Patella issue/Kneecap misallignment

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BrunoM

 
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Patella issue/Kneecap misallignment

by BrunoM » Thu Jan 07, 2010 7:42 pm

Ok, here my story.

Last april, while running, someone challenged me to a sprint. What the heck I thought.

Afterwards, a little pain in my left knee. Ah well happens often I thought.

Next day, same problem, hmmm, it'll pass, right?

I continued running for some weeks, until I thought it wise to stop running because the pain wasn't diminishing.

Fast forward to september. After 2 weeks of trekking and bouldering in the French Alps, the pain is still there.

I go see a doctor and he diagnoses a light patella inflammation (no shit).

9 sessions of physiotherapy. To strengthen my knee and re-align my kneecap. Appearantly, it's too far to the left. After 7 of them, things are going a lot better, and I quit.

I continue doing the exercises at home (every day, at least an hour a day, often more).

Things are going better, but the problem is still there, because if I don't do my exercises for a while, the pain comes right back.

So, on to another specialist. Yes, still a slight inflammation, reason: misaligned kneecap.

I show the exercises I do daily, no problems there, but he tells me that they won't make a bloody difference in re-aligning my kneecap. I'll always have problems with that knee, the exercises just make the pain manageable.

:?

So tell me then, why is it that prior to my injury in april, I have been able to hike in the mountains, to play soccer in school on a daily basis, to go to the gym and do squats, etc, without EVER having problems with my left knee?


Anyway, I'd like to hear experiences from other people with similar issues. How long did recovery take? What exercises did you do? Anti inflammation drugs yay or nay?

Anyway, I simply refuse to accept 'yeah well, you have this problem, it'll always be like that, deal with it'.


Thanks

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moonspots

 
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Re: Patella issue/Kneecap misallignment

by moonspots » Thu Jan 07, 2010 7:48 pm

BrunoM wrote:Ok, here my story.

Last april, while running, someone challenged me to a sprint. ...So, on to another specialist. Yes, still a slight inflammation, reason: misaligned kneecap.
...Anyway, I'd like to hear experiences from other people with similar issues. How long did recovery take? What exercises did you do?

Anyway, I simply refuse to accept 'yeah well, you have this problem, it'll always be like that, deal with it'.


Thanks



I go to my favorite chiropractor and get it put back where it belongs. Drugs, not so much. Maybe some ibuprofen, maybe not.

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Guyzo

 
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by Guyzo » Thu Jan 07, 2010 7:55 pm

Bruno.... bummer for you, I hope it turns out well.

Will your "Medical System" let you go to: Kerlan Jobe Orthopaedic they can fix whatever you need fixed. No bogus answers like "Just learn to live with it".....

good luck.

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fatdad

 
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by fatdad » Thu Jan 07, 2010 8:37 pm

Sounds like runner's knee. I was diagnosed with that about five years ago. It resulted from a long time muscle imbalance in my legs after having my knee rebuilt a good 20 yrs. ago.

Long story short, my outer thigh never entirely came back after two surgeries, though my inner thigh (that muscle on your inner thigh, just above the knee) has always been somewhat over developed. I always had problems with squats and the like but it never slowed me in the mountains or stopped me from being a strong runner.

I first felt the pain after (guess what) going for brisk 3 miler after not having run for several months. AFter that it never really went away completely. I went to PT, which resolved it while I was in therapy, but it was too hard to maintain the same exercises independently, so it's continued to bother me some. My knee crunches way more than it use to, the kneecap area does get inflammed easier than it used to, particularly on steep trails, and it has prevented me from running much, though hasn't hurt my biking.

I just chalk it up to age and 20 years of over use. I really need to get to do my PT exercises and get back on the wobble board and see if that will permit me to start running again. A chopat strap helps, as does ibuprofen and stretching my hamstrings. If you do run, stay on flat groomed stuff and avoid trails or other uneven surfaces.

The good part is that it hasn't debilitated me. I did a five day trip over Shepherd's Pass last year, etc., and the same hard road and mt. bike rides that I used to; it's just slowed me down somewhat when sore and limited my running.

Edit: BTW, Kerlan Jobe did my second knee rebuild after a company doctor took some shortcuts on the first repair. I saw Dr. Ralph Gambardella. He's awesome, as is the rest of that crew.

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jordansahls

 
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by jordansahls » Thu Jan 07, 2010 8:44 pm

Get an Orthotic, Just don't use it for everything. Orthotics can and will help to re-align the knees, but using them to much can weaken or deactivating intrinsic foot muscles and alter biomechanics for the worse. You could also consider doing some exercises to build up your foot muscles. Good luck!

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foweyman

 
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by foweyman » Thu Jan 07, 2010 10:42 pm

Its pretty apparent that you have an acute injury from the sprint, and not a chronic-use injury. Based on your symptoms, I'm guessing that you roughened up the cartilage on the back of the patella (chondromalacia) by exerting a stronger than usual force perhaps at a seldomly used angle.

The conservative treatment (described in the links below) is just about always tried before surgery, because surgery doesn't have a much higher success rate. The good news is that there are many people with very ragged patellar cartilage that experience no symptoms, and over time the roughness can get worn smoother or into a functioning and non-irritating but still rough configuration. Hopefully this will soon be your situation.

For a more complete description and rehab exercises:
http://www.pamf.org/sports/king/condromaliciapatella.html
http://orthopedics.about.com/cs/patelladisorders/a/chondromalacia.htm

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BrunoM

 
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by BrunoM » Thu Jan 07, 2010 10:57 pm

Thanks for the quick and quality replies :)

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WouterB

 
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by WouterB » Fri Jan 08, 2010 10:07 am

I'm living with it. Doing my excercises, climbing and being in pain. I've tried it all and it has improved, but it never really goes away. If I stop doing the excercices I'm in trouble... .

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JackCarr

 
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Re: Patella issue/Kneecap misallignment

by JackCarr » Fri Jan 08, 2010 5:53 pm

BrunoM wrote:
Anyway, I simply refuse to accept 'yeah well, you have this problem, it'll always be like that, deal with it'.


Thanks


Best you do mate. I spent a few years exhausting every avenue, seeing numerous medical professionals and getting my hopes up. I've just accepted it now, the pain won't go, I just have to manage it. The whole thing has left me pretty annoyed with the medical profession. There's no consistency whatsoever, everybody in their field things their diagnosis and treatment is right, but in reality I have no idea what's truly wrong with my knees and I don't think any of them did.

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Athos791

 
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by Athos791 » Fri Jan 08, 2010 6:07 pm

I am going to agree with what others have said about orthotics. I have suffered from extremely similar symptoms and diagnosis as yourself, and the best I have been able to do was visit a chiropractor, who noticed the mis-alignment of my knee due to a semi, non-functioning toe (broke it years ago badly) that has causes my right foot to supinate out of position, which in turn mis-aligns my knee and patellar traction. The chiropractor was able to give me custom fit orthotics and help me with toe-exercises that re-strengthened and stretched my toe, as well as knee and quad strengthening exercises. My knee is currently doing much better, and the orthotics are working amazingly. I would highly recommend seeing a good chiropractor and seeing what he/she says.
Cheers,
Luke

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ksolem

 
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Re: Patella issue/Kneecap misallignment

by ksolem » Fri Jan 08, 2010 6:47 pm

JackCarr wrote: ...Best you do mate. I spent a few years exhausting every avenue, seeing numerous medical professionals and getting my hopes up. I've just accepted it now, the pain won't go, I just have to manage it. The whole thing has left me pretty annoyed with the medical profession. There's no consistency whatsoever, everybody in their field things their diagnosis and treatment is right, but in reality I have no idea what's truly wrong with my knees and I don't think any of them did.


That seems pretty hard to accept. I mean, the knee is a well understood joint and top orthopedic doctors have high success rates with most problems (assuming the patient does all the right things in P/T etc.) Even if your problem is something really unusual an accurate diagnosis should be available.

Good luck with that.

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cb294

 
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Re: Patella issue/Kneecap misallignment

by cb294 » Fri Jan 08, 2010 7:07 pm

BrunoM wrote:Ok, here my story.

Last april, while running, someone challenged me to a sprint. What the heck I thought.

Afterwards, a little pain in my left knee. Ah well happens often I thought.

Next day, same problem, hmmm, it'll pass, right?

I continued running for some weeks, until I thought it wise to stop running because the pain wasn't diminishing.

Fast forward to september. After 2 weeks of trekking and bouldering in the French Alps, the pain is still there.

I go see a doctor and he diagnoses a light patella inflammation (no shit).

9 sessions of physiotherapy. To strengthen my knee and re-align my kneecap. Appearantly, it's too far to the left. After 7 of them, things are going a lot better, and I quit.

I continue doing the exercises at home (every day, at least an hour a day, often more).

Things are going better, but the problem is still there, because if I don't do my exercises for a while, the pain comes right back.

So, on to another specialist. Yes, still a slight inflammation, reason: misaligned kneecap.

I show the exercises I do daily, no problems there, but he tells me that they won't make a bloody difference in re-aligning my kneecap. I'll always have problems with that knee, the exercises just make the pain manageable.

:?

So tell me then, why is it that prior to my injury in april, I have been able to hike in the mountains, to play soccer in school on a daily basis, to go to the gym and do squats, etc, without EVER having problems with my left knee?


Anyway, I'd like to hear experiences from other people with similar issues. How long did recovery take? What exercises did you do? Anti inflammation drugs yay or nay?

Anyway, I simply refuse to accept 'yeah well, you have this problem, it'll always be like that, deal with it'.


Thanks


Hi,

take that seriously! A good friend has patella misalignment (caused by a tendon attachment to the shin just a little too far off to the side), fixed well (surgically) on one leg, not fixed on the other. As the fixing happened a little late, he has now arthritis in both knees at age 40, to the extent that he gets fever from the inflammation in the joints after 10 km of walking in the hills. A few years ago, when he just had "knee trouble", I ended up carrying his backpack out of Sarek National park as well.... He will only be able to go to the backcountry again after his transplants, which he will have to wait for for another few years (one replacement possible, life expectancy minus two transplant lifetimes...)


Christian

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BrunoM

 
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by BrunoM » Sat Jan 09, 2010 12:47 pm

Thanks again for the replies.

The specialist also concluded that when I walk, I walk on the outside of my foot.

Maybe this puts extra strain on the outside of my knee, which in turn misalligns my kneecap?

Anyway, orthotics are definitely something I'm going to check out.

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JackCarr

 
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Re: Patella issue/Kneecap misallignment

by JackCarr » Sat Jan 09, 2010 4:38 pm

ksolem wrote:
JackCarr wrote: ...Best you do mate. I spent a few years exhausting every avenue, seeing numerous medical professionals and getting my hopes up. I've just accepted it now, the pain won't go, I just have to manage it. The whole thing has left me pretty annoyed with the medical profession. There's no consistency whatsoever, everybody in their field things their diagnosis and treatment is right, but in reality I have no idea what's truly wrong with my knees and I don't think any of them did.


That seems pretty hard to accept. I mean, the knee is a well understood joint and top orthopedic doctors have high success rates with most problems (assuming the patient does all the right things in P/T etc.) Even if your problem is something really unusual an accurate diagnosis should be available.

Good luck with that.


I did physio every week for about 4 months, did the exercises and stretches she gave me and still do them now. I’ve tried three different types of orthotics, none of which have really done much, and I’ve had an operation, which if anything has made it worse. It’s been diagnosed as patella problems, cartridge damage, ligament damage, tendonitis of my hamstrings and quadriceps, gait, or simply genetics. One doctor who is apparently the best knee specialist at my local private hospital gave it a thorough examination and said he couldn’t say for certain what it was, and it could be any or all of the above!

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by dien2liv » Mon Jan 11, 2010 3:39 am

I've had the same problem for a year now, same responses to PT and conventional treatment. I recently found yoga and it has become my savior. The pain is gone and the flexibility has improved my climbing significantly. At the least, try doubling your stretching routine. Good luck

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