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Patella femoral misdiagnosis?

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Patella femoral misdiagnosis?

Posted by
Davina on March 21, 2002 at 18:05:28:

I was diagnosed with patella femoral syndrome about 9 months ago and sent for physiotherapy, which only further aggravated my very stiff and sometimes painful left knee, causing a pinched nerve in my left buttock. I've never had a joint problem or a broken bone, or leg injury in my 38 years. Do not run or participate in any demanding sports aside from some hiking and dancing and lots of walking.

This condition occurred after a short 8 week period where I took part in an exercise class that stressed lunges and knee bends. It began with a very tight muscle just above my knee cap and eventually the knee became inflamed for a couple of weeks.

I was told that the damage had been done and maintenance was my only option, not total healing -- walking should be kept to a minimum and biking was helpful. However, when I bike (30 min to work and 30 minutes home, 2-3 x/week) my knee is even more stiff than before, unless I bike again the next day.

I have tested it out walking (50 min to work) and found that it helps. It appears the trick is to keep it mobile.

I've completely tossed aside my physio exercises. Supplementation of 500 mg of Glucosamine sulfate mineral ascorbate with 1,000 mg vit C 3+ times a week is part of my regime in addition to a healthy diet.

Now just a little stiff in the back of the knee. Could I have been misdiagnosed and if so, what do you think this is/was?

Thanks in advance for your reply.

DH



Re: Patella femoral misdiagnosis? (Archive in knee.)

Posted by Walt Stoll on March 22, 2002 at 12:36:09:

In Reply to: Patella femoral misdiagnosis? posted by Davina on March 21, 2002 at 18:05:28:

Hi, DH.

Have you been seen by a sports medicine specialist? If not you need to be seen (WITH copies of ALL your records in your hand).

Has ANYONE told you about the underwater exercises available in your community?

Have you seen a Chiropractor in concultation?

In MY opinion, deep knee bends are among the most damaging of exercises!

Let us know what you learn.

Walt



Re: Patella femoral misdiagnosis? (Archive in knee.)

Posted by Lincoln on March 22, 2002 at 15:04:32:

In Reply to: Re: Patella femoral misdiagnosis? (Archive in knee.) posted by Walt Stoll on March 22, 2002 at 12:36:09:

"In MY opinion, deep knee bends are among the most damaging of exercises!"

How would you propose a accomplishing significant strengthening of the muscles associated with the knees, without actually bending the knees?



Re: Patella femoral misdiagnosis? (Archive in knee.)

Posted by Walt Stoll on March 23, 2002 at 09:23:31:

In Reply to: Re: Patella femoral misdiagnosis? (Archive in knee.) posted by Lincoln on March 22, 2002 at 15:04:32:

Hi, Lincoln.

Which exercise have you found to be the hardest and that develops the muscles of the leg the most--deep knee bends or half way knee bends??

It is the stretching of the knee ligaments that occur with deep knee bends that causes the problems with this exercise.

Which position do you think you could hold the longest: the deep knee bend position or the half way down position?

I would bow to any specialist in sports medicine's opinion.

Walt



Excuse me for interjecting...

Posted by Jeff C. on March 24, 2002 at 14:55:17:

In Reply to: Re: Patella femoral misdiagnosis? (Archive in knee.) posted by Walt Stoll on March 23, 2002 at 09:23:31:

...But I remember the three of us (Walt, Lincoln, and myself) having this exact conversation about a year ago.

The conclusion reached was that deep knee bends on the BALLS of the feet were inherently dangerous, while those on FLAT feet were much safer. To this idea I remeber Walt responding, "That would make a big difference!"

I never thought *I* would be doing the recommending of archives, but I suggest everyone look up the archive "Weight lifting=weight bearing?" string posted by myself under knee.

Namaste' and healthy knees to everyone!

Jeff



Also!

Posted by Jeff C. on March 24, 2002 at 15:01:58:

In Reply to: Re: Patella femoral misdiagnosis? (Archive in knee.) posted by Walt Stoll on March 23, 2002 at 09:23:31:

Hi, Dr. Stoll.


I think you would find this article by world-renowned strength coach Ian King--a man who himself is skeptical of the allopathic paradigm to a degree and who (I think) is beginning to obtain a rudimentary understanding of bracing--entitled "Bucking the Trends."

http://www.testosterone.net/articles/179buck.html

Go down about one third or so to where he starts talking about the squat and leg extension.

Enjoy!

Jeff



Re: Excuse me for interjecting...

Posted by Walt Stoll on March 25, 2002 at 10:13:24:

In Reply to: Excuse me for interjecting... posted by Jeff C. on March 24, 2002 at 14:55:17:

Thanks, Jeff C. for the reminder.

Namaste`

Walt

Follow Ups:


Re: Also!

Posted by Walt Stoll on March 25, 2002 at 10:15:19:

In Reply to: Also! posted by Jeff C. on March 24, 2002 at 15:01:58:

I cannot get the address to work. Can you set it up as a link?

Walt

Follow Ups:


Full vs. Partial squats

Posted by Lincoln on March 25, 2002 at 12:20:39:

In Reply to: Re: Patella femoral misdiagnosis? (Archive in knee.) posted by Walt Stoll on March 23, 2002 at 09:23:31:

"Which exercise have you found to be the hardest and that develops the muscles of the leg the most--deep knee bends or half way knee bends??"

Deep knee bends (full squats) by far. Partial squats only activate the quads. Full squats work the quads, the hamstrings, and the muscles of the hips - overall, a much better leg workout. In addition, full squats are a full range of motion (ROM) exercise, partial squats are not. Much has been written about the benefit of full ROM exercises and the long-term dangers of doing partial ROM exercises.

"It is the stretching of the knee ligaments that occur with deep knee bends that causes the problems with this exercise."

There should be no stretching of the knee ligaments when done properly. Which ligaments are allegedly getting stretched?

"Which position do you think you could hold the longest: the deep knee bend position or the half way down position?"

Partial squats, but so what? Partial range of motion exercises are always stronger, for various reasons such as leverage, muscle length, etc. But partial range of motion exercises, done exclusively over a long period, will lead to shortening of the muscle involved and a potential imbalance between agonist and antagonist muscles.




Re: Full vs. Partial squats

Posted by Walt Stoll on March 26, 2002 at 09:45:54:

In Reply to: Full vs. Partial squats posted by Lincoln on March 25, 2002 at 12:20:39:

Thanks, Lincoln.

Which exercises do YOU think caused her problem?

Walt



Re: Full vs. Partial squats

Posted by Lincoln on March 26, 2002 at 18:03:25:

In Reply to: Re: Full vs. Partial squats posted by Walt Stoll on March 26, 2002 at 09:45:54:

Just a guess here, but she did say this happened after a period of doing "stressed lunges and knee bends." There are CERTAINLY many ways to do these exercises wrong that could cause knee distress.

Lunges, for example, can be very dynamic, which means that technique might vary radically from rep-to-rep. A mistep or or a step that puts the knee well forward of the foot is easy to imagine. Knee bends, as you have noted, can stress the knees if done on the balls of the feet or with the heels excessively elevated. Lifters who squat a lot know that knee stress rises in direct proportion to heel elevation. Knee stress will also occur if the knee is allowed to "dive in" upon rising(excessive medial movement, a rather common error in squatting) rather than staying aligned over the foot.



Re: Full vs. Partial squats

Posted by Walt Stoll on March 27, 2002 at 11:24:45:

In Reply to: Re: Full vs. Partial squats posted by Lincoln on March 26, 2002 at 18:03:25:

Thanks, Lincoln.

This is why I suggested she see a Sports Medicine specialist in consultation.

Walt



Re: Full vs. Partial squats

Posted by Davina on April 05, 2002 at 00:23:11:

In Reply to: Re: Full vs. Partial squats posted by Walt Stoll on March 27, 2002 at 11:24:45:

Thanks for your responses. I have seen a sports medicine specialist -- he looked at my knees and then made his diagnosis -- all within 60 seconds.

My next plan of action is to see a chiropractor -- perhaps some adjustments or some x-rays would shed some light -- no pun intended.

I have recently become aware that I do turn my left knee slightly inward and probably this was aggravated by all those $%*#$ knee bends and lunges!

Anyone who embarks in this type of exercise should not only be aware that in a knee bend their knee does not go past their toes, but that the knee STAYS ALIGNED with the foot.



Re: Full vs. Partial squats

Posted by Walt Stoll on April 06, 2002 at 07:09:12:

In Reply to: Re: Full vs. Partial squats posted by Davina on April 05, 2002 at 00:23:11:

Thanks, Davina.

I guess there are financial opportunists in every field.

Sorry you had to find one in sports medicine.

This is one reason I am doing everything I can to get people to become knowledgable in their problems so that they can judge.

Namaste`

Walt

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