Why Your Knee Hurts AFTER Golf (Not During)

Introduction to IT Band Syndrome 0:00

I once had a patient tell me, Doc, my knee doesn't hurt when I swing, it hurts when i stop. If that sounds familiar to you, you're not alone. You're probably dealing with something called IT band syndrome. Hi everybody, I'm Dr. Guyan Preventor. I am a medical doctor, i am golf lover, and for the last 15 years I have helped thousands of golfers continue playing the game they love without having to resort to invasive surgery. Now today we're going to be talking about something I see way too often in the clinic but something that gets ignored too much.

It's called IT band syndrome or as some of my patients like to call it, angry leg band pain. If you're a golfer and your outer knee is screaming at you after nine holes, this video is for you. And if you are the ones been told you just aging but you still out there swinging like a pro on the range, it's probably not your age. It probably your IT Band and it probably tired. So what is IT band syndrome? Well, let's make this really simple. On the outside of your thigh that goes from your hip to the side of the knee, there is a long, strong band of tissue called the iliotibial band, or as we call it, the IT Band for short.

You've got to think of it like a seatbelt for the outside of your legs. So when that seat belt rubs or gets irritated over this bony bump on the inside of the knee and it gets irritating and painful,

What the IT Band Is and Why It Hurts 1:12

that's called IT band syndrome. The pain usually shows up on outside the knees. It's not something that you see in the front or in back or on inner part of knee. Now, some people feel it when they're walking or running. Others feel that when their climbing stairs, someone they squat, others when the swing a club or they walk 18 holes. If you're a golfer, you might notice it every time you hit that lead leg. So let me tell you a little story. This is about myself and this is something that a lot of golfers may recognize.

Imagine that you're on the 18th hole. It's a beautiful par four uphill with an elevated green. Your second shot was a little short, so you had to lay up. And now you are pitching on and your pitch is perfect. You're ready to hole out. you were looking at your ball, you looking up the hole, You grab your putter and you walking up to the green and ting, your knee starts to complain.You walk from the fringe up that little hill to green, still watching the ball but with every step that outside of your knees just twinges a bit.

That's weird. It felt fine just a second ago. But by the time you're walking back down after you hold the putt, you are limping a little bit. Now you get to your cart and that outside of your knee is throbbing and protesting. And it's basically telling you no more. That happened to me screams IT band syndrome. Listen, it's not always the swing that's the problem. Often it is the walking the hills, the repetition, and the way that your leg is moving. That elevated green that I went up was just a little stress test for my knee.

Now you may be asking me, why do golfers get knee pain? Or why did they get IT band syndrome?

Golf Swing Mechanics and Common Causes 2:48

Well, let's talk about the mechanics of the golf swing. The lead leg is the land of the heavy lifter. In your golf swing, your lead, which is your left leg for you right-handers, is basically the star of this show, right? As you turn, you hit the ball, and your leg bears up to four times your body weight. It's twisting, it's rotating, It helps you hold the pose on your follow through like a little mini statue with a club on every single swing. If your hip muscles are weak, especially the ones on the side of your hips and your glute muscles, your butt muscles or weak.

Your lead leg ends up wobbling just a little bit, kind of like jello on a plate. Now that tiny little wobble, which doesn't seem like much, makes the IT band snap back and forth over a bony little bump on your knee. Every swing, that band rubs a bit more. So after 100 swings in a day, you're knee is going to say, hey, hi, I'm done. Another big reason for this is a sudden overload. Think about this in the golfer who suddenly increases practice. They're hitting more range balls, they're doing more walking, They are returning to golf after the long winter, playing more rounds, walking more hills, or walking on uneven ground.

Remember, your body is like a shy teenager at a party. It needs time to warm up. So if you throw it into the deep end too fast, it's going to get stressed out. And when the IT band is stressed or overused or irritated, It gets angry and it throws a fit. Kinda like a teenager, right? Your feet and shoes also can play a role. If your shoes are worn out or if your feet roll too much inward or outward or too many pronation or supination, it does end up changing how your leg lines up. Now that can increase how hard the IT band rubs on the outside of the knee.

So the problem here is not just bad knees, right? It's often a whole leg chain issue. It is the hips, the knees the ankles the feet and on top of that how you move. So what does IT band syndrome feel like to a golfer? Well most golfers with IT Band Syndrome feel pain on the outside of the knee or pain that starts to get worse during the swing or after walking nine or 18 holes. They'll have sometimes pain when they're going up and down the stairs at the clubhouse. Sometimes you notice it when you've been standing in line for a long period of time.

Other people will notice the pain on the outside of their knee that's related to IT band syndrome when their squatting or trying to bend the knee, like putting on your golf shorts in the morning. And sometimes a pain is really mild at first like a dull ache, but over time it becomes sharper and it become more constant. So if you keep pushing through it, that pain can get worse and can take even longer to heal.

Symptoms and Other Sports That Trigger It 5:24

Now, golfers are not unique in the IT band syndrome world. It is actually very common in other athletes like runners. Runners often get it because they also use their legs a lot. They do a lots of bending and straightening of the knee. A lot of them have weak hips or they have sudden increases in training. Think about like your neighbor that's suddenly training for a 10k or a half marathon who's never run before. Right? Cyclists also get it, especially if the bicycle is not set up properly, if their saddle is too high or too low, If the pedals are too far out in front or to close into you.

Another sport with a lot of overlap is hikers and walkers. People that are exposed to a lots of hills or uneven ground, they can also Get it. The pattern injury is this. Any activity that uses the outside of the knee a Lot, Especially if hips are weak or the load is to high, can cause IT band syndrome. That's why the runners and the golfers, the cyclists, and hikers all end up with a similar pain in my office. So, this is cool, but what do you do if you think you have it? Well, if think have IT band syndrome, The first step is to back off from what aggravates it.

Now I know that's amazing advice from a doctor, right? If it hurts, don't do it. But the good news is you don' always have to stop completely, but you should avoid these activities that make the pain worse. So in golf, cut back on the amount of swings that you take in a day, the number of practice rounds that your doing, stop walking if it's hurting and use that as an excuse to take the cart. Give your body time to calm down. In most cases, people improve with rest and activity modifications. Sometimes they need to use ice on the outside of their knee or take anti-inflammatory medications if it's safe for them.

Sometimes patients also need physical therapy that's focused on hip and the leg. The biggest long-term fix, though, is better hip strength and better leg control.

Treatment, Recovery, and Return to Golf 7:12

That often means doing things like side hip exercises. These are things, like, side-lying leg raises or clamshells. And also doing glute muscle strengthening. Those are the muscles in your back, your gludial muscles, by doing bridges or squats with good form. Now, you should probably also be doing some step down work to improve how your knee tracks to give you some better balance and better core control. The best piece of advice I can give, though, is remember that this is going to be a gradual return to sport if this a problem for you.

Now one quick note on a really popular thing that everybody asked me about with IT band syndrome is stretching and foam rolling. Everybody wants to get the foam roller out when they have this and they want to know if it's helpful. And the answer is yes. For a short period of time, foam rolling and stretching can help with IT band pain syndrome or IT Band Syndrome pain. But remember, the real goal here is to fix why the band is getting overused. Now, if you're a golfer with it band syndrome, I like to tell my patients three simple rules.

Number one, reduce the load. Do a little bit less for a bit. That again means just some fewer swings, fewer hills, and fewer holes in one day. So play 9 instead of 18 if it's bothering you. Number two is build the hip. Work on that side hip and glute strength so that your leg is more stable on your lead side. And number three is return slowly. Do not go from no golf at all to full go all at once. In sports medicine, we do something called a return to play protocol. So this is a safe way to return your activities and a smart one for a golfer may look something like this.

You start with a short rain session using maybe a small bucket of balls. Then you progress to a longer session by using a bigger bucket a balls, then you do some walking on the course. Finally, you play a full round. This gradual return is like helping train your need to be your friend again. It's a safe way to progress your activities without overloading it because you're not gonna have a big flare up that's gonna set you back. Cool. Other cool things are shoes and swing mechanics matter too. You know, I love shoes, so any excuse I can get to buy a new pair of shoes I'm gonna take it.

But worn out shoes shoes that have poor arch support or you know sudden changes in how you stand or rotate can all play a role in IT band syndrome. Some golfers also try to change your swing because their knee hurts or they change their follow through or their backswing. Now that can sometimes help the pain, but it may also create a completely new problem somewhere else in the kinetic chain. So if you're thinking about changing your swinging because of pain it's worth having it checked out by a coach or a clinician.

The good news is most people get better without surgery, but you should see a doctor if you have severe pain or the knee is swelling a lot or you cannot put weight on the knees. Sometimes you need to go see the doctor. If the pain is not improving, even though you've been following all this advice, if You have numbness in your leg or locking or fever or You had a major

When to See a Doctor and Final Advice 10:00

injury like you got hit by a golf cart. Most people do really well with non-surgical care and many return to activity within six to eight weeks with a proper treatment and smart plan. But here's my honest advice as a doctor. Please, please do not ignore outer knee pain. Do not just assume that it's just some soreness. Don't try to just power through it for weeks on end and hope that goes away on its own. Because the sooner that you calm it down and fix the weak link, which as we've talked about is usually the hip and the way that move, the soon you can get back to playing golf with less pain If you're a golfer with pain on the outside of your knee, IT band syndrome may be your problem.

The good news though is that it's often fixable and with the right plan, most golfers can get back to the course, they can build better strength, and they feel better again. And now it is time for my standard disclaimer. While I am a medical doctor, I'm not your medical doctors. Not yet anyway. This video is meant to be educational. It is not specific advice for your situation. Now if you found this helpful, please like, subscribe, share this with a golf buddy who keeps telling you that their knee is hurting every time they play.

I'm Dr. Guy in Poovendrin. Stay safe out there and keep swimming smart. I'll see you pain-free on the fairway.