As a newcomer to the Forum , I’ve been impressed by the quality and thoughtfulness of the responses, so I thought I’d see if there’s any good input for me on a problem which started for me about 7 months ago. I have had persistent knee pain in front of the knee cap on both legs and radiating through the knee area. The pain is bad when I skate (ice hockey) and also when I go down stairs and when I go upstairs, although less so there. Squats hurt but abstaining from them hasn’t made much of a difference. Wide stance box squats hurt less due to the greater involvement of the hips. To relieve the pain,I’ve tried ibuprofen, chondroitin, glucosamine MSM (recently), and aspirin, none of which seem to work very well.When the knees hurt, a long drive can be awful, requiring stops to stretch the hip flexors, which relieves the pain temporarily As a result of this observation, I’ve been doing a lot of stretching, and have good range of motion everywhere. Nevertheless, the pain persists.Needless to say, running is out of the question. I’ve had 2 acupuncture treatments and electrical stimulation but have had a hard time getting regular treatments in the Boston area ( the ART specialist is from Canada and only in the area once a month). These treatments gave only modest relief. I’d guess that the problem relates to poor tracking of the patellar tendon, caused by a weak VMO. Anyone out there have any suggestions or observations? I’ve been doing peterson stepups and regular stepups to strengthen the VMO but other suggestions here would be appreciated. I’ve also really emphasized posterior leg work. Would VIOXX help? I’d really like to get at the root cause but getting rid of the pain would be nice too.
Look for a chiropractor named Bill Brady in Boston. He’s an assistant ARt instructor and level three performance credentialed. You might need a little more regular treatment than once a month at first. Art can be a godsend, but still can require patience. My jock patients do well, but they sometimes need some regular tuneups, do to the stress of their training.
Irondoc, thank you for your reply. i have set up an appointment with Dr. Brady in Boston for early next week. To others out there, have you experienced similar symptoms and,if so, how did you eliminate the pain? What approaches and adjustments did you make? Additional feedback would be most appreciated. And thanks again, Irondoc.
It kind of sounds like you have a muscle imbalance (When I was running cross country I developed my quads much more than my hamstrings and when I would start to run the pain was excruiating), so I would go to a good doctor (or chiropractor) that is used to working with athletes and could diagnose this. Until then you can try a stretch that bicyclists use when they have a shortening of a muscle in their knee (I can’t remember what it’s called, but I have had it and it is very painful). While doing a standing quad stretch (heel to but) rotate your knee in circles of approximately one and half feet, you’ll be able to tell when you do where exactly the position is, this stretch is also quite effective when laying on one side. You need to do it at least three times a day for it to be very successful, so try it for a while and if it doesn’t alievate any pain you’ll at least have some more limber quads. Best of Luck.
The first time I had ART done, was for a twelve year old shoulder injury. The primary area of injury was in the subscapularis, near the brachial plexus. The work hurt so bad that I actually bled from my nose! My strength shot up immediatly. I sometimes take some aleeve after the work , ice, stretch, and drink a lot of water.
ACtually the worst soreness was the first few times I had it done. Now I don’t notice anything bu relief and better rom. You’ll will get used to it.
I’ve had some of your same symptoms. Also I couldn’t straighten my leg into a leg extension without pain until I had ART. My leg would constantly give out with instability just while walking. ART changed all of this. Also my ART guy who is an instructor noticed that my inner quads were developed more than my outer quads. He told me to do squats and pressing movements with my feet straight ahead and NOT slightly outward. By doing this I have been able to counter act my inner quad development and have managed to regain the balance between outer and inner quads. Turns out that the whole problem of my knee was that there were “adhesions” better known as scar tissue in the tendon on my outer quad leading down to the side of my knee. From my experience you need to use ART twice a week and use a product called INFLAVONOID INTENSIVE CARE by Metagenics. It’s an all natural synergistic anti-inflamatory that really seemed to help me recover from the intense ART sessions. Best of luck! Oh, by the way I will never do a leg extension ever again. They are way to hard on the knees. Do a search on this site for an article titled “no need for knee pain”. A great article written by Lori Gross.
When I was running exclusively, I had similar problems off and on. What was at the root of my problems was a strength imbalance between the vastus medialis and the other quad muscles. What happens is that the vastus M. is the only one of the quads which pulls the kneecap medially (towards the body midline), so if this muscle is weak, the kneecap tracks out of its groove and causes pain. What you describe for your long drives soounds like what we used to call the “positive theater test” for chodromalacia patella (now usually called patello-femural syndrome). If the imbalance is extreme, straight legged leg raises with the hip rotated outward and the toes held up hard can help. I’ve never had the condition since I started cycling, as it tends to balance out the development of the quads. If you start riding, however, have a qualified cyclist or shop set up your saddle height, as it has a big effect on knee health.
Though patellofemoral syndrome sounds like the obvious cause, it is possible that your pain is patellar tendinitis. In that case, strengthening VMO would do nothing for you and it may even aggravate it. See a doctor to pinpoint the cause.
The information you’ve provided leads me to believe that ART will not resolve your complaint (hopefully, I’m wrong). Why would your VMO be weak? Did you have a direct injury to both knees? The fact that your pain is consistent with certain movements and prolonged and unchanged may indicate a chondral defect. Why? You play hockey AND you train hard. That means you perform a very repetitive activity (skating) in which the patella may be rubbing over the same area for years. Also take into account the fact that skaters typically maintain a certain amount of hip and knee flexion which will maintain tension on your rectus femoris which increases patellar compression. If you don’t get results from the ART, see an orthopedic surgeon ASAP. Your problem may be chondromalacia. It will not show up on an x-ray. An MRI with gadolinium will really bring out contrast in the articular cartilage. Worse case senario…minor athroscopic surgery and back in action in a month. Best case senario the ART works. Good luck.