Lateral knee pain when fully bending leg?

[Physical Wreck]

I play Golf and for many years have experienced low intensity pain on the lateral side of my left knee after playing to much golf. Recently I have found that I cannot fully squat without modest pain in the same place on the lateral side of my left knee. After re-extending my leg the pain quickly subsides. I seem to be able to do all other exercises including walking, running and cycling without any pain? I went to the doctors and he simply offered me pain killers. However I suspect this is a meniscus or ligament injury and want to see if I can undertake physio to help recovery? I also want to understand if I should be avoiding any forms of exercise / movements? Any advice would be greatly appreciated.


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[gcoe]

Hi Physical Wreck

If you play golf, walking running and cycling at 44 you can't be that much of a wreck so keep going! However I dare so you'd be playing golf in a lot of snow at the moment! BRRR!

Yes there can be a number of causes of pain on the lateral side of the knee. Some common things you will find in your age group are:

Option 1 Lateral meniscus pain - this is usually due to the meniscus starting to break down a bit and the pain and tenderness is usually right on the joint line. Conservative mangement - getting the knee stronger particularly the quadriceps muscle - the muscle in the front of your thigh that you squat with, straighten the knee with and do things like kick the caddie with when you fail to score. this usually is best done with something like a leg extension weights machine at the gym (you would need something quite high intensity if you are quite physically active and getting some advice about this. If it really doesn't settle you could get an orhopaedic surgeons opinion but I would recommend avoiding considering the knife to start off with

Option 2 is an iliotibial band problem which may be causing an irritation of one of the the bursa (slippery cushion of lubricant that lies between tendons) or irritating a tendon itself. Iliotibial band problems are quite common and may be due to to much tightness of the one of two muscles around the hip. You really need to get a physio to look at this. Often there may be a concurrent weakness of the medial part of the quadraceps muscle. specific strengthening and stretching exericses can fix this.

Option 3 is you could be your lateral hamstrings tendon (biceps femoris) causing problems but this much less likely on a squat.

It is unlikely to be a ligament - that usually requires and inury.

Probably worth spending your money and going to see a good MSK or sports physio who can sort it out for you.

[Physical Wreck]

Hi Gcoe

Thanks for the response and possible causes.

I am going to seek further specialist advice as you suggest.

I am guessing at this stage, but feel it is probably your first suggestion i.e. Lateral meniscus pain as I am also experiencing clicking in the knee when I have been sat down for a while or make sudden movements.

One thing I forgot to mention was that I have over mobile joints. Well that is what a Physio told me when I dislocated my shoulder whilst playing squash way back in my twenties. He told me not to play racket sports or high impact sports, not that I took any notice :-)

Anyway the strengthening exercises sound good and then perhaps I will have to settle for sub 300 Yard drives :-)

[gcoe]

Yes keeping strong and being active in sports are great ideas, and is obviously something you enjoy. so keep going. As our joints and soft tissues get a a bit older, compensating by building muscle strength is a great way to keep on the field, have less pain and injuries and counter the aging in our locomotor system. And you re right with joint hyper mobility - building and keeping muscle strength can keep this in check.

Even if you do have a meniscus problem that eventually requires a visit to the surgeon, keeping your knee as strong as possible may reduce the need for that intervention and if not, improve the post-surgical outcome and reduce rehab time.