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Chronic Knee Pain

Outside-the-box Solutions

right knee front left

This article is offered to readers as a sort-of outside-the-box collection of curative suggestions for chronic knee pain.  There are so many sites on the Internet pedaling useless products for knee pain, it’s sad.  I hate to see people spend money of these worthless products without first trying some off-the-beaten path methods of diagnosing and correcting their knee pain.  I am uncommonly qualified to give advice on the subject because I’ve actually had two different problems with my knees and eventually successfully treated them, so here’s the straight sh!t.  Just like we do with all joint dysfunction here on Floota.com, we need to identify what muscles are acting on the joint.  There are two different planes the knee can be screwed up in, the left-right plane and the forward-backward plane.  If you have pain in the front or back of your knee, we’re probably dealing with a hamstring vs. quadriceps strength or laxity (length/tightness) imbalance.  If you have pain on the sides – in the outside (by your hand) or inside (by your other knee) – of your knee, we’re probably dealing with a groin (adductors) vs. hip (abductors) strength or laxity (length/tightness) imbalance.  Those are the muscles above the knee.  The calf muscles (soleus, gastrocnemius, and especially the popliteus) can contribute any and all types of knee pain.

Now, I have only experienced pain in the front of my knee and pain in the outside of my knee, so I can only speak from experience on those issues.

best itb stretch

Pain on the outside of the knee.  I got this from doing lunges hardcore with no warmup every other day for about a two weeks (moron).  Turns out to be iliotibial band syndrome (ITB syndrome).  Fun!  Here’s the deal: there’s a huge tendon running down the outside of your leg (coincidentally, the tendon is called the “iliotibial band”).  Two muscles pull on the iliotibial band to move your leg out to the side (think Jane Fonda): your butt (gluteus maximus) and your hip (tensor fasciae latae or “TFL”).  So ITB syndrome is just tendonitis in this tendon, which manifests as pain on the outside of your knee. 

But wait, it gets better.  So I ice the outside of the knee and do some ITB stretches.  It gets a little better but doesn’t go away.  Guess what?  It’s very difficult to stretch the ITB, in part because there are no stretch receptors on the actual ITB because it’s a tendon, so any stretch you do for it should include butt and hip stretches.  Anyway, the best way to get rid of ITB syndrome, in my experience, is to use self-massage with a foam roller.  No joke, my pain was gone within 2 days of rolling my ITBs twice a day. 

Problem solved, right?  Not exactly.  In graduate school at the time, I was sitting in my bed a lot during the day with a laptop on my lap, legs out straight in front of me.  Two months of doing this at least eight hours a day and I had new pain…in my ass.  Seriously.  A little research discovered that this pain was coming from a little-known muscle called the piriformis.  No problem, stretch the piriformis and stop sitting in that position right?  Didn’t work.  Long story short, the piriformis syndrome and the ITB syndrome went hand in hand.  And this brings us back to where we started, the knee. 

Contributing to both the ITB syndrome and the piriformis syndrome was super-tight groin muscles.  How did I figure this out?  I looked at the function of the piriformis and the ITB.  The piriformis, along with its five friends (other smaller external hip rotator muscles), externally rotates your leg (femur).  The ITB is used to pull your leg to the outside.  What muscle does the opposite of both of these motions?  The groin muscles have two functions . . .

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Last Updated: 9/29/2008
Originally Posted: 4/7/2008