Q+A: A road camber is giving me knee pain... Help!

Our experts answer real-life questions

Posted: 9 September 2000
by Martin Haines

Q I used to train on grass and gravel, but since I’ve started running on the edge of the road I’ve noticed that the knee closest to the road as I run becomes sore. I can run through it, but afterwards I’m left with a dull ache in the knee, which becomes really painful when I undertake activities that involve turning or sideways movements. I’ve set my sights on a half-marathon later this year, and I’m worried that several weeks off will put me back to square one.

A Most roads have a camber, which effectively makes the leg nearest to the middle of the road ‘longer’. The body naturally compensates for this by trying to shorten the leg to reduce the pressure on your body, in particular your back. In your case the compensation seems to be at the knee, which is bending to shorten the leg, and at the same time your foot will also flatten more than usual. As the knee bends more, it also tends to rotate inwards. This puts pressure on the medial ligament on the inside of the knee, which can become damaged. The problem is further compounded by the fact that this ligament attaches to the cartilage (or meniscus) on the inside of the knee, and when damaged can increase the pressure on the cartilage. The group of tendons on the inside of the knee will also become overloaded, and will become inflamed and tender.

The best way to manage this on your own is to avoid running consistently on a camber and revert to your original type of terrain. As for treatment, ice and massage will help with the aching symptoms. Of course, if this proves to be unsatisfactory, you’ll need to see a specialist physiotherapist in running injuries.

Martin Haines, chartered physiotherapist and sports-injury specialist

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I am suffering from a niggling pain on outside of knee, that seemed to start at mile 18 of FLM, which caused me to stop & walk .It is more noticible going down stairs, and when side movement of leg occurs. I also seem to have a 'clicking' as if something is moving over a bone. I have found advise on inside of knee, but as yet, not on outer knee problems.
Any help out there please
Posted: 20/04/2003 at 00:51

Almost certain to be ITBS. There are several threads on it since January - there is a lot of it about! Look at the injury prevention pages for the stretches and also on www.pponline.co.uk. Good luck!
Posted: 20/04/2003 at 11:13

Also, have your trainers worn down on the outer heel? Mine tend to do that and my outer knee hurt for a while when I delayed changing them too long.

Don't worry too much. I ran through it. It was more of a distracting niggle than an injury.

Agree on the stretches to prevent ITBS.
Posted: 20/04/2003 at 11:20

Thanks for that.

However feel free to call me thick if you want, but what is ITBS?
Posted: 20/04/2003 at 12:38

Illio tibial band syndrome, its a tendon which runs from your hip area and joins the outside of the knee.

I always ice it after a run, regardless of any pain, seems to keep it in check. Stretching has also helped.

Posted: 20/04/2003 at 12:48

Thank you again.I hope everyone is right abot it being a 'niggle' and nothing too serious. I only started running seriously this year & would be gutted if I had to stop so soon
Posted: 20/04/2003 at 14:28

I had it two years ago after taking 2 weeks off running!! Fortunately, I sorted it before it got too bad, but I wouldn't agree to just run through it. I still do the stretches today.
Posted: 20/04/2003 at 15:07

Definately ITBS. I had this problem at the beginning of this year. Had to completely rest for about 4-5 weeks, before trying to to run again.
Be very patient, and increase the mileage slowly (no intervals or speedwork) once the pain has gone. If you expereince pain at any time stop straight away and rest again for a few days.

there are lots of stretching exercies once the pain has subsided which are very good. There is a lot of info available on the web.

Good luck.

hopefully you will be ok, i'm now back to running the same mileage and times as i was prior to the injury.
Posted: 20/04/2003 at 15:42

I had similar pains and fixed it by getting my gait checked and buying appropriate running shoes.

Posted: 20/04/2003 at 17:01

There seems to be a difference of opinion here. I'd get yourself checked out by a sports physio. Remember they always err on the side of caution. In 4 years of running I've only had one injury that I wasn't able to run through. Constant niggles though. Basically if the discomfort does not affect your running gait then carry on. That's my philosophy.
Posted: 20/04/2003 at 17:11

Definitely, definitely stop, since it was bad enough to make you stop and walk. I tried running through it and did a heap of damage - it can take weeks or months for the inflammation to subside properly if you've mangled it good and proper, and I'm pretty sure there is a residual scarring issue. The shoes/gait thing is very important - go to a sports physio for advice.

Mind you, these days, with proper shoes, I get the odd ITB niggle which I do run through, but I really wouldn't notice if I weren't paranoid about it.

This link gives some excellent advice.

Posted: 21/04/2003 at 09:12

agreed - I have just recovered from exactly the same thing, and it took about 5 weeks of NO RUNNING. I went to a chiropractor (fairly sure it wasn't my shoes, bearing in mind I sell running shoes for a living!) and she said my IT band was very tight and also a bone in my leg wasn't rotating properly because of swelling in my knee.

I can't fault the treatment I got, she also cleared up my ongoing runner's knee and pain in the back of my knee, as well as helping me with calf problems. Miracle worker! but Im sure any specialist will be able to help you.

Rule out any problems with old/unstable shoes, make sure you aren't always running on camber, and stretch your it band, check out this site as well (swerve, Im sure I am following you about on this problem!)
Posted: 23/04/2003 at 12:46

See a physio. I had the same thing - a niggle on outside of knee which I thought was ITB. According to the physio it isn't and I have damaged my lateral ligaments.
Posted: 23/04/2003 at 13:11

I had a b ad case of ITBS related to cycling a few years ago, but since the Henley 1/2 M I've had an on/off pain on the outside of my knee that doesn't feel the same at all. It's most noticeable going down stairs and seemed to wear off, only to come back after an easy pace 8 mile a week after Henley.

Henley has some cruelly steep downhill sections and I'm convinced I've got a lateral problem after some over fast corners on a camber. I always do ITBS stretches since the cycling injury kept me out for 3 months, so I don't think it's ITBS.

Having unsuccessfully tried to run through it, I'm going to rest and talk to my osteopath on my next visit, but lateral ligaments sounds like a promising diagnosis John.

Maybe follow RICE and HARM (avoiding heat, alcohol, running and massage) in the meantime, with the exception of massage on the quads to help in case it is ITBS.

Posted: 22/10/2007 at 11:18

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