- Hello, my name is Yeong Kwok,
and I'm a primary care internist and a recreational runner
at the University of Michigan,
and this is Anthony Pariano, who's a marathon runner
and also coach of the Huron High School cross-country team,
and we are here today to talk to you about knee pain.
Specifically, we wanna talk to you about knee pain
on the side of the knee
or lateral knee pain on the outside of the knee.
Now, the first thing to figure out
when you're dealing with lateral knee pain is
whether it's above or below the joint line.
The knee is a hinged joint
where the thighbone meets the leg bone,
and the joint line is where the two bones actually meet.
So let me demonstrate that on Coach Pariano.
So the way you can tell
where the joint line is is here is the kneecap,
and right near the bottom of the kneecap is
where the bones meet if you're in this seated position,
and that's where the joint line is.
Now, if you're having pain above the joint line
on the outside of the knee,
by far, the most common cause
of that is going to be iliotibial band friction syndrome,
which I'm sure many runners have heard of.
The iliotibial band is a thick, fibrous band
that runs from the hip or ileum,
all the way down the side, down to the leg bone or tibia.
Hence, it's called the iliotibial band,
and as it goes over this region here,
it tends to rub on the thigh bone,
the bottom part of the thigh bone called the femur,
and cause friction and cause pain in this particular spot.
If a runner develops this during a run,
the best thing to do is stretches for the iliotibial band
so that it's not as tight,
and it does not cause as much rubbing,
but today, we're going to focus on cause
of joint pain below the knee joint,
especially in this particular spot here.
This is one area that really hasn't been commented on much
but I do believe it is a common cause
of knee pain in runners.
This particular spot is significant because this is
where the big muscle in the leg called
the tibialis anterior muscle attaches,
and this muscle is responsible for flexing the ankle upward,
and you can see the muscle contracting
as the ankle is flexed upward.
This is very similar in structure and function
to the muscle and the forearm here,
which can cause tennis elbow if the forearm is overused.
During the typical course of a run,
this muscle contracts thousands of times
and can develop tendinitis below the knee joint
or in this spot.
Now, if you're a runner and you have developed pain
in this spot below the knee joint,
I have adapted a very successful exercise
that was adapted for tennis elbow to treat tendinitis
in this particular spot,
and Coach Pariano will kindly demonstrate that exercise.
It involves three simple steps.
Any elastic band is useful for this exercise.
First, cross your injured leg over,
as Coach Pariano is doing,
and place the elastic band over the ball of the foot.
That's step one,
and then under tension, straighten the leg
with the ankle bent backwards.
That's step two, and finally,
step three is push down on the gas pedal,
and then repeat those three steps 15 times,
three times a day,
and I have found that this was very effective
in getting rid of this particular tendinitis
or pain below the knee joint.