Patellar Pain

[chughesie]

Hi,

I've been experiencing knee pain for around 3 months now and with a new season of rugby starting soon I am getting anxious about my fitness.

I broke my fibula above my ankle in March. This healed perfectly fine with no complications. However, sine this has happened I have been experiencing pain ON and UNDER my patella. While the pain was already there, it was really brought on after attempting a high jump in a school sports day. Even though the high jump was fine, my knee felt unstable and stiff.

The pain is most pronounced as a pinching/sharp pain just on the bottom and slightly to the right of the patella bone. This pain goes through my knee when I kneel down and is very sensitive to touch.

I have gone to the rugby club physio who has told me my knee is mal-tracking and this is causing the pain. I have been given exercises to stretch and strengthen my glutes and have been told to strengthen my VMO which I have been doing. I have been doing this for 2 months but find the pain increases when doing these leg exercises (squats/single leg extensions/single leg press/lunges). As a result the sharp pinching pain is there pretty much constantly and is joined by a dull numbing pain under my patella bone. As I am trying to build up my legs I am doing heavy leg weights three times a week which means the pain is constantly there.

While I accept that the knee is mal-tracking I find the pain quite sore and don't have any confidence in running on my knee at this time. With pre-season fitness training starting this week, I want to do these exercises through the pain to ensure ill be OK for the start of the season but am worried that I might be doing more damage to the knee.

Any help is appreciated!!

Colin

[Heidi]

Hi
My intial thoughts when reading your post was the same as the physio you have seen.
However, I don't agree with working through the pain. If something is painful then it is a warning sign to stop as damage is occuring.
I think you would be better to go back a step to VMO contractions and glute strengthening, provided these are painfree. As well as flexibility exercises for the hamstrings and groin muscles.
Some sports massage to the thigh, especially the lateral muscles and ITB may also be helpful.
Other things to try include taping the knee or wearing a knee support with a patella buttress to control the movement of the knee cap. For example: http://www.return2fitness.co.uk/Supports_And_Braces/Knee_Supports/lpknee708
Given this came on after an ankle injury have your feet been looked at? Ankle injuries can cause changes in the way the foot and ankle function and it may be that the arch of the foot has fallen or that you overpronate. This twists the lower leg inwards and in turn affects the kee joint alignment. You may require some insoles.

[chughesie]

Heidi,

Thanks for the response.

I have in-soles at the minute, but it could be a case that they need to be altered.

Thanks again!

[GG2]

Have you considered a low-impact trainer like a GlideCycle or Elliptigo? I played hard in High School: Volleyball, Basketball, long jump, triple jump. Then I followed that up with volleyball in college. I had to give it up because of the knee pain I experienced. At night when I was sleeping my knee would "pop" out of place, after practicing that day. Hurt like the dickens to get it back into place, and the next day it would swell up. Anyhow to make a long story even longer.....I gave up athletics to avoid the pain. Recently, my husband purchased a glidecycle for himself. I have taken it on a run three times now, and my knee has not popped out of place. It got a little achy, but that was probably more due to me being out of shape than anything else. I hope your injury doesn't stop you from enjoying your sport.