20 years 10 miles per day Mailman

[Newman]

Alot of walking has led to sever pain on the inside of my right knee as well as part of my knee cap. It aches all the time and I`m off work because within 30 minutes of repetative walking or even standing it becomes extremely painful.

MY GP sent me for an x-ray which came back as a slight narrowing of the joint. But, a visit to one orthopedic doctor was depressing. He bent my knee, looked at the xray and said, " you`re fine".
My GP then sent me for an MRI which was read as negative and to a physiotherapist. The therapist actually pressed the soft area between knee cap and the bony areas of femur/tibia and stated they felt alot of "scar tissue" and said it was possibly patella femoral syndrome.
The Physio didn`t help because as a letter carrier i`m physically active outside of work and the physio exercises were almost identical to what i did as exercises.

My work requires pain free limbs to walk up to 10 miles per day and without a proper otrtho`s dianosis they will not accomidate an employee.

I`m on the edge of dimissal if I can`t solve this problem.
Anyone have any idea what`s going on in my knee?

[Heidi]

Hi,

Have you had your feet assessed? By this I mean getting a podiatriast/physio/sports therapist etc to look at the position of your feet when you stand and walk?

The reason I ask is that if your feet roll in, meaning you have a fallen arch, flat feet or overpronate (all mean the same) this places additional stress on your inner knee.

Have a look at this page for a description of overpronation:

http://www.sportsinjuryclinic.net/cybertherapist/general/pronate.htm

If you put your foot on the floor with bare shins and knee and rotate your foot so that you raise and lower the arch you will see how much this affects the shin and knee position. When your arch flattens, your shin and knee rotate inwards.

My advice would be to get this checked out and if you do have overpronated feet you will need some orthotics to correct this. Probably some soft tissue work to the medial knee (especially medial ligament and retinaculum) and thigh muscles, maybe ultrasound too. Stretching on a twice daily basis will also help.

Obviously I cannot say for definate without seeing you, but this is an idea of what could be going on which you can look into further.

Good luck!

[Newman]

Thank you for the information. I don`t have fallen arches but will make a point of insuring my Ortho checks to see if it looks crooked down there since my appointment is next month.

Slight postscript, my R.knee did incur some swelling on the side close to the kneecap where it is soft (inside, not out) when it was first injured. Years ago a similar injury occured when I placed mail in a box, pivoted to turn and felt a searing pain in the same knee. Took 3 weeks for the pain to subside but now it is a permanent ache and when articulated when walking for more than 30-60 minutes it becomes painful to the point of sleep interruption.