Lateral knee pain is pain that occurs on the outside of the knee. The causes of lateral knee pain can vary as it may develop slowly or quickly, with or without an injury.

Lateral knee pain can also have various characteristics. It may feel sharp or a general ache, there can be swelling or bruising on the outside of the knee, some people may be able to continue walking on it whereas others need assistance as the knee is too sore or mobility is restricted.

Because the causes of lateral knee pain can vary, that also means that the injury or condition can happen to anyone. Those from young or old, male or female, athlete or general population.

Below we’ll look at the most common and some rarer causes of lateral knee pain, their common causes and some of their main symptoms.

• Iliotibial Band Syndrome: Irritation of the distal Iliotibial band due to the band rubbing against the lateral femoral condyle
  • Causes: sudden increase in activity, lower limb muscle tightness, lower limb muscle weakness, runners
  • Symptoms: pain worse with running, cycling, stairs, lots of walking
• Lateral Collateral Ligament Injury: Stretching or tearing of the outer ligament that helps stabilize the knee from being pushed outwards.
  • Causes: sudden twisting of the knee, awkward falling, a blow to the inside of the knee causing it to bow out, contact sports
  • Symptoms: instability, bruising and swelling, a report of a traumatic injury
• Lateral Meniscus Injury: A tear of the cartilage that lines the outside of the knee joint.
  • Causes: sudden awkward twisting, gradual wear and tear
  • Symptoms: locking sensation, difficulty straightening knee, lateral knee pain
• Lateral Knee Arthritis: Loss of joint space in the knee joint and wear and tear over a lengthy period of time.
  • Causes: wear and tear over time, aging, history of knee injuries or surgeries
  • Symptoms: dull ache, morning stiffness, crackling knees, may appear swollen
• Distal Hamstring Tendinopathy: Inflammation, degeneration or tearing of the distal biceps femoris tendon.
  • Causes: overuse of the hamstring, sports/activities where there is a lot of acceleration/deceleration
  • Symptoms: tender distal hamstring, pain with knee flexion, pain with resisted knee flexion
• Peroneal Nerve Injury (rare injury): Damage to the nerve that usually causes pins and needles around the outside of the knee and shin.
  • Cause: direct blow to the lateral knee hitting the peroneal nerve
  • Symptoms: pins and needles around and down the lateral knee, numbness around same around, weakness in shin muscles.
• Proximal Tibiofibular Joint Dislocation (rare injury): Dislocation between the tibia and fibular bones just below the knee joint.
  • Causes: significant impact to knee/proximal shin (car accident), major tibiofibular ligament injury
  • Symptoms: instability with squats, deformity on side of knee, possible peroneal nerve irritation

Diagnosis of lateral knee pain can be done by your treating physiotherapist, doctor, or sports trainer. In most cases, imaging is not required as it does not change the course of treatment and diagnosis can be made by the clinical presentation.

During the initial assessment by the treating therapist, they will begin by taking a detailed medical history and understanding of nature of the injury. Thereafter, they will:

• Observe your walking pattern
• Feel for tenderness on the outside of the knee
• Assess the range of motion of the knee and hip
• Assess the strength on the quadriceps, hamstrings, calves and glutes
• Feel for any tightness
• Perform specific tests to help determine the cause of lateral knee pain

 In some cases, imaging tests like X-rays, ultrasounds, or MRI scans may be recommended to help rule out the rarer injuries such as dislocation or nerve injury, or if an injury is taking longer than expected to heal. However, this is usually unnecessary.

As the need for a surgical opinion of lateral knee pain is rarely needed, physiotherapy therefore plays a crucial role in the management of lateral knee pain. Here’s how it can help:

• Pain Management
  • Manual Therapy: Massage or releases can help reduce pain, improve blood circulation to the affected area and release any tension of muscles to provide effective short-term relief.
  • Taping: Taping can help unload the structure around the outside of the knee to help reduce the stress that may be around the knee.
  • Brace or Splint: Depending on the cause of lateral knee pain, a brace or splint may be required to help offload the knee, stabilize the knee, and promote healing of the injured area. A brace can also be used if the injury is causing significant pain.
• Stretching and Strengthening Exercises
  • Stretching: Stretching and releasing of muscles and structures can help improve the flexibility of the knee.
  • Strengthening: An appropriate strengthening program is important to complete as this will improve the strength and endurance of the muscles around the knee, overall improving the function of the knee.
• Education
  • Understanding the cause of the lateral knee pain, how to treat it and what to expect from your rehabilitation will improve the overall outcome and give you a sense of autonomy. Your physiotherapist will help explain the condition and prognosis. And there is no such thing as a silly question!
• Activity Modifications
  • During the rehabilitation, you made need to adjust your daily activities and exercising to avoid flaring the injury. Activity modifications can include frequency and duration of breaks, adaptations of techniques, and a gradual return to activity.

Lateral knee pain can be a debilitating condition, but with the right diagnosis and physiotherapy treatment, you can manage the pain and get back to your normal activities. Remember, early intervention is key to preventing chronic problems.

So, if you’re struggling with lateral knee pain, don’t let it hinder your daily activities and enjoyment of life. Contact us today to schedule a comprehensive assessment and personalised treatment plan.

Our experienced physiotherapists are here to help you recover quickly and prevent future injuries.

Call us now on (02) 4721 1222 or book an appointment online.