Can an Ankle Sprain Lead to Knee Pain?

I’m a competitive runner, and during my marathon training, I increased my mileage. Not long after, I twisted my ankle while running. Interestingly, my ankle isn’t bothering me, but I’ve developed a painful tenderness on the outer side of my knee, just below the joint. Could this be related to my ankle sprain?

Yes, it’s possible. When an injury occurs, it can often affect the joints above or below the injured area. It’s possible that you injured both your ankle and knee at the same time, but the more noticeable ankle pain may have overshadowed the knee issue initially.

Additionally, the force from the ankle injury could have transmitted a twisting motion to the joint just below your knee, known as the tibiofibular joint, where the two bones of the lower leg (tibia and fibula) connect.

Before resuming your training, it’s important to get this checked out. There could be a more serious issue, such as a bone fracture, ligament damage, or nerve strain causing your knee pain. Addressing it now could prevent further injury down the road.

Reference: Sekiya, J.K., & Kuhn, J.E. “Instability of the Proximal Tibiofibular Joint.” Journal of the American Academy of Orthopaedic Surgeons, March/April 2003, Vol. 11, No. 2, pp. 120-128.