When I listened to other people—who seemed to have trouble even though their [knee replacements] went well—[I learned that] they didn’t make the commitment to rehab . . I can walk forever now—pain-free . . I can hit a tennis ball again.
Billie Jean King, six years after her 2010 knee replacements
Although acute knee injuries and anterior knee pain are very common presentations in sports and exercise medicine practice, patients presenting with lateral, medial or posterior knee pain are not uncommon and can provide the clinician with both diagnosis and treatment challenges.
Athletes can present with the chief complaint of lateral knee pain for a number of underlying problems, including: lateral meniscus tears and cysts; bone bruises or cartilage injuries of the lateral compartment; patellofemoral syndrome or patellar instability; injuries of the posterolateral corner structures (popliteus, lateral collateral ligament, mid third capsular ligament anterolateral ligament); biceps insertional tendinopathy and injuries; tibiofibular joint instability; and iliotibial band syndrome at the knee.
Lateral knee pain (Fig. 37.1) is a particularly common problem among distance runners and cyclists, the most common cause of lateral knee pain being iliotibial band friction syndrome (ITBFS). Training errors as well as alignment and biomechanical abnormalities can precipitate ITBFS. Patellofemoral syndrome (Chapter 36) or instability may also present as lateral knee pain. In the older active person, lateral meniscus degeneration or lateral compartment osteoarthritis should be more strongly considered as part of the differential diagnosis. For sprinters and footballers, overuse injuries of the biceps femoris tendon and its insertion onto the fibula should be considered more highly in the differential diagnosis. The biceps femoris tendon may suffer compression and irritation as it passes posterolaterally to the knee and inserts into the head of the fibula, likely as a result of the repetitive flexion and rotation demands on the knee. Injuries of the superior tibiofibular joint may also cause lateral knee pain.
Lateral aspect of the knee (a) Surface anatomy (b) Anatomy of lateral aspect of the knee
The astute clinician should always be conscious of the potential of associated injuries or referred pain involving the lateral aspect of the knee. Ligamentous injuries of the posterolateral corner are rarely isolated and frequently involve injury to the ACL or PCL. Lateral knee pain may also occur as a result of referred pain from the lumbar spine. The causes and differential diagnoses of lateral knee pain are shown in Table 37.1.
Causes of lateral knee pain
|Favorite Table|Download (.pdf) Table 37.1
Causes of lateral knee pain
Not to be missed
Iliotibial band friction syndrome
Lateral meniscus abnormality
Log In to View More
If you don't have a subscription, please view our individual subscription options below to find out how you can gain access to this content.
Want remote access to your institution's subscription?
Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.
If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.
Clinical Sports Medicine Collection Full Site: One-Year Subscription
Connect to one of the most renowned references in sports medicine and explore all aspects of diagnosis and management of sports-related injuries and physical activity. Subscription includes access to a library of sports medicine videos.
Pay Per View: Timed Access to all of Clinical Sports Medicine Collection
48 Hour Subscription $34.95
Pop-up div Successfully Displayed
This div only appears when the trigger link is hovered over.
Otherwise it is hidden from view.