How to Fix Lateral Knee Pain for Climbers (LCL, IT Band, Meniscus, Outer Knee Pain)

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// TIMESTAMPS //
00:00 What this video is about
00:22 The anatomy involved in lateral knee pain
00:45 Biceps femoris
01:05 IT band
01:42 Lateral meniscus
02:03 LCL
02:39 Mechanism of injury chart
02:51 How to test and diagnose lateral knee pain causes
03:21 Test 1: Resisted Knee Flexion
03:43 Test 2: Specific Palpation
04:23 Test 3: Varus Test
04:51 Test 4: Meniscus Test Cluster
06:52 Diagnosis Chart
07:06: Treatments for lateral knee pain
08:07 More information about rehab exercises
08:38 Treatment chart
08:57 An added bonus!
// SHOW NOTES //
Episode 104
No matter what’s causing your lateral or “outer” knee pain, it is treatable! So in this video we’ll discuss why lateral knee pain happens in climbers, how to diagnose your specific issue, and what you can do on your own to fix it. Let’s goooo!
Lateral knee pain from climbing-related activities is common due to the high stresses we impose on our legs while heel hooking, high stepping, hiking, and of course falling.
These activities can result in traumatic or overuse-related injuries to one or more of the following tissues:
The biceps femoris
The iliotibial band or ITB
The lateral meniscus
The lateral collateral ligament or LCL
Biceps Femoris
The biceps femoris is one of our hamstring muscles. The tendon for this muscle attaches on the back, lateral side of our knees. That tendon can get damaged if loaded with excessive force, which can easily happen during a heel hook. This maneuver often places rotary forces on the knee as well, which can exacerbate the strain on the biceps femoris and other hamstring muscles.
Ran out of room!! For the rest, please check out the show notes:
www.hoopersbeta.com/library/w...
// DISCLAIMER //
As always, exercises and rehab programs are to be performed assuming your own risk and should not be done if you feel you are at risk for injury. See a medical professional if you have concerns before starting a new training or recovery program.
// IMAGE ATTRIBUTIONS //
- Biceps femoris: *derivative work: r@geGluteus_maximus.png: Nikai, CC BY-SA 3.0 creativecommons.org/licenses/b..., via Wikimedia Commons
- Biceps femoris animation: BodyParts3D/Anatomography, CC BY-SA 2.1 JP creativecommons.org/licenses/..., via Wikimedia Commons
- IT Band: Jmarchn, CC BY-SA 3.0 creativecommons.org/licenses/..., via Wikimedia Commons
- IT Band: Healthimage, CC BY-SA 4.0 creativecommons.org/licenses/..., via Wikimedia Commons
- Glutes: BodyParts3D/Anatomography, CC BY-SA 2.1 JP creativecommons.org/licenses/..., via Wikimedia Commons
- Knee X-ray: Mikael Häggström, M.D. - Author info - Reusing images- Conflicts of interest: NoneMikael Häggström, CC0, via Wikimedia Commons
- Knee anatomy: Blausen.com staff (2014). "Medical gallery of Blausen Medical 2014". WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436., CC BY 3.0 creativecommons.org/licenses/..., via Wikimedia Commons
#trainclimbsendrepeat #climbingtraining #physicaltherapist

[@HoopersBeta]

PSA: If you have catching or locking of the knee PLEASE go see a doctor so they can give you a proper assessment. :)

[@acasccseea4434]

i would like a playlist of all the episode that contains injury/strain tests so that i can run through and find if i have any problems.... more often than not, my whole body is just in pain after a great send, but i dunno if it's just excercise lethargy or actual injury...

[@hetistijmen]

@@acasccseea4434 the general body pain for me usually comes up if I try real hard at the end of a bunch of hard sessions. If it keeps coming back, I usually end up going up a grade (or more) after a short break. If it's common for you the big pile of mini-injuries and niggles might be holding you back.

[@SydeLeaderRay]

I had many x-rays a couple injections and an MRI and every doctor says they don't see anything. The most recent doctor (2022) I seen about my locking lateral knee told me I'm probably twisting/walking improperly. I have had a few knee locking in my right knee before. But only when I put too much strain on it. My left lateral knee on the other hand I've been having multiple lockings doing the simplists things. And all day everyday I can feel it pinching. Especially when dealing with heavy equipment and in the cold.

[@josue52977]

20yrs og rehab since Iraq and yrars of trail running n marathons. Great info. Thank You!

[@ultraseal9193]

Thank you so much for making this video! This content is insanely helpful!!!

[@Phyto_Chemicals]

BEST VIDEO on the subject, comprehensive, easy to understand, I subscribed and I'm grateful I found your channel!

[@HoopersBeta]

Thanks so much!

[@mwoods3]

Wow, so timely for me and really well presented. You made me feel a lot more optimistic about my lateral knee pain that I sustained from climbing a couple weeks ago. Thank you!

[@HoopersBeta]

Glad to hear that! Hope this helps resolve your issue.

[@domxgun]

Amazing stuff right here. Not a climber, but I do hike and run on extra gnarly terrain. This is exactly what I needed. Time stamped and straight to the point. Thank you!

[@HoopersBeta]

Stoked that you found this helpful!

[@Hernandez90s]

Same here man, do you have any locking or catching in your knee cap?

[@laurap975]

Packed with information!

[@CJski]

would love to see more about wrist injuries!!

[@Lazankas]

This is freaking amazing, Jason! Taped my Biceps Femoris and feel better already. Saved the video for future rehab. Thank You :)

[@HoopersBeta]

Nice! Glad you found it beneficial :) Thanks for commenting.

[@bennettcrouch515]

This guy is the goat great vid

[@chazott]

exactly the content I was looking for. Thank you!

[@HoopersBeta]

You're welcome!

[@Reckoning2943]

This helped a lot! I wasn’t sure whether my pain was caused by a meniscus injury or IT-band syndrome but aside from slight pain if I pressed right next to my knee where the it band is located, I checked negative on all of those tests. I ran a marathon and went back to running too early. I experienced a little pain after the second run. I only feel pain after running a few miles and the pain always goes away after stretching and waiting for a bit. if I ran for more than 10 miles I would feel the pain a little when walking down the stairs but nothing serious. Yet. I’ll go see a doctor regardless. The next race is up in April.

[@davidpleydell3522]

Great stuff. I'd be stoked if you could do a video on PRP injections for treating things like meniscus injuries and arthritis. I tore my medial meniscus bouldering in 2017, had 4 years of knee instability (medial dislocation) and reinjury. Then took a PRP injection last year, followed by lots of physio. The result is a much more stable knee and I can now do lots of stuff that was impossible in the previous 4 years (flagging, breast stroke, dancing etc). IMO more people should know about PRP as a treatment option.

[@HoopersBeta]

PRP would be a really interesting topic. We'll look into it!

[@summerdays5900]

Extremely helpful. How are toe hooks are taking part in those various injury patterns?

[@pbaxmannjennings]

I am wondering why this outer knee pain is happening to me for a couple of weeks now. Finally I know exactly what it is!

[@sharatht8909]

Hi. How did you cure that?

[@Ninjanugets123]

love these vids, thanks! i dont have any knee pain now but was curious if there were any recommended preventative things to do to help condition my knee for the stresses from climbing?

[@HoopersBeta]

Keep the hamstrings strong and stretched, keep the rectus femoris loose, and strengthen those hips ;) Glad you're liking the vids though! Thanks for the support!

[@jrodericklane]

Unlikely LCL heel hook injury unless you do what Pete did in that Magnus video :)

[@demoman2]

just adding a data point: just high grade partially tore my LCL (FCL) and low grade partially tore my PFL while doing a high intense heel hook (MRI results). it does happen! heel hooks are a staple of my strengths, so this one came as quite a surprise. there was a loud pop (re very fkn loud, it sounds like a tree branch snapping...) but I was able to walk out of the crag, with my dog pulling... lol. I was shocked nothing was completely ruptured by how gnarly it sounded. anyways, really nice video here! glad I have my ortho and PT onboard to help out with the process. definitely recommend seeking professional help if you can.

[@HoopersBeta]

Dang, sorry to hear that! Always a drag when it's one of your strong suits and yet, "stuff" happens still. Best wishes on the rehab process and hope your crushing those heels again soon!

[@demoman2]

@@HoopersBeta thanks dude! Much appreciated! Already happy with the recovery just one week in 💪🏼 the way I see it, just the cost of doing business. It’s not like I’m gonna NOT do heel hooks ever. Shit happens and we ride!

[@zachmurri]

Thank you

[@shengzhou6185]

I ruptured my patellar tendon on a fall from bouldering. Are there any recommendations for stretches/exercises as I rehab with the PT post-surgery?

[@TomCernikShin]

Hello, I was just diagnosed with partial LCL tear - I was heel hooking and suddenly pain and cracking sound from knee came... Is it safe to start doing some exercises for that? I am using brace for walking, but it does not hurt anymore when walking even without brace... Going down from stairs is not still completly OK, when going up, i do not feel pain. Thanks for help!:)

[@gabimihalik6530]

FANTABOLOUSSSSS

[@keithclimate]

My pain seems to be concentrated in the MCL (and a little in the popliteal fossa area). It's more like stiffness and irritation that won't go away. It came on once I'd returned to the climbing gym after a week or so doing a lot of hiking/climbing in Washington. I'd had some cramping in that area while doing a climb of Mt Olympus (8000 feet of gain, 40 miles, 50lbs on my back). It's not enough to noticeably impact my climbing (yet) but is more noticible when I squat in the days following any climbing. Thoughts?

[@teomalchio]

The cure: just campus everything, no more leg pain 😂

[@illanmd]

Campus down also

[@valman008]

At the moment, I don’t have pain with any of the tests here but I do get swelling at the joint line on my right lateral that has been coming and going for about 5-6 years now. Can you help me understand what might be some possibilities for swelling at the joint line. I do notice the swelling occurs after a long day on my feet and sometimes after jogging. When it is swollen sometimes there’s mild pain during the jog. I’m 45, male, and have not been diagnosed with gout but I’ve always had high uric acid. Thanks for your help and your time.

[@psicologiageneraleconalleg369]

Unrealted, but I have been recently (last two weeks or so?) feeling pain in the posterior part of the ankles, one more than the other, when pointing the feet down. Do you think it might be climbing related?

[@OanDeWaal]

Please listen to Dr Hooper! I had a grade 3 LCL, popliteofibular ligament and popliteus tear (which makes up the posterior lateral corner, and yes it was traumatic). Interestingly enough, it wasn't during a fall, I just pulled SUPER hard with my heel hook using the outside (lateral) of my heel while on the climb. (As I am tall and don't fit the box properly, this was the only beta for me). After hearing a loud BANG in my knee, I decided to push myself off the climb and fall on the boulder pad on my back, so that my knee doesn't get injured more. Everyone in the area (even far off) rushed to me as they heard my knee go. Luckily there was a medical doctor at the crag. After seeing a few knee specialists, it turns out I (k)needed reconstructive surgery Surgery went very well (Anciero reconstruction technique). Doing my rehab and looking forward to start climbing again. The climb that has taken many knees in Rocklands - A Question of Balance (V7/8): kzbin.info/www/bejne/fXKsdmqcmsRjjqs Be safe and use proper heel hook technique!

[@mikebrunt4099]

Thank you 🙏🏼❤️👍🏼

[@HoopersBeta]

You're most welcome!

[@sarad.206]

And if it's an inner knee pain due heel hooks? In the MRI all the structures (ligaments, tendons...) seem ok. 🤔🤔 Thanks for the videos!

[@psicologiageneraleconalleg369]

What if I have pain in the MEDIAL knee when doing the restisted knee flexion? Loved this video and I already do some of these exercises

[@HoopersBeta]

The hamstring muscle group bifurcates and attaches on the medial and lateral side of the knee so it could be an issue with the semitendinosus or membrinosus hamstring muscle :) But it could also be an adductor issue. Our medial knee pain script is in the works though :)

[@psicologiageneraleconalleg369]

@@HoopersBeta can't wait for the new video then!

[@eileenlocke7877]

Thank u

[@Particularpete]

I’m extremely thankful to have found this pretty niche info. Pretty sure I did my meniscus on a gnarly heel hook. So not worth it. Damn

[@HoopersBeta]

Wishing you a speedy recovery!

[@brianbrenner4288]

Do you hear of many people getting inner knee pain, especially from heel hooks? I've been dealing with that, but not sure if it is something common with a known fix.

[@adamtothefuture]

Same, I get inner pain on heel hooks, especially when there is a heel-toe cam.

[@HoopersBeta]

Our medial knee pain is in the works to help complete this series :)

[@brianbrenner4288]

@@HoopersBeta Awesome, love the channel

[@KnueppelkarlLP]

Since there is no video about inner knee pain (while heel hooking) yet and I can't find anything online or in my two climbing injury related books, did anyone solve the problem and how? I have inner knee pain when heel hooking. It's not a sudden injury and my knees really only hurt while or after heel hooks. I tried basic strength training and all sorts of lower body/hip stretching but nothing seems to really help yet. I want to be able to use heel hooks again.. :/

[@scottkerr1936]

Wonder if anyone could direct me. None of the tests caused me any pain. It only hurts when my knee is externally rotating. Pigeon stretch is painful. Any sort of torque force, like heel jams and heel hooks where the foot is rotated outwards. Straight pulling or extending my leg causes no pain. My knee tweaked on a heel hook and has been bothering me ever since.

[@masoncostoff5625]

I have an injury that has weakened my knee and is causing it to catch. The part confusing me is the pain is almost solely felt in the mid lateral calf. I only experience pain when rotating my foot outward and it amplifies when I then pull into my heel. Lots of good information in this video but I cannot seem to figure this out. None of the tests caused me any discomfort.

[@probablyclimbing7738]

this video was really interesting to me because I usually get more inner knee pain (mostly my sartorius) from climbing than outer??? Is it just me???

[@hodorable6789]

Anyone know, I feel pain on the outside of my knee, only when FULLY bending my knee or FULLY putting it straight and forcing. No other movement cause pain, and it's been doing this for over 2 months. I'm still moving and climbing fine tho, so really weird. Thank you

[@fabianseiss6409]

I don't feel any pain at all doing the tests. But for some weeks I can feel/ hear my outer knee slightly crackling while walking. Not that I have any issues but i'm a little curious where that sound comes from... 😅

[@ashabamorris4593]

My injury is deep lateral just below the knee Cup. It only pains when running. But can walk pain free and also do most gym leg workout pain free. It's confusing abit.

[@mahaskills]

Hi I am from India and 63 years old woman....I have pain in the inner side of my knee lightly upper side towards the thigh...bended and criss cross is not a problem at all...only when I get p from the bed I feel a lit of pain to stretch my leg. .. can you suggest some exercise please .

[@ig2376]

how can i contact u sir i want to show you the video that how i got injuring i felt this injuring more than a year it never get well it happening again and again

[@amansaini204]

I have pain only during running on lateral part of my right kneee pain only after run 300 meter or 500meter sharp painn

[@ultraseal9193]

Could you do a response video to Kyle Hill's "Dangerous physics of rock climbing"? It made it seem like pulley injuries are an inevitable fate if you keep climbing! Do you agree?

[@HoopersBeta]

That's a great idea

[@mrhaandi]

Overall in your videos you mention heel bridges and (quite often) nordies, but iirc not once the "reverse plank"? (I expected it in the scapula video or here.) Is it a strictly inferior exercise, less effective, or more dangerous?

[@wiryawankhemal7125]

I have feel restriction and sore on lateral side: from knee to glute, when doing exercise like frog pose yoga... there was a trauma... googling for years but no clue what is it... is it a form of IT Band syndrome? Thanks

[@HoopersBeta]

Without knowing the trauma and if that is a mild/moderate/significant factor, hard to say. Have you seen any specialists or PT's? That may be a better route than googling if you've been unsuccessful.

[@RedPanda915]

This video reminds me of the saying "a little knowlwdge can be a dangeeous thing". I find a lot of patients can have a hard enough time doing the right thing even after a comprehensive assesssment and significant patient education, so I am torn with videos like this because i do believe alot of self care can be taught to the general populations but you need it to be more of a series of videos rather than short snipets and stress a lot more the importance of seeing a professional if not 100% certain of what they are doing. Alot if meniscus tears for example might not experience cacmtching or locking, or people watching might litterally do the exercise you showed for each patholigy and progress more slowly or worse do more harm. If you want to educate people in these areas you cant just give a couple minute snipits of what is involved, you need to have indepth education of the process. I feel like this will either lead to more harm than good or people will try, realise immediately they dont know what they are doing and hopefully go see someone who does. There is too much wrong with this video for me to bother getting into and im sure you know that as well which is why I am surprised you uploaded something like this.

[@AmirNickname]

All boulderers should learn how to fall: T-Rex, Turtle, Roll! By the way I forwarded this video to like 3 friends who have pain in the knee from heel hooks. Hope this helps them 👍🏽

[@ultraseal9193]

So true haha. Many of my friends think is exaggerated to fall like this: I prefer keeping my knees working well into my 80's.

[@HoopersBeta]

Thanks for sharing! :)

[@panksimus]

I get knee pain while hiking but after 2 days, pain is gone. No pain while skipping ropes, no pain on leg day, no pain while walking or playing badminton. Only while hiking, specially while coming downstairs or downhill. Do I have IT band issue?

[@Midnight8869]

Bro got any idea why it's caused . Same for me it only gets when I run. I can walk , skipp , squat but when I run it gets the pain and after that I have problem walking downstairs

[@johnsuperhist5219]

I have a lump for like 2 years from playing bball

[@hetistijmen]

If the forced (hyper)extension test is positive and has always been, did I test positive for being an inflexible noob who has been skipping out on stretching? Asking for a friend.

[@joslinpinto6392]

can it also happen to runners?

[@jskweres2]

Ack no pain on any of these.... I have excruciating outside of knee pain when I'm in a deep squat and stand up. I can't figure out what caused it or how to fix it

[@dorkette888]

That's me too -- deep Asian squat is pretty painful on the outer back of the knee and it's temporarily weak after I stand up, though the pain passes pretty quickly too. I'm sure it's due to a heel hook and I'm also fairly sure it's a biceps femoris injury. I'll try the exercises in the video, but I'll also mention that those painful Asian squats for a minute at a time seem to help, though I'm not consistent enough to be very sure.

[@dorkette888]

Though I've been doing the last 2 exercises already (Nordies and single-leg RDLs) with no obvious benefit and no pain.

[@jskweres2]

@@dorkette888 i'm the same. Can seem to figure it out yet.

[@nbka8rs]

algogogogo

[@emmanuelsalas5298]

You didnt include meniscus rehab?

[@HoopersBeta]

You should see a professional if you suspect a meniscus injury

[@emmanuelsalas5298]

@@HoopersBeta thank you sir

[@marcchrys]

My knee pain was caused by dragging a heavy sack of logs backwards along a muddy uneven path :-(

[@HoopersBeta]

I could certainly see how that could cause irritation! Sounds tough.

[@cedricradloff8152]

haha jokes on u I don't use my legs when I climb

[@TheManofsorrows]

This is painful!

[@ForTheDailyRide]

This guy looks look andrew Tate

[@TS-2SLoW]

Dude talks to damn much. Just get to the pint

[@HoopersBeta]

I do love a good pint. What’s your favorite brew?

[@TS-2SLoW]

@@HoopersBeta 🤣🤣🤣🤦🏻‍♂️. Autocorrect definitely failed me lol