Would you humour me and have a read?

*before I start - yes, i have an appointment with my GP tomorrow and am hoping for a referral to someone who might know something, but I know that could take months sooo........any advice or thoughts gratefully received!*

Okay. Brief history - last spring I developed PF. Had 3 months off, saw a podiatrist, got some orthotics, got it back to a manageable state and started running (ha! Run/walking) from scratch again.

Got myself back into regular running (not loads, I'm still a beginner, doing maybe 15 miles a week at most). Was training for my 10k back in August and ouch! Had weird knee pain running down a hill. It passed fairly quickly but in the mornings, and when I stand up at work and set off anywhere, I got a strange pain at the top of my knee/up the front of my thigh. 

This pain has persisted now for 3 months. It usually wears off when I walk for 30 seconds or so. Sometimes it feels like it is more on the outside of my thigh, but mostly it's the front, above my knee and up my thigh. (although the pain I have had when actually running was definitely *in* my knee..). 

A few times I have thought it's gone, have been pain free for days, then I walk the dog or try a very light run (like a fortnight ago when I literally ran for 100 metres during a dog walk!). The next morning it's there again. One annoyed leg!

Does this sound even vaguely familiar to anyone?

One thought I did have - the orthotics. Is it possible that wearing them (all thie time, all shoes, including running) has knackered my perfectly good knee?? I do still have a bit of PF - it aches a little most days. Had my running shoes fitted and checked at a reputable running shop, by the way!

Any ideas at all?

xxx

Comments

  • It could be to an IT band problem, it can cause friction in the knee area and can be made worse on hills. It's quite a common injury and is often refered to as runner's knee. Most people use stretches and foam rollers to fix the problem and prevent future occurances. However, it is definitely worth consulting your GP as you have said as it may be something else.

      Hope this helps at all!

  • Sorry Lass havn't a clue but if it helps Aitch is on about the pub sunday if your about. image
  • LOL! Thanks Cake - I like the theory (if in doubt, go to the pub!) but it's my wedding anniversary this weekend.

    x

  • I had a similar thing years ago, but it was under the bottom of my kneecap. Doc I spoke with reckoned it was possibly a piece of torn cartilage that was moving about and getting caught every so often causing the pain. My knee also used to lock if bent at a certain angle for any length of time, (dunno if that happens to you).
  • Hmm - it's never locked WG, although it does make a revolting creaking  noise when I go up and down stairs! I've had that for years though. Interesting! Did you have to have treatment for it?

    x

  • sounds like an ITB problem to me......no expert tho.
  • Iliotibial band pain is at the side of the knee, though - and York Lass is saying this pain is at the front.

    Could be a tendonitis where your quads is meeting your patella - particularly as you say it first started on running down hill (quads-heavy exercise).

    Just a guess tho....image

  • Apologies for slight hijack of your thread YL but question for WG - did your problem resolve itself - I have the same thing but I don't really want to get an op as I can live with it - slightly concerned it might cause long term wear though.
  • Sounds pat-fem to me not ITB. As Basil says, patella tendon is eccentrically loaded when you walk / run downhill.

    If you've a muscle balance in the quads this pull can affect kneecap tracking and cause pain.

    Then there's the PF to consider -> overpronation? Or orthotics over-correcting (Poss leading to tibial torsion). Could be related. Many things to consider.

  • Siance! Glad you turned up image  It's definitely not at the side (I ruled out ITB in my head - done a lot of reading and it doesn't sound like that in any way). Patella tendon - yes quite possibly - now Ive had a look where that is, it feels like the pain is there. Would that make sense in that it hurts when I stand up and walk, but it quickly wears off? It aches when I'm sat at work too...and the chair doesn't support my leg all the way to the knee..I wonder if that means anything? Hmmm...

    I'm a walking medical flippin nightmare lol! Did I ever mention that it's only 2 years since I had to have corrective surgery to my hands because of carpal tunnel syndrome? Biomechanically, I'm shot to pieces!

  • It could be that your quadriceps muscles need strengthening?  Do you do any sort of weight training at all?

  • No - none at all. And I'm on the heavy side image Would I be able to start some strengthening with it like it is, or do I have to wait until it is healed, do you think? And....what is this mystical strengthening....I have a horrible feeling this is going to involve lunges lol....
  • Hi - try this link

    I saw a physio yesterday who gave me some of these exercises for similar pain (I hate stairs and inclines!!). He gave me one other that's not on that website - it pretty much involves doing squats (only to about 45 degrees) down a 'slidey wall' (very technical terminology image) whilst holding a ball between you knees. The whole idea, as Siance says, it to balance the strength of the quads so that the patella tracks properly.

    As for lunges - they are the worst exercise for my knees. Causes so much pain - too much strain on the joint. Avoid like the plague!!

  • Thanks for the link Sarah! That's really helpful. It doesn't look like any of those could do any harm, so if I have to wait years for a referral, I will make a start on those! I have also just remembered that I have a free month at a gym to use - so I could use their crosstrainer..hmmmm!!

  • http://www.stonyfield.com/images/wellness/WallSquats_TN.jpg

    http://www.healthline.com/blogs/exercise_fitness/uploaded_images/LungeRick-736700.jpg

    Try squats with a swiss ball. Place a football between your knees as you squat. Angle yourself from the wall so when you're at the bottom of the squat both knees are in line with the ankle.

    When you progress from that, try short range 1-legged squats and look to see where the kneecap goes - it should track over the 2nd / 3rd toes for good alignment.

    Static lunges are a good exercise for quads providing they're executed correctly (knee in alignment and not too far forward). Running is a single leg activity afterall.

    Get into the position and try some body weight ones, staying in place for 10-20 reps on each leg. Walking lunges or dynamic ones aren't for you (yet). Technique is important - get a PT to show you if you're not sure.

    Any pain on any of the exercises - stop.

  • popsider wrote (see)
    Apologies for slight hijack of your thread YL but question for WG - did your problem resolve itself - I have the same thing but I don't really want to get an op as I can live with it - slightly concerned it might cause long term wear though.
    Popsider, the doc wanted to get me in and get under the kneecap and scrape away any debris, but I wasn't that keen. Over the years, (19 yrs), the problem came and went. In the end I did nothing and I still get it, (rarely), but hasn't really hindered my running or my way of life. I'm sure medical technology has advanced in 19 yrs, but back then I was told it could take months to heal and even then wasn't full proof. Hence the reason I left it....
  • Can I just thank you all for the replies today? Been really useful. And thanks for the practical stuff too (Sciance - can you come to my house and demonstrate?? image). I'll give an update after seeing the GP tomorrow!!
    x
  • I'd wait until you're pain free to start the strengthening exercises. There's obviously some inflammation in the area and it's best to wait until that subsides before putting demands on the area.  Do you belong to a gym at all?
  • HI YG - no I'm not  gym member, although I have a free month to use at one any time I like - so there's that to consider!

    I went to my GP - who was predictably quite useless! Although - he did a lot of manipulations and prodding and agreed with me/you/Siance that it's nost likely Pat Fem tendon thingy. He was happy to rule out anything ligamenty or anything needing an arthroscopy. Good news, I guess! He has referred me to a physio but said it's unlikely to be before Christmas. He also said I could try other exercise but the only way of knowing if cycling or swimming would aggravate it was to have a go. Right then! So it's back to the brufen and anything I can do myself in the meantime! 

    Suggestions please!! image image

  • JJ2JJ2 ✭✭✭
    Pay for an initial private physio assessment to get things started?
  • YEah - I suppose it's an option, JJ2. Although the budget really might not stretch that far image
    Gah...
  • Dear All,

    I say dear all because without taking a history, examining a patient and organising special investigations I cannot offer individuals advice via the internet.

    I was interested in all the advice offered so far without there really being a diagnosis. This is OK I guess if the pain is recent in onset (less than 6 weeks) and not life threatening. Treatment, if it is to be effective, for any condition depends on the diagnosis. Treatment should be evidence based especially if it is to be paid for.  This holds true for the patient paying for NHS treatment through taxation or out of their own after tax income. Casual advice is not without cost especially if you include a patients time adhering to or trying out casual advice.

    I am going to give you all some information on the patients who come and see me with pain above the patella (knee cap) in the region from 11am to 1pm (if you consider the patella as a clockface).  Any of the structures beneath this area can cause pain. The structures below this region include: skin, vessels, nerves, fat, patella spurs (in the older patient), quadriceps tendon, synovium, the suprapatella plica, intra-articular bands, extraperiosteal fat, periosteum, the femur.  Believe it or not, over the last 25 years, I have seen pathology causing pain in this region from all of these tissues. Some of these causes are benign and easy to fix by advice others not so.

    So what should you do if you have pain in a knee that lasts more than 6 weeks?

    A pain that is mechanical easy to pinpoint and is not relieved by conservative measures like exercise, manipulation, physiotherapy, pain killers, orthotics, magic crystals etc? The answer is go to your GP.

    To go and see a GP first is sensible whatever you think of him or her.  GP's often are well enough trained to take a history, examine you and triage you to the next step.  If this is a pat on the head and a non-steriodal anti-inflammatory try it.  If that does not work go back and ask for a referral.  Pain in the knee lasting over 6 weeks is not normal. Crepitus (creaking knees climbing stairs) is not normal.

    So who should I see?

    The first person to see is a Consultant in Orthopaedics and Trauma. 

    You have the right to ask for a referral of a second opinion.  This is where you will get the time to have a proper history, examination and special investigations (even in the NHS).  The advice you get from a Consultant in Orthopaedics and Trauam does depend on three things:

    • Who you have seen (in the NHS many patients do not get to see a Consultant).
    • Whether the professional you have seen has properly correlated the history and examination findings with the special investigations (many scans are not fully or properly reported these days and sometimes the symptoms do not match the findings on MRI).
    • The experience of the Consultant (you are going to do better with a Knee Surgeon for knee problems thatn a hip surgeron).

    Do not expect an operation just because you are seeing a surgeon.  I estimate that about 50% of the patients I see do not need surgery.  This is largely because the patient I am referred have excellent GP's and Physiotherapists.

    Hope this helps.

    John Hardy

  • HI John,

    Thanks for the lengthy reply!  Not sure what to do with the information though  image. You say that a pain "not relieved by physio" etc.... go back and ask for a referral. I certainly will - although my GP estimates that a physio appointment is going to materialise sometime after Christmas image.  Certainly if there is no improvement by then, I'll go back and ask for a referral, as I'll have had pain for over 6  months by then!! Eeek.

    In the meantime I'll do exactly what I have been doing thus far. Which is nothing much. Take the brufen. Not run. It's a long wait, but then I also have plantar fasciitis, so I'm used to injuries which stick around!

    x

  • Crepitus (creaking knees climbing stairs) is not normal.

    You have me worried now........I thought this was really normal especially with age..............my knees and ankles do this all the time as does my shoulder whern doing some activities.........all these joints hurt as well but i have put this down to age and dodgy joints.........

    When I was doing exercises for my NHS physio for my achillies tendon earlier this year he lauged at the fact my ankle clicked every time i went up and down on the step so this also made me think its harmless.image

    yorklass i hope it gets sorted soon

  • Dear all,

    If you have knee pain for more than 6 weeks then ask for a referral to a Consultant in Orthopaedics and Trauma. Physiotherapy is the treatment for some knee related conditions.

    Crepitus is a the crunching noise a loaded joint in motion makes (like fingernails running down a sheet of coarse sandpaper). This is not normal.  The simple pops and clicks of a joint are common and if not associated with pain are nothing to worry about. These are normal.

    Hope this helps.

    John Hardy

Sign In or Register to comment.