Pain on the outside of the knee, especially when bending, is a common complaint that can disrupt daily activities and exercise. Understanding its causes can help individuals address it effectively.
Common Causes of Outer Knee Pain When Bending
Iliotibial band syndrome (ITBS) stems from inflammation of the iliotibial band, a thick fibrous cord along the outside of the thigh. Repetitive knee bending, common in running or cycling, can cause the IT band to rub against the knee’s outer prominence, leading to pain. This pain often worsens as the knee flexes and extends, particularly around 30 degrees of knee flexion.
A lateral meniscus tear can cause outer knee pain, especially with bending. The meniscus is a C-shaped cartilage that acts as a shock absorber between the thigh and shin bones. Tears result from acute twisting injuries or gradual degeneration. Damaged cartilage can pinch or cause discomfort during knee flexion, squatting, or twisting. Patients might also experience clicking or catching sensations within the joint.
The lateral collateral ligament (LCL) stabilizes the outer knee. An LCL sprain occurs when this ligament is stretched or torn, often from a direct impact to the inside of the knee, forcing it outward. Bending the knee, especially with side-to-side stress, can worsen pain along the outside of the joint. Swelling and tenderness directly over the ligament are common.
Popliteus tendinopathy involves inflammation of the popliteus muscle tendon, located at the back and outer side of the knee. This small muscle assists with knee rotation and unlocking. Overuse, such as from downhill running or activities requiring repetitive internal rotation, can lead to outer knee pain, particularly when bending or walking downhill.
Initial Steps for Relief at Home
Implementing the R.I.C.E. protocol can provide relief for outer knee pain. Rest means avoiding aggravating activities. Apply ice to the outer knee for 15-20 minutes several times daily to reduce swelling and numb pain. Gentle compression with an elastic bandage can minimize swelling, and elevating the leg above heart level helps reduce fluid.
Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can alleviate pain and reduce inflammation. These medications block substances contributing to pain and swelling. Use them as directed for short durations to manage acute symptoms.
Gentle stretching can improve flexibility and reduce tension in structures like the iliotibial band. For example, lie on your side, cross the affected leg behind the other, and gently lean away to stretch the IT band. Light strengthening exercises for hip abductors, such as side-lying leg lifts, also support knee mechanics.
Modifying activities that provoke pain aids recovery. Temporarily reducing the intensity, duration, or frequency of exercises like running or cycling can prevent further irritation. Substituting high-impact activities with low-impact alternatives like swimming or elliptical training allows the knee to heal while maintaining fitness.
When to Consult a Healthcare Professional
If outer knee pain persists for several days despite consistent home care, seeking professional medical advice is appropriate. Pain that doesn’t improve or worsens over time warrants an evaluation, as this could indicate an underlying issue that requires specific medical intervention.
Immediate medical attention is necessary for severe pain, especially if it prevents you from bearing weight on the affected leg. This could signal a more serious injury, such as a fracture or significant ligament tear. Any noticeable swelling, redness, or warmth around the knee joint also warrants a visit to a healthcare provider, as these can be signs of infection or substantial inflammation.
A feeling of instability, where the knee seems to buckle or give way, indicates a potential ligament injury affecting joint stability. Mechanical symptoms like clicking, catching, or locking within the knee joint also warrant professional assessment. These sensations often suggest that something inside the joint, such as a torn meniscus, is interfering with normal movement.
Professional Diagnosis and Treatment Options
A healthcare professional will typically begin with a comprehensive medical evaluation, including a detailed discussion of your symptoms, medical history, and physical activities. A physical examination will assess the knee’s range of motion, stability, and tenderness to pinpoint the source of pain. Specific tests, such as palpating the IT band or performing meniscus-specific maneuvers, help guide the diagnosis.
Diagnostic imaging may be utilized to gain a clearer picture of the knee’s internal structures. X-rays can rule out bone fractures or degenerative changes like arthritis, which can sometimes mimic soft tissue pain. Magnetic resonance imaging (MRI) provides detailed images of soft tissues, useful for identifying issues such as meniscus tears, ligament sprains, or tendon inflammation.
Conservative treatments are often the first approach. Physical therapy plays a significant role, focusing on specific exercises to strengthen surrounding muscles, improve flexibility, and correct biomechanical imbalances that contribute to pain. Therapists may also use manual techniques or gait analysis to optimize movement patterns.
Prescription anti-inflammatory medications or stronger pain relievers may be prescribed for more severe pain or inflammation that does not respond to over-the-counter options. In some cases, injections like corticosteroids can reduce localized inflammation, while hyaluronic acid injections might be considered for joint lubrication in certain degenerative conditions. Surgical intervention, such as arthroscopy for meniscus repair or debridement, is generally reserved for cases where conservative measures have failed to provide adequate relief and a specific structural issue requires repair.