight
c. Abduct the leg while having the hip slightly extended
2. Abduction with bands
3. Squats with bands
4. Clam shells
5. Bridging with band
6. Side stepping with bands.
7. Massage/Mobilize Tensor Fascia Lata.
Suggested standing stretch:
While standing, cross nonpainful leg over painful leg. Have your arm on the painful side lean against a stable object and begin to lower your painful hip to the floor. You should feel the stretch on the painful hip side.
Check out the full Knee Pain Relief Program series of videos, along with downloadable guide sheets, here: https://www.bobandbrad.com/health-programs/knee-pain-relief-program
