Patella femoral pain

[Redskea]

I've had long term problems with the ITB in my knee but now it has come up with a new problem
This is painful going up hill (knee flexed) unlike the ITB
Less painful after i've iced it but I can't go up hills with an ice pack on my knee and the relief is temporary.
Vitimin I does nothing.
More painfull when the muscle is fatigued.
Using the roller for the ITB every 2 days and started doing leg extensions to strenghten the quads..
Anyone have any other ideas?

(the ankle, the knee, the shoulder, the back, the knee again!!! )

[WICS]

What got me back to running without pain, after 15+ years of patello-femoral pain:

1. Changed how I ran. Read "Chi Running" and "Born To Run."
2. Priopioceptive training. Google it. Lots of resources online.

It is doable. Just needs special considerations, experimentation, patience, slower running, building distance and pace, etc.

My knee surgery was a total miss.
Running shoes really aren't that determinative.
Aging sucks.

Best wishes for speedy recovery and much running in your future.

[lookinback]

Do you have platella alta? could the platella be subluxing or grinding on your tubercle?

your medial musculature might be fatiguing causing the lateral to pull the platella up against the tubercle with extended althletic insult especially if your IT band is inflamed

[Redskea]

I swam today instead of running which still hurt but less

I got some good ideas from people here for the ITB (the roller, the cho-pat)

[lookinback]

Thought about this a bit more, could also be jumpers knee if you are doing alot of hill climbing with heavy packs...it would be a microtrauma to the insertion of the quads tendon to the infroplatellar ligament. You would feel pain above or below your platella that would be aggravated by exercise. You could try and implement an exercise drop program

Its hard to give you anymore information without knowing exactly where and how it hurts. Depending on this you could have a secondary injury aside from your ITBS

[volklpowdermaniac]

I just got bakc from Doctor with similar pain...I had surgery on my left lateral meniscus in January and was certain that it was something to do with that...I had pain high in my medial knee cap, and towards the femur area, thought it was it band, had a precautionary mri, turns out I have fluid building up behind my patella/ knee cap from running and the surgery. Doctor says tons of ice and rest, and if its not gone in a few weeks, he'll drain it and shoot it up with all kinds of nice steroids.

[Vinman]

Red, one of the most common causes of ant. knee pain in active folks that i find is tightness in the hamstrings. If you are tight in the IT band you might also be tight in the hams. basically your quads have overcome the tightness of the hams to be able to straighten the knee and tightness in them as causes a compression force at the PF joint.

Add a stretching routine to your program. Spend 10-15 min, 1-2x/day stretching the hams/IT band/quads and hip flexors and see what happens after a few weeks.

[Redskea]

I changed to a sports dr and he thought it was actually a fissure or cyst on the external miniscus and sent me for another MRI..
but that left me with a month to wait and my knee still really hurts when I run or walk hills (or stairs and I live on the second floor)..

so I went to the best sports physio in chamonix who also thinks it could be the external meniscus or the fat pad under the patella get squashed and then pinched due to a muscle imbalance..

and so having changed the probable diagnosis I am back to VMO is too weak and seems to be on strike (maybe it's too used to living in France) lateral quad and ITB is too tight and hip flexors are reeealy tight..

so I'm icing it, doing leg extensions activating the VMO and trying to stretch the tight stuff.
I've never heard of a pinched fat pad knee pain but the physio was convincing
At least the weather sucks so not being able to run is less annoying.

If I run on the treadmill or swim it hurts a bit but not the knife like stab I get on hills, so if I'm supposed to be resting and it doesn't really hurt does that count as rest?

[farmer]

I had this problem about 5 years ago, so my memory is a little fuzzy, but iirc it was due to one side of my quads (upper or inner, don't remember) being a lot stronger than the other due to the sports I was doing (mtb, basketball, soccer). I did some excersises to strengthen the weaker side, and it helped a lot. A knee brace with a hole to stabilize the knee cap and those braces that put pressure on the ligaments just below the knee cap (something like the first one here)also helped.

[lookinback]

see my first post... in simple terms the lateral musculature can often get way to strong leaving the medial musculature the hopeless job of keeping the platella aligned. Even if the bottom of the platella is not getting sheared it can "pinch" the other stuff below it. The easy cure for this is to strengthen the medial musculature so it has a chance. If you have ITBS the lateral musculature often over compensates and puts excess tension in hopes of relieving the IT band from a workload (the body always trys to avoid a painful state)

A MRI/X-ray should tell you whats up

The above brace tightens the ligament (takes up slack) that attaches to the platella keeping it from subluxing. You can also make a makeshift brace too see if it solves the problem without spending the coin in two ways. First way is to take some "pro-wrap" and wrap it around your leg right below the platella for 5-8 times. Then "roll" it up so it forms a band right below the platella pushing it up. Another way is to grab some elastic tape and rip it down the middle both ways forming an X. Apply the tape below the platella and pull "UP" and "down" on the X forcing the platella up, the tape job will be much more comfortable than the prowrap because it does not put pressure on the popliteal space(site of nerves) aka it hurts to push in the space on the back of your knee.

[farmer]

I'm trying to figure out if that ^^ is what I said, translated into fancy doctorish or not. I think it is.