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Patella issue/Kneecap misallignment

Tips, tricks, workouts, injury advice.
 

Postby BrunoM » Mon Jan 11, 2010 9:38 am

Care to be more specific? What kind of exercises?
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Postby ksolem » Tue Jan 12, 2010 11:54 pm

Yoga and Pilates both have many exercises which stabilize the hips and knees. However it would be irresponsible for someone to recommend exercises or try to teach them to you on a forum.

Your best bet regarding this type of work is to seek out a good teacher who has the skills to assess your problem, get you started at a level you can do safely, and progress the exercises as you improve.

I teach Pilates, but where I've been working a person in your situation would see a physical therapist first. Then I would meet with the PT to design a program for you. I don't know if there are places like that in your area, but that is what I'd be looking for. A practice which combines Physical Therapy and personal training like Pilates and/or yoga.
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Postby Sierra Ledge Rat » Tue Jan 19, 2010 8:26 am

I got a seriously bad case of chondromalacia at mile 25 of a 30-mile trail ultra. It was my 8th trail ultra-marathon in 8 weeks.

Had to limp the last 5 miles and it put my time over 7 hours. Shit.

Couldn't run again for TWO YEARS. Oh, yeah, running uphill was fine, but then I could neither walk nor run downhill without excrutiating pain.

Physical therapy. Motrin in the 500-pill buckets. More physical therapy.

Fast forward 15 years.

Problem is still there. Gave up running, gotta stick to power walking. Downhill still gives me knee pain. Skiing is okay, even telemark turns. No more heavy backpacks.
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Postby Michele » Fri Jan 22, 2010 2:47 am

I have been living with patella femoral syndrome a.k.a. runners knee for 18 years now. What I do know is that there is a very low rate of success in treating this condition, which I believe is partly due to it having numerous and complex causes. Twice I have tried physical therapy with little improvement, if any. In addition, I practice Pilates religiously and have even changed my walking gate, but my knee pain continues to no avail. I have the crunchiest sounding knees you have ever heard! Nevertheless, I will just live with the pain until I eventually find an exceptional doctor. Wish I had better information for you.
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Postby BrunoM » Sun Jan 31, 2010 5:36 pm

Went for a 3 hour walk through sandy/moderately rough flat terrain today, and my knee feels pretty good right now. No pain during or after the walk, and doing stairs feels ok as well.

All those squats & leg raises are maybe paying off after all.
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Postby Guyzo » Mon Feb 01, 2010 3:38 pm

BrunoM wrote:Went for a 3 hour walk through sandy/moderately rough flat terrain today, and my knee feels pretty good right now. No pain during or after the walk, and doing stairs feels ok as well.

All those squats & leg raises are maybe paying off after all.



Keep it up...... :wink:
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Postby Michele » Mon Feb 01, 2010 7:44 pm

BrunoM wrote:Went for a 3 hour walk through sandy/moderately rough flat terrain today, and my knee feels pretty good right now. No pain during or after the walk, and doing stairs feels ok as well.

All those squats & leg raises are maybe paying off after all.


Good for you. Just something I have observed; when my knees are hurting and grinding a lot, it seems to be linked to very tight IT bands. As was the case this week and when I rolled out (using the physio roller) my IT bands they were extremely tight. I believe in addition to gluteal and VMO strengthening, tight hips and IT bands should be addressed as well. But then, lucky you. It sounds like you're already on the mend.
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Postby BrunoM » Wed May 19, 2010 2:34 pm

Small update:

my oldtime physio that I was visiting for something else, took a look at my legs, hips & feet, and concluded that my left quad is grossly underdeveloped because I walk the wrong way.

Why I do this? Because my left ankle is very weak due to numerous sprains in the past. In some kind of protective reflex I lock the left side of my lower leg up when I walk. This then in turn causes the underdevelopment of the left quad.

Finally someone who takes a look at the rest of my body.

All those ****ing specialists look at your knee, conclude that you have an inflamation on your patella, try to cure that small area and be done with it.

Treatment: walk differently! (it's free too ! )

I'm not sure if it's gonna work but it sure sounds plausible.
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Postby Luciano136 » Thu May 20, 2010 12:15 am

Interesting. As a general observation, I just try to limit the abuse I give my knees when I'm not in the mountains. Biking is my main training when I'm not on the trail and it is so much better from your knees. I actually noticed my knees are stronger than before.
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Postby Husker » Thu May 20, 2010 12:56 am

BrunoM -Ksolem is right and you have gotten a therapist to look at you. If you think of your knee cap moving up and down in the femoral groove as a train moving on a track, the exercizes you are doing to align the patella (hopefully shallow squats) help the train to move on the trackroperly. But if the track isnt moving properly under the train, then you get the same problem.

The way you control the track under the train (Knee cap) is about hip and foot alignment-when doing a squat your hip, knee and foot should be in a straight line (plumb line). Orthotic wouldn't probably help as you are already supinated in the foot since you walk on the outside of your feet (and frequently sprain). An orthotic would push you even more to the outside putting your ankle even more at risk. So you need to look up to the hip. A weak hip will allow you to pronate thus allowing the kneecap groove to move inward under the kneecap (causing the kneecap to move to the outside in relation to the femur). To do this you need a piece of theraband loop fairly tight loop, stretch it around both ankles and as an exercise- walk sideway keeping your feet pointing staight ahead. Do it until you can't take the burn on the outside of your hip any more. Then sideway the other way (don't turn around). Usually 30-50 feet each way left and right

If you can't get any theraband, I can send you some with a picture of this exercise-just PM me your address.
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Postby ksolem » Thu May 20, 2010 1:33 am

Husker wrote: ...If you think of your knee cap moving up and down in the femoral groove as a train moving on a track, the exercizes you are doing to align the patella (hopefully shallow squats) help the train to move on the trackroperly. But if the track isnt moving properly under the train, then you get the same problem.

The way you control the track under the train (Knee cap) is about hip and foot alignment-when doing a squat your hip, knee and foot should be in a straight line (plumb line). Orthotic wouldn't probably help as you are already supinated in the foot since you walk on the outside of your feet (and frequently sprain). An orthotic would push you even more to the outside putting your ankle even more at risk. So you need to look up to the hip. A weak hip will allow you to pronate thus allowing the kneecap groove to move inward under the kneecap (causing the kneecap to move to the outside in relation to the femur). To do this you need a piece of theraband loop fairly tight loop, stretch it around both ankles and as an exercise- walk sideway keeping your feet pointing staight ahead. Do it until you can't take the burn on the outside of your hip any more. Then sideway the other way (don't turn around). Usually 30-50 feet each way left and right

If you can't get any theraband, I can send you some with a picture of this exercise-just PM me your address.


^^^^^^^^^^

A golden nugget from an experienced pro. :idea:
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Postby BrunoM » Thu May 20, 2010 1:56 pm

Interesting stuff, thanks a lot!

Will try!
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Postby BrunoM » Mon May 24, 2010 11:08 pm

Hmm, everyone I've seen so far tells me exactly the opposite.

Stay active, do the exercises or your tendon will become weaker, shorter, and worse than it is now.
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Re: Patella issue/Kneecap misallignment

Postby cgarcia4039 » Thu Apr 10, 2014 3:31 am

Slightly similar problem. I started ice skating when I was almost 14, after about the first year I noticed a misshape in my knees. If I point my hands downward/ faced sideways and line them up with the top and bottom of my legs, I can see that the line isn't straight and when you look closely you can tell my kneecap is in a lop sided position. It doesn't cause me any pain at all, and barley noticeable, unless you're actually looking for it. Based on the stories I am seeing here, I am guessing it is runner's knee.
Now here's my concern. My mom has an issue with her hips and knees. When she over exercises, she has severe flair ups and can barely walk for up to 3 days. She was a cross country runner when she was my age, so again, maybe just a case of runner's knee and it's just old injury flair ups.
I just can't help but wonder though, if my problem is genetic and if my knee issue will develop into something similar to hers. Anyone?
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Re: Patella issue/Kneecap misallignment

Postby Tev » Sat Apr 12, 2014 10:32 pm

I have some version of this problem. It started about 18 months ago. As in your case the onset was sudden and was precipitated by sprinting. For the first month severe pain at the top of my shins made even climbing stairs difficult. After that things moved into the current condition where I feel general soreness behind my kneecap. What I've been told is that the misalignment and cartilage roughness behind the knee cap causes stress on my tendons leading to the sharper pain at the top of the shin after sprinting. I have avoided sprinting since then and avoided that particular symptom still,the soreness comes and goes but is always there.

In general my experience has been that PT seems to work at first but that's largely because the two times I started PT I was instructed to stop other exercise. So I felt good for a couple months since I was resting but as I returned to activity the problem returned to some degree. That said my second round of PT with a new provider and a more rigorous exercise program focused on hip stability definitely was more effective than the first. For now at least I can hike, although steep downhills are a little rough; ski without issue, even in moguls steeps etc.; run at moderate pace for 3-6 miles (sometimes with mild soreness) even up and down hill; and climb without issue.

I was told that they could try surgery but it was unlikely to be successful. I still might consider it in the fall if I can't get more improvement from exercise before then. Still, the thought of being out of commission for weeks or months with little chance for improvement is not really very appealing. I assume this will evolve a crippling problem sooner or later but there seems to be nothing I can do. So for now I'll climb mountains while I still can.
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