Lateral pain, just below knee
(11 discussions)
I’ve recently developed a pain while running that is just below my knee, on the outside of the leg. When standing, it ‘feels’ like the knee, but when I put my finger on the spot, it turns out to be just below the joint-perhaps at the top of the fibula. There has been no injury, and the the pain occurs in both legs. But it has just started to really hurt over the past few weeks, seemingly with no ‘trigger’. Again, no injury, on change in distance or speed. The pain is sharp, and I have to stop running. No pain when cycling, though I will feel it at odd times, such as when operating my clutch or brake pedals in my car. Any ideas on what this might be. I haven’t found anyone with these same symptoms. Thanks
11 comments
Xrsyzer
In my experience the piriformis is responsible for unilateral lower back pain and or referred “sciatic” pain. Referred sciatic pain in 90% of the cases i’ve worked with has manifest itself as a “dull ache” on the lateral aspect of the lower leg distal to the fibular head and (occasionally) the lateral foot.
Moreover, the description of external rotation of the leg exacerbating symptoms would seem to suggest that an external rotator muscle is invloved.
I do agree that a hands on examination is (always) warranted as there is the possibility that the problem is actually a disk rather than muscular compression of the sciatic bundle by the piriformis.
If massage of the piriformis, releasing ant detected spasms, improves the symptoms; that’s the place to start backtracking the problem.
Muscledawg
In my experience the piriformis is responsible for unilateral lower back pain and or referred “sciatic” pain. Referred sciatic pain in 90% of the cases i’ve worked with has manifest itself as a “dull ache” on the lateral aspect of the lower leg distal to the fibular head and (occasionally) the lateral foot.
Moreover, the description of external rotation of the leg exacerbating symptoms would seem to suggest that an external rotator muscle is invloved.
I do agree that a hands on examination is (always) warranted as there is the possibility that the problem is actually a disk rather than muscular compression of the sciatic bundle by the piriformis.
If massage of the piriformis, releasing ant detected spasms, improves the symptoms; that’s the place to start backtracking the problem.
Xrsyzer
Piriformis pain is usually either localized in the gluteal region or, it exhibits itself through referred sciatic irritation. (posterior aspect of the leg)
Although it sounds like your pain could be some sort of a functional biomechanical imbalance, it does not sound like a Piriformis problem.
Look at what has changed, or needs to change in your training protocol. Scrutinize every aspect:
Entire exercise protocol
Adherence to appropriate rest
All dietary considerations
New or worn equipment (shoes)
Etc
Go see your doc for the qualified diagnosis!
Xrsyzer
_________________
If your goal is achieving a specific goal, and a focused state of mind is what is required to achieve that specific goal, than the primary goal shifts from achieving a specific goal to achieving a specific state of mind. Xrsyzer
Muscledawg
This is classic referred pain from the piriformis in your hip. My guess is the pain is brought on by rotating your hip to the clutch from the brake pedal and that if you stood on one leg (as if putting on your pants) it would be somewhat painful in your lower back on that side.
First, go to the doc to get a proper diagnosis (I suggest a sports doc) and here are something you can try on your own provided they don’t make anything any worse.
Stretch the piriformis: Lie on your back and place the ankle of the affected leg on the thigh of the other leg just above the knee. Grasp the thigh with both hands and hug it to your chest. You should feel the stretch just below the “cheek” on the affected side. This *may* bring on your symptoms at first.
Deep piriformis massage. This will hurt a little. Lie on the floor (or your bed) with a tennis, cricket, or baseball. Place the ball under your cheek on the affected side and roll round on it (to the delight of family, friends, and neighborhood children ) until you find the spot in which you’d most like it not to be…leave it there breathing deeply until you feel the knot release. That should reduce your symptoms immediately.
Ultimately, you need to determine why your piriformis has tightend on you which a good sports doc can help you do. You might need some formal physiotherapy to strengthen your piriformis to prevent it happening again.
Good Luck,
Muscledawg.
Xrsyzer
[quote]
On 2003-11-14 18:39, DSA wrote:
[quote]
On 2003-11-13 17:42, chase wrote:
I seem to be having the same problem. After a three week break after Ironman Canada, I started to run again. Just short distances (5 km – 30-40 minutes) and developed pain in what feels like the top of my shin bone, just under the knee (laterally). It hurts to put pressure on it. Using ice doesn’t seem to help and though I’ve taken a few weeks off, I seem to have pain even after I do simple hiking. I also seem to have some mild pain when I lift my foot up.
My physiotherapist concluded that my ITB was so tight, it was causing my knee to be pulled in the wrong direction – with pain resulting. He’s used cupping and other release techniques to loosen it up. My massage therapist thinks the cause is further up – says my hips are slightly out of alignment. I too had pain on both sides, but now it is only on one side. My ITB is so tight that it is actaully painful to stretch…the more I stretch, the tighter it seems to get, in fact.
Still dealing with this very frustrating injury – no solution in sight. Would appreciate any thoughts/suggestions.
Soleus tightness, biceps femoris tightness?
Improper muscular proprioception due to a biomechanical issue, fibular collateral ligament issues, possibly?
Think it through, what has changed? The answer is there.
Xrsyzer
Bilateral proximal fibula pain… Running…
Are your shoes new or are they old and worn out?
Did the start of the pain coincide with a change in shoes, running surface or any other change in training protocol?
_________________
If your goal is achieving a specific goal, and a focused state of mind is what is required to achieve that specific goal, than the primary goal shifts from achieving a specific goal to achieving a specific state of mind. Xrsyzer
DSA
hi there, tight ITB and pain when hiking – one cause could possibly be a gluteal injury that has developed into a muscle adaptation/imbalance problem. Tight or inhibited gluts can refer pain into ITB, TFL and eventually the lateral knee – treatment on the gluts may help.
Leeloo
The first time I had ITB FS, my pain was below the knee a bit, just like one of you has mentioned. If you take a good look at a GOOD anatomy book, you’ll see that the ITB attaches below the knee, and actually a few “fingers” that go in toward the patella as well. Anyway, I would not rule out ITB as a possible culprit – your pain sounds similar to my first bout.
Unfortunately, ITB doesn’t always act just like the textbooks say. I have had it in both legs at different times and it has behaved differently in both instances and in NEITHER instance like the textbooks say. Both my cases have challenged my sports med doctor.
As for the post directly above mine, I have read several accounts which state that trying to stretch the ITB (which in itself is a difficult task as its location does not lend itself to being able to be stretched) in an acute case is contraindicated.
Here is a good article on ITB FS:
http://www.physsportsmed.com/issues/2000/02_00/fredericson.htm
Anyway, I recommend continuing to work with a massage therapist – and have him/her not only work around the ITB toward the knee area, but also up in the area of the TFL (tensor fascia lata). That is where a lot of trouble can hang on or eventually migrate to, as I unfortunately found out.
Good luck to you all. It wouldn’t hurt to get a MRI as well. At least that could give you some peace of mind.
chase
I seem to be having the same problem. After a three week break after Ironman Canada, I started to run again. Just short distances (5 km – 30-40 minutes) and developed pain in what feels like the top of my shin bone, just under the knee (laterally). It hurts to put pressure on it. Using ice doesn’t seem to help and though I’ve taken a few weeks off, I seem to have pain even after I do simple hiking. I also seem to have some mild pain when I lift my foot up.
My physiotherapist concluded that my ITB was so tight, it was causing my knee to be pulled in the wrong direction – with pain resulting. He’s used cupping and other release techniques to loosen it up. My massage therapist thinks the cause is further up – says my hips are slightly out of alignment. I too had pain on both sides, but now it is only on one side. My ITB is so tight that it is actaully painful to stretch…the more I stretch, the tighter it seems to get, in fact.
Still dealing with this very frustrating injury – no solution in sight. Would appreciate any thoughts/suggestions.
cj70001
Thank you for responding.
However, I’m almost certain it is not an ACL issue. The pain location is very specific, and on the outside(meaning both-lateral and on the surface) of the leg. It really almost sounds like ITB, except it’s below the knee.
sprklndanc
sounds to me like an ACL issue. i would try exercises that have low impact on the knees and see how you feel. applying ice and/or heat after workouts will help.