Going round in circles with Knee problems, can anyone help?

[MattDyer]

Hi there
I wondered whether anyone could give any help or advice on the below? It’d be hugely appreciated!

Ever since I had my calves operated (compartment release) on in March 2008, and had a long spell of inactivity (6 months pre op without sport, then 2 months post op), my knees have been causing a lot of discomfort, however, the MRI scans I had recently have shown that my knees are okay. I’ve listed all the symptoms below:

- Discomfort when walking upstairs – almost like there’s something catching which irritates the knees under the knee cap
- Knees feel weak and I generally feel unstable on my feet – the weight of my body feels heavy on my heels
- Standing feels uncomfortable
- Knees feel sore 24/7, but feels fine when I put my feet up
- After running for a couple of minutes it usually feels okay, although I might get the odd pain or two in my knees which I can usually run through - its afterwards then that they feel even weaker

Other things to note:

- I’ve tried wearing knee braces/supports with the hole, and strapping and I’ve tried strengthening exercises – originally I thought it was maltracking
- I’ve tried resting for a period, and running through it
- Following the MRI scan results I will start doing exercise again – but I still need to find a way to manage this pain

Maybe just maybe it could be maltracking of the knee, but my exercise weren't good enough.

[Heidi]

Hi
I agree that it sounds like patella maltracking, patellafemoral pain syndrome: http://www.sportsinjuryclinic.net/cybertherapist/front/knee/patellofemoral_pain_syndrome.php
Continue with the exercises, but also look at other possible causes, such as tight muscles on the lateral thigh and knee which might benefit from sports massage, insoles or different running shoes if you overpronate, hamstring, calf and quad stretching, hip abductor strengthening, VMO strengthening.

[MattDyer]

Thankyou! Must admit, I have tried stuff, but I've got a few physio appointments lined up and will refocus.

Presumably maltracking doesn't show up on MRI scans?

I've been wearing specially made orthotics for a year, and made no difference. I've since been told that I don't really pronate that much, so I'm thinking about ditching them?

Its soooooooooooooooooooooo frustrating!! Do most people get over maltracking? Should it in theory be easy to sort out?

[Heidi]

No maltracking wouldn't show on MRI scans. If there is considerbale damage to the cartilage as a result, this msy show up, but I think you would struggle to get referred for an MRI on your symptoms.
If you were measured and fitted properly for your orthotics then I would keep wearing them. It doesn't matter if you don't pronate very much. Wearing them will make sure you don't pronate at all, so as long as they aren't causing any problems then I would continue to wear them.
No, most people don't get mal-tracking, although it is reasonably common. It is more common in women due to a wider pelvis.
Treatment can be challenging in some cases. The most important thing is to find qhat is causing your particular problem and correcting that. It may be more then one thing though which is where it becomes complex.

[MattDyer]

Thanks - but I've had an MRI scan off the back of those symptoms!! So do they know what they're doing?!!? And then when it showed up clear on the scan they didn't want to help - which is why now I'm trying to sort out my own physiotherapy. Regardless of the results of the scans, I'm still getting the same pain and discomfort.

There are so many exercises and stretches I could do - so its knowing where to focus!

Is fine to do a bit of running and sport while trying to sort this out isn't it?

I've had the problem over 2 years, and clearly its done no damage because my scan was clear - so I guess I should do whatever I can without going mad. Some people say if you experience pain then rest, but if that was the case, I wouldn't get out of bed in the morning! Having put up with this for so long, I can't tell you how frustrating it is, just effecting day to day life and walking around and up and down stairs. Some days its very depressing. You just want some hope to cling onto.

Thanks for your help!!

Matt

[Heidi]

Ok, well the MRI scan you had was based on your symptoms and to rule out any structural damage. As it was clear, they have said there is no problem and left you to get on with it. That's not unusual unfortunately!
Basically my opinion is that you should do what you feel comfortable doing, but avoid anything that you know flares it up.
In most cases you would be looking to stretch the groin and quad muscles and strengthen the hip abductors and VMO.
Have you considered a knee support for patella maltracking. You can find lots here: http://www.return2fitness.co.uk/Supports_And_Braces/Knee_Supports
The Donjoy trupull are the best ones.

[MattDyer]

This is the thing though - anything flares it up, i.e. walking, and walking up the stairs in my office which I have to do numerous times a day - so I may as well do exercise while strengthening - unless you suggesting keeping it to a minimum?

Any standing or bending of the knees causes it irritation!

That's why I've now decided to do a bit of sport while I try some of the exercises mentioned on the link you sent in your first reply.

I did try a knee support with a hole in it for the patella - but I found it moved around a bit too much and didn't have any effect. I'm also sure I heard 1 or 2 people say its a waste of time. I've also tried taping the knee.

I will continue trying stuff - and will really step up the exercise for a sustained period.

[MattDyer]

Another question Heidi - before you get REALLY fed up of me - the knee thing that I bought was - LP Open Patella Knee Support.

Which do you recommend as being the best few in terms of patella maltracking? Bearing in my mind that I would need 2 for both my knees.

Appreciate your help by the way - its really helping.

[Heidi]

Hi.
The Donjoy lateral J is the best for lateral tracking provided there is no other knee injury involved and the joint itself is stable.