Pain in the sides of the knee is characteristic of several conditions involving structural problems. Iliotibial band friction syndrome, sometimes referred to as "runner′s knee," is focused on the outer area of the knee. When damage occurs to a ligament, the question may be less where the pain is (it is everywhere or, with nerve damage, nowhere) and more where the instability is. Instability and pain may occur predominantly on the outside (what physicians call the lateral aspect) or inside (medial aspect) of the knee.
Runner′s knee, a general term for what doctors call iliotibial band friction syndrome, is a tendonitis or an irritation on the outside part of the knee. Physicians prefer the technical term because "runner′s knee" is a term used to refer to any knee pain. The tensor fasciae latae muscle on the outside of the hip connects to a thin but very strong structure called the iliotibial band. This band then attaches to the bump on the outside of the knee and below the knee. When the knee extends and flexes, this band moves across the bony contour of the knee and becomes irritated. Cumulative irritation eventually causes pain. The friction may also irritate a small bursa underneath this attachment, causing localized bursitis here also.
The pain caused by this friction is very insidious. Many times when patients evaluate their activities, they find they have put more stress on this area than usual; for example, they have taken a longer-than-usual bike ride, run on the side of the road instead of on a track, or have taken long hikes after training with only short walks. Symptoms can vary from hurting all the time to only starting to hurt after so many times or after so many minutes into an activity. This pain is very unlikely to occur after participation in such non-weight-bearing sports as swimming.
The iliotibial band connects hip muscles to the knee. Knee movement can cause the band to become irritated and result in pain on the outside of the knee.
A common mistake in treatment is only treating where it hurts. Usually the pain is caused from tightness in the whole tensor fasciae latae muscle and iliotibial tract structure. Remember, the structure goes from the hip all the way to the knees; therefore, special types of stretches, such as Ober stretches, are used to stretch out the whole length and thus remove tension from the distal, or end, attachment. Deep tissue massage throughout the whole side of the leg is helpful, as are anti-inflammatory medicines. Occasionally a localized cortisone injection, treatment with cortisone pads, or localized electrical treatment may be beneficial. Sometimes the increased stress may be coming from misalignment of the knee or ankle, and exercises that are arthrotic may be beneficial.
This is a section from Dr. Jack E, Jensen′s book The One Stop Knee Shop. Read the next section Ligament Injury.