Are you experiencing knee pain when running? Are you able to ramp up your mileage to a certain point until the outside or inside of the knee starts to hurt? Have you tried icing, stretching, foam rolling, and strengthening, but your knee pain continues and you can’t ramp up your mileage.
If this is the case and you believe you have it-band syndrome, you’re going to want to stick around at the end of this video and learn a few things about common knee problems that you’re experiencing that are probably not I t-band problems.
Hi, my name is Mike Ricchiuto, MPT, EMT-P and I’m from Physical Therapy Now. I’m a runner and have been plagued with outside and inside knee pain specifically during running.
This creates frustration, especially when someone is training for an event or performing sports. In fact, you don’t have to be a runner or an avid exerciser to experience some of these problems and symptoms.
I think that any runner will experience some type of knee or ankle pain, whether there are novice runner or if they are an expert runner. But you have to prepare yourself in any condition, all year round to be able to run frequently.
The first problem that may not be it-band syndrome or iliotibial band syndrome is meniscus problems. The meniscus in the outside of the knee is almost like a cushion that when the top of the knee bone hits the bottom of knee bones, the cushion there protects it from trauma.
Another problem that may arise and precipitate like it band syndrome is lateral strains of the hamstring. The hamstring has a tendon on the outside of the back of the thigh that comes down and attaches below the knee.
Sometimes this is misconstrued as it-band syndrome. Meanwhile, it’s a strain of this hamstring muscle or a sprain of the hamstring tendon.
So this can be misconceived as it-band syndrome. The third problem that can create lateral knee pain that’s not it-band syndrome are pelvic problems.
So a portion of the pelvis can be rotated back and forth, up and down. There can be leg length differences, and this can place abnormal strain on the outside of the knee.
So someone stretching and trying to stretch their hamstrings and their it-band maybe stretching them forever. But it’s really because their pelvis is out of alignment, and not functioning the correct way.
And that creates once again tension and pressure, sometimes to the outside lateral aspect of the knee. Well, there you have it.
There are three reasons why it-band syndrome may not be occurring with someone who is experiencing lateral knee pain, especially in runners and sports enthusiasts. If you have lateral knee pain and would like a specific evaluation to determine if this is or is not it-band syndrome or something else, give us a call and we’ll schedule an evaluation (412) 794-8352 is our number you can schedule at any of our three clinics.
Also you can type “pain” below, and we’ll answer direct questions toward your condition. So I hope this has been helpful and have a nice day.
Pain on outside of knee that goes down and behind leg , upper leg doesn’t bother me or hip doesn’t hurt. Had meniscus surgery in 2019 four months later still the same, orthopedic doctor wanted to chop at meniscus again I would not have it done because I believe it’s not meniscus. I seen another orthopedic dr. He had me do therapy because he said it was on the outside of knee but never mentioned IT band syndrome. I did twelve weeks of therapy with no relief. So on to another orthopedic dr I went.he said it’s on the outside of knee and it sounds like IT band syndrome he said if it doesn’t get better in a few weeks come bad! I’m so frustrated I can’t even walk without so much pain and I can’t get any relief . This has been going on since 2019 every step I take it hurts so bad and I can’t get answers I’m not a runner or a triathlon person, all I do is get up in the mornings and walk like everyone else does but with severe pain within five minutes of walking. I hope you can give me some answers or guide me in a direction on what to do or who to go to about this. Really do not think it’s IT band syndrome. I’m not in your state but hopefully you can give me some answers
Hi Cheryl! I am sorry about your circumstance. There are many patients you don’t quite have clear answers while going through the medical system and unfortunately we do see this often. Many diagnoses can be made from looking only at imaging or when a clinician does not have enough time to do a fully comprehensive exam. In your case more information is needed. If you stepped into our office and I examined you we would take a deep dive into your low back, hip, sacroiliac complex, and the muscles controlling the front and back of your leg. I am not sure that when you had physical therapy this was done but having 12 weeks of therapy I am hoping that this was the case. A clear diagnosis and prognosis must be made as well as clear action steps and communication to you for the solution to the problem. Many times IT band syndrome is really low back pain, it can manifest itself as true hamstring problems, or can be the result of a leg length difference. Sometimes the timing of when muscles fire is the problem. There are also internal structures of the knee like the meniscus that can be the true problem but in your case this does not seem to be true. In any case I would never have someone continue to take the meniscus of your knee away. What I would do is find a physical therapist in your area that specializes in sports medicine and orthopedics who could spend a good bit of time with you. I would explain your situation and have them fully evaluate your condition. I would attempt another month of therapy but not 3 more months. At our clinic if you are not making at least 10% progress in the first two weeks then we have to change our plan or refer you out to another clinician. I hope that this helps and don’t stop fighting for your wellness. You will get this. Take care!
I’ve had swelling and pain on right lateral chondyle area for about 4 years. Right TKR in 2014 made right leg 1/4″ longer. Seen 5 knee surgeons and they all say it’s IT band. I don’t think it is because I wasn’t doing alot of cycling when it first happened. One surgeon said I needed a revision to TKR. I got it and still have the same pain and swelling. The only thing that relieves pain is hip stretch. I think this is pelvis related, as I’ve been told in the past that pelvis is rotated.
Possibly related, I have chronic, 2.5 year hamstring strain on left leg.
Hi Jeff, thanks for the comment and sorry about your situation! I’m going to start with the most simple of things and go from there. After the revision there was a determination that the right leg was 1/4″ longer and that there was/is a pelvic innominate (rotated pelvis). Did the therapist determine whether this was a true leg length difference (One that is caused by an actual limb length) or a functional leg length difference (One that is caused by a pelvic rotation)? Thanks!
Pain. I’ve had pain for two years in my buttocks (outside and piriformis) hamstrings, hip flexors, lateral hip and lateral thigh mostly to knee. Tore meniscus in rt knee. Walked hiked up on rt side for 5 months or a bit longer. Had a partial meniscus removal rehabbed knee. Rehab was fine. Then all started in butt, hip, legs snd has never let up. Hip alignment was off. One higher than other and rotated. Weak rt glute med. Had some SI dysfunction. Strengthened core,, hip, buttock muscles during PT for slmost two years. but still have severe (what feels like) muscle tightness in hamstring low and where meets buttock, same in outside buttock and piriformis, hip flexors. Lateral knee (it band?). I can’t walk or stand w/o significant pain for two plus years. I can’t participate in life very well. I’m so exhausted with the constant pain snd no diagnosis. Tried shots in back in facet and lumbar discs- no change, tried SI joint injection- felt 60% better for one week then straight back to pain, try dry needling- get some relief for a day or two sometimes, tried acupuncture, tried muscle relaxants- no change. I am full of anxiety now and down.
Thank you for your description of your current problem and I am sorry that you have been having so much trouble with this. There is a lot going on here from your present history so it might be a little difficult to pin-point the problem without examining you specifically. We definitely see patients like yourself all the time and many patients have very good outcomes with us after finding out the source of the problem. It looks like you have had “some” relief from facet and disc joint injections but unfortunately this was short lived. The good news is that this has provided some information (a diagnostic) about your condition which indicates that there is a lumbar spine component to this. If you were a patient I would in-fact start with evaluating your lumbar spine and pelvis. Although the IT-band, hip flexors and other musculature could definitely be contributing to your condition many times pain residing in the hamstring the source could be from the lumbar spine, pelvis, and/or sacroiliac joint or a combination of all of those and the hip. Confusing right? This problem has to systematically be looked at to rule “out/in” certain conditions and sources of pain. If you are close to one of our offices we could certainly evaluate your condition and look into this further. If you would like to discuss more about this on the phone then here is the link for a free 30 minute consultation. https://calendly.com/physicaltherapynow/30-min Thank you so much and best of health!
I started running almost after an year on a hard surface (concrete Road) but after a few days i started feeling pain on the lateral side of my left knee specially during running, then i took rest for a week, but whenever i try to run it hurts a lot, i can walk often without pain or with minor pain, i can bend my knee, but whenever i run the pain is just intolerable, what could be the cause? IT band syndrome or meniscus tear?
Thanks Bharat for responding to the blog. There are many causes of knee pain most commonly meniscal tears, as you mentioned, IT band syndrome, hamstring and calf disorders, ligamentous tears, arthritic conditions, and the list goes on. Many times these conditions develop because of abnormal or repetitive forces on the knee, hip, or ankle that will create problems at the knee. Eliminating the source of the poor biomechanics often but not always eliminates pathology that develops. Although your specific problem requires a physical therapy evaluation to find out the source of your problem here are a few quick general tips for making sure that you are reducing accessory forces on the knee. 1) Make sure that if you are running on on concrete make sure that you are aware of a grade of payment. Many roads tilt and if you are running one way on a tilted grade make sure that you reverse your course to even out the forces on your body. 2) Make sure that you are changing your footwear every 500 miles. Foam, plastic, and rubber, wear down and can create an altered ankle that can send unfavorable forces to your knee. 3) Make sure that you have an evaluation with a physical therapist or physician. Good luck. You should have longevity with running well into you elder years if you are smart about what you do:)!