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Chronic Patella pain, seems to be cause by tight quads

(12 posts)
  • Started 15 years ago by Schokel
  • Latest reply from creator1

  1. Schokel
    Member

    This is a pain that I have been dealing with for several months. Right knee cap, just to the inside of center, at the bottom is the only pressure point of pain. Otherwise, stairs (both up and down) are extremely difficult and there is also a lot of ratcheting under cap during the process of lifting my foot from a 90° bent position. Knee seems stable in general, although the chronic inflammation makes it sometimes feel "mushy", but it's not. Running seems to be out of the question as every attempt, has not been pleasant. Quads are pretty tight and stretching them seems to help. Several two week cycles of Naproxen Sodium (1100mg daily) over the last few months have only helped a little. seems to be a connective tissue issue, but I can't get it to settle down.

    Any thoughts?

    Posted 15 years ago #

  2. jpassmore
    Member

    How old are you?
    Are you on a medications that thin your blood?
    Do you have type of clotting disorders?

    I have a BIG suggestion...but get back to me first.

    It sounds like you are having patella tracking issues... This often occurs from tight connective tissue, improper joint mechanics at, below, or above, and some type of muscle imbalance. Any one of these can alter the natural tracking ability of that patella of that knee and thus lead to a "grinding" between the underside of the patella and the tibia/femoral joint. I would do your best to address this ASAP b/c over time this will slowly "wear down" the cartilage.

    Your quad stretches:
    What method do you use? Standard standing, prone, propping?
    How long do you hold the stretch for? Is your body temperature increased when stretching?
    You should also be adding in hamstring stretches with a sraight knee to emphasize the tendons under the knee.
    Basically, hold the stretch for as many seconds as you are old. When quad stretching, maintain good knee alignment. Make sure you also through in some hip flexor stretching.

    Do you hyperpronate , or more so on the same side as the problem?
    When you sit with your legs straight out in front of you, and muscles relaxed (comparing the two knees), does the patella look to be in a different place? Can you move is medially, laterally, superior, inferiorly the same on the right and left?

    Look fwd to hearing back from you.
    If you know anyone else with an issue, pass the word...
    THANKS

    ~J

    Posted 15 years ago #

  3. Schokel
    Member

    How old are you? 48
    Are you on a medications that thin your blood? Negative
    Do you have type of clotting disorders? Negative

    For Quad Stretches, I am basically using a Hurdlers Stretch, (laying on my back with foot pulled upwards, behind me, and the opposite leg crossing over onto the flexed leg to apply more downward pressure)this typically is only working the outside of leg, so I am augmenting it with a sitting groin stretch. Both areas are pretty tight. A Majority of my stretching is done cold (realizing it is not the best option, but it's pretty difficult to get "warmed-up" when, everything seems to aggravate the condition)

    I'm pretty neutral with a slight overpronation.

    Knee cap examine, yields. Visually the same alignment, with equal move of both caps in all directions (They seem to float pretty well) Some puffiness at the lower interior problem cap. (at pain pressure area)

    This part you need to know. Pain originally occurred while training for a half marathon. I ramped up my distance too quickly, time constraints and stubborness, led me to "train through it" which was not a particularly good idea in retrospect. Once the race was done and I took some time off, is when things started to really get bad, as I obviously started to tighten up. I have been trying just to let it heal, but to no avail so far.

    Posted 15 years ago #

  4. jpassmore
    Member

    First, the hurdler stretch is not great, especially if you have knee problems! I would rather you either: Stand and pull your foot behind you, or stand and place your foot on something, or lay prone and pull your foot behind you with a belt.
    When stretching quads, AVOID the misalignments that a hurdlers stretch provides. Good alignment is essential!
    If you need some pics let me know...

    Okay, my BIG idea for you to try...
    Get a large metal spoon and some lotion. We use cocoa butter...
    Sit with your knee bent approx 90 degrees and get comfortable, perhaps with some back support. Lotion up your distal quads, especially down by your knee.
    Next, is the techincal part. Your need to find the best angle to apply the spoon's edge. Often this is around 70/80 degrees. If to vertical or too flat, nothing will result.
    Now, run the edge of the spoon over your quad, covering it from medial to lateral and also going with the fibers, longways. DO about 4 passes down and 4 up. Make sure to get all aspects of the quad.

    What did you notice? Painful areas? Bumps? Redness?

    Stretch wuads after as mentioned earlier and then sit and stand from a chair 10-120 times iwthout increasing pain.

    What did you notice?

    This is difficult to explain, but easily performed in the clinic.

    Get back to me as soon as you try this and we'll move forward...

    ~J

    Posted 15 years ago #

  5. Schokel
    Member

    A fair amount of redness, one small patch at centerline about 4" above the knee, and a significant patch on the inside of center starting about 4 1/2" above the knee and going up about 8" from there. With a very sore spot (knot) deeper inside the leg, right at about the center of all the redness.

    No bumps to speak of.

    Did stretches and then sit/stand squats. Not sure what I was supposed to notice??? Pain did not seem to increase and an argument could be made for a slight decrease. Redness did not disappear, but the painful Knot was still there.

    Posted 15 years ago #

  6. jpassmore
    Member

    Okay, now we are getting somewhere!

    Do this every 3-4 days depending on the sore/tenderness of the tissue, followed by the stretching as perscribed. Then followed by the activity of sit and standing from a chair 20 times. If no problems, then try 1/2 lunges, 10-20 times. Ice after for 10 minutes if sore/tender.

    I was going to guess small patch centerline 4" above your knee! :) Also suspecting some medial type response!

    Bumps don't have to be present for it to be working. You should se a gradual decrease in symptoms after each treatment.
    Remember the sore/red areas for the next application. Use long strokes from below and area to past it. Keep messing around trying to find the optimum spoon angle. Also, the broad edge of a spoon would be good to start with, then work down to more of the point. Remember, don't carve out your leg! Maintain the angle and "scrape."

    Keep me in the loop as often as you want or need, I'll be curious and ready to progress you as soon as possible!

    ~J

    Posted 15 years ago #

  7. Schokel
    Member

    Side Note:

    As of this morning I have what appears to be 4 small bruise type irregularities above the inner thigh knot (medial ?) and it's pretty sore to the touch.

    Second side: similar issue exists on the left leg and appears to manifest itself as what feels like a lower stomach muscle tear.

    Is this possible?

    Posted 15 years ago #

  8. jpassmore
    Member

    First side note: This is a normal response, most likely you went too hard! Easy killer, this can take several applications...

    Second: What do you mean "similar issue exists on the left leg?" Problem with the knee? Did you scrape both sides? If so, why?
    Also, "feels like a lower stomach muscle tear," What do you mean, I am confused? More detail please! Is the area in question above/below the crease of your thigh? If above, may be a hernia?

    Let the tenderness ease before scraping again and go easier!
    Ice after scraping, correct?

    How is the knee pain?

    Get back to me ASAP...
    ~J

    Posted 15 years ago #

  9. Schokel
    Member

    Sorry. Similar as in there seems to be a knotted (less so) area in the same region on the left leg.

    Not a hernia, as I had that checked. more of a ligament strain (I now forget the name of the ligament that runs from the top area of the thigh, across to the stomach area) Anyway this pain seems to manifest itself (when flared) kind of right at the pubic bone (a connection point there) Yes I am quite a mess :o)

    Knee pain... slight trend towards improvement.. but I kind of baby'd things yesterday so hard to tell.

    Posted 15 years ago #

  10. jpassmore
    Member

    Perhaps you are referring to the inguinal ligament. Pelvic issue are much more complex and I would rather advise in them in person.
    Palpate your pubic bone. Coming down from your navel and rest atop the bone. Compare the R and L side. SPend some time and see if you notice any differnce in position (may be slight) or tenderness?
    Positional differences may demonstrate one side to be higher/lower, or even more fwd/bwd than the other.
    Get back to me on this...

    I will hope your knee sligtly improves with each application. Get back to me after your next "treatment."

    Keep in touch and let anyone else you know dealing with something about this resource...

    ~J

    Posted 15 years ago #

  11. creator1
    Member

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