Q+A: I have three injuries on the same leg…

Q I have a triple injury. First I got a pain under my hip, then a swollen ankle and now a pain in the back of my knee. All on the right side. I recently switched from trail to road running – could it be due to the camber?

A There could be two reasons for your right-sided ailments. Firstly, as you suggest, running on an adverse camber could be the cause of your problems. However, you do not normally spend an entire run on the same camber (because you cross roads, turn corners etc). I think that the most likely cause of your problems is a combination of the change in running surface and some underlying biomechanical problems with your right lower limb. These two factors combined could well have caused your problems.

The pain just under your hip could be an inflamed bursa (cushioning pad) underneath the iliotibial band. Such inflammation usually occurs following a direct fall onto the hip, or because of a tight ITB that is increasing the friction between the tissues and the femur beneath. (There’s often associated tenderness and/or some slight swelling.)

Icing the injury early on is very important as it enables the tissue to heal more effectively and prevents further damage. Electrotherapy (such as ultrasound) may also help, but the most important part of full recovery from this injury is to identify and treat the underlying cause. This usually involves stretching the ITB and strengthening the lateral hip rotators.

Your ankle problem may be either localised tendinitis of the peroneal muscles, or dysfunction of the inferior tibio-fibular joint. It’s a good idea to ice and compress this injury; however you probably still need to have the ankle fully assessed to get an accurate diagnosis and appropriate treatment.

Finally, your knee injury. If there are any consistent, painful clicks originating from the knee and/or feelings that the knee is about to lock, it could be a cartilage injury. If there’s a firm swelling around the back of the knee, you could have a baker’s cyst. These are benign swellings in the back of the knee, which cause problems to varying degrees, but can lie dormant until something aggravates them.

As you’ve suffered three injuries on the same leg and in quick succession, I honestly think that you should visit a chartered physiotherapist who can provide a full biomechanical assessment. It may be that they are unrelated, but I think that a common cause will probably be found for all three injuries.

Andy Caldwell, chartered physiotherapist