need help re: knee pain while seated

[jykneepain]

Stamped my feet last april when rubber boat almost capsized. I was able to go home with no pain or swelling. Light swelling started at the evening on my right knee only.



Xray says no fracture, no dislocation. Took oral and topical anti pain & anti inflammatory meds. Rest, ice compress, elevate, the next 14 days on both knees. But hot compress after swelling subsided. Consulted rehab doc to be sure.



Rehab doc said chondomalacia patella. Had 17 PT sessions. After the accident and up to the 13th session, no pain when walking or sitting. But on the 14th session, discovered there’s moderate pain when sitting on a low chair. But during this time, weights during PT sessions are heavier (leg press is 60lbs) A week after the 17th session, a doc advised me to do tip toe walking and heel walking. Did it for 3 days. Just a few times though.

On the 4th day, felt pain on both knees when sitted, walking and when bending knees. Even while in bed when I straightened or bended knees, there was pain.When I wake up in the morning and move my knees, there’s pain. A rehab doc said could be due to tip toe walking, gave me topical anti inflammatory, anti pain meds.



Pain persisted, so consulted a 2nd doc. An orthopedic surgeon, sports med doc requested another xray (both knees AP/Lateral). Xray says no demonstrable fracture or dislocation seen. No abnormal findings in the visualized bones, joints and soft tissues of both knees. Doc said patello femoral stress syndrome. Was advised to take oral and topical anti-inflammatory, anti meds, cold compress and exercises. Didn’t do the exercises for fear that it might aggravate the pain. The pain was reduced after 10 days. Fr level 8 to 5. During the 2nd visit 2 weeks after, doc advised me to do the exercises saying the pain is not from the knees/bones but from weak muscles. Did exercise for 3 days only. Afraid that exercising might aggravate the pain. Consulted 3rd doc- rehab doc. He prescribed treatment with no exercises. Treatment included: hot moist pack on both knees 20 mins, tens 20 mins, ultrasound on both knees x 1.5 watts per square cm 5 mins, electrical stimulation 10mins, isometric exercise 7 secs hold x 10 reps of both quads. I experience pain mostly above the knee cap area when sitted on a low chair. After sitting, when I bend my knees or straighten knees while lying down. So for now, I am doing the last program which is supposed for 2 weeks straight.

Does anyone know how can i deal with the pain especially when i sit down. This is what they call "theater" something... help please. Thanks

[Heidi]

Theatre sign, or moviegoers knee, yes it does sound like that. It just refers to pain and/or stiffness on standing after long periods of sitting and is not a condition as such, more just a symptom which could be due to a number of conditions.

I don't really understand what you first did to injure your knee? Could you explain this more?

Your symptoms do sound like patellofemoral pain syndrome. Unfortunately this is a long-term thing that requires extensive rehab to fully correct. Have a look for exercises here:
http://www.sportsinjuryclinic.net/cybertherapist/front/knee/patellofemoral_pain_syndrome.php

However, if you have previously had no pain at all, until you did something when you suddenly felt pain then I feel this is unlikely to be the main cause. PFPS is an overuse injury which comes on gradually and slowly gets worse. It can be caused by a sudden injury to soft tissues within or around the knee, but if this is is the case then it would tend to come on later, again gradually as a result of the soft tissue injury.

I hope that makes some sense to you!

[jykneepain]

hi heidi. thanks for your reply. Really appreciate it. I went white water rafting last April. We rode a rubber boat. At some point it almost capsized so to gain balance, I instinctively pressed both feet hard on the raft. That's how i got my initial injury. Then I started my PT sessions with no pain until around the 13-14th session which was around August, i started having pain on my left knee while driving. Then a week after, i did tip toe walking exercises for 2 sets with 10 reps for 2 days... then after a day or two, i began to feel the pain on both knees while seated until now. so it has been 4 months now since August.

My main concern now is how to deal with the theater sign because I couldn't drive and sit for a long time. Thanks

[My Aching Knee]

I agree it does sound like movie goers knee which is a symptom of patellofemoral syndrome. To eliminate the pain in your knee you need to have your patella track in the trochlear grove. After you can get in that pain free range then you can do exercises to strengthen the muscles around your knee. Until you can get the patella to track correctly though and strengthen you are just treating the symptoms not the cause of the pain. Patellofemoral syndrome is something that can be treated. Another website of interest for you may be www.myachingknee.com.

[jykneepain]

[QUOTE=My Aching Knee;3266]I agree it does sound like movie goers knee which is a symptom of patellofemoral syndrome. To eliminate the pain in your knee you need to have your patella track in the trochlear grove. After you can get in that pain free range then you can do exercises to strengthen the muscles around your knee. Until you can get the patella to track correctly though and strengthen you are just treating the symptoms not the cause of the pain. Patellofemoral syndrome is something that can be treated. Another website of interest for you may be www.myachingknee.com.[/QUOTE]

thanks a lot will check out the website. How does one put back the patella back to the pain free range? only through physical therapy?