<p>I’m looking for any information you have about this disorder. I recently went to my doctor for on and off again knee pain that lasted a month, and by the time I had my follow up I noticed my knee was swelling and it was getting worse. I couldn’t bare standing and walking for more then 30 mins. Sitting for long periods also caused pain. Before the x-ray she offered physical therapy, but I pushed her into giving me an order for the x ray because of the swelling. I have not had any knee injuries in my life. After the x-ray the first thing out of her mouth was surgery. I declined and said I wanted the physical therapy as the semester was just starting.</p>
<p>Basically the x ray showed my knee cap in the wrong place, it was on the lateral side of my leg. The doctor did not notice this during the physical exam when she checked for damage to the ligaments/tendons. </p>
<p>I am going to see an Orthopedics doctor this week and I want to know about some experiences so I can formulate questions. The physical therapy is helping, and I just went to go get some better quality shoes as I found out I have one flat foot plus 4 other new “diagnosis” the physical therapist gave that no doctor in my life has.</p>
<p>So any experiences, or warnings you have I’ll take. I’ve only been able to find info on webmd, and a Canadian form. From these two sites I have found this condition is life long and can cause the cartilage in the joint to fade away. Surgery for something like lateral release doesn’t necessarily work, but scope work could help clean up any scar tissue and look for any damage to ligaments/tendons.</p>
<p>Thanks I didn’t get any hits when I googled from U’s med schools which is strange. Google mainly returned with insurance websites, or with exercises which isn’t what I want since I’m paying for physical therapy.</p>
<p>What kind of sports to do you do? Tennis, running, hockey, basketball, anything jarring or requiring twisting?</p>
<p>Does it click in and out of place?</p>
<p>Have you tried a knee sleeve or patella strap?</p>
<p>I’ve had this on and off for about 15 years and it’s exercise-related. Some rest usually resolves it.</p>
<p>I’ve read that it’s due to an imbalance in the muscles above the knee which results in the patella pulling to one side. The long-term solution is exercises which balance the muscles.</p>
<p>I played volleyball and basketball in high school but haven’t played since sophomore year. I’m now a sophomore in college. It does click/crack a lot I noticed lately. </p>
<p>I tried a knee sleeve, but physical therapist and doctor said to stop. They believe it will cause my muscles to depend on the sleeve and become even lazier. I also tried kineso tape for a day it was the worst feeling I’ve ever had on my knee. The swelling also increase under the tape as well.</p>
<p>My physical therapist agrees with you on the muscle imbalance and I’ve switched my exercises. I no longer use a treadmill and I bike more often. She said if it ever flares up again to just call the dr and hopefully she will put the order in without a visit. I am switching to a different physical therapist though if it flares up again. This one was nice, but the one I will see works with a lot of athletes and is very active himself. Just thought it was strange that the doctor would suggest surgery immediately! I also was skeptical because she didn’t give a name to this diagnosis like dislocation or patellar tracking disorder it was the physical therapist who said tracking disorder.</p>
<p>D suffered a fall in her sport. Clean x-ray, MRI, cleared to return to training (4 hours a day, 5 days a week), with the assurance the pain would go away. It didn’t. 3 years later, an ortho determined pftd. In an effort to reduce the pain she tried j braces, chiropractic, pain relievers, physical therapy, and orthotics. This went on for 3 more years. X-rays showed kneecaps that are not straight. </p>
<p>Family doc finally sent us to a different ortho. Ordered another MRI. (Still nothing of significance but a little fluid). Decided on an arthroscopy on the worst knee to see what was behind the kneecap. What he found was that D has an atypical anatomy. Her kneecaps do not face forward and never will, but the track just fine. The arthroscopy found an area of inflammation that was probably responsible for much of the pain and swelling (likened to biting one’s cheek repeatedly). However, it’ll be months before she knows how much pain relief she’ll experience.</p>
<p>My completely non-medical opinion? Go noninvasive first because the success rate of surgeries for this condition aren’t all that high. PT and, yes, orthotics, provide relief. Dr. is recommending D continue wearing orthotics. But don’t suffer for years like d did. If PT and orthotics don’t ease the pain, start thinking about surgery.</p>
<p>Yes, they are part of the physical therapy. I was just curious because it’s only been flared up for a month with rest, and ice being used to treat the swelling. I wasn’t even in physical therapy when surgery was mentioned and from what you said, and on other forums physical therapy is often what is used. On other forums most posters recommended seeing the specialist right away because of the complexity of the knee joint.</p>
<p>I have this now for 40 years, since 16 years old. Knee clicks and gets stuck feeling when bent for any length of time and I have to straighten it and click it out. Awkward when in someone else’s car or at the theater! Most helpful thing for me:do not sit cross legged. I was having a nice meditation practice in college when the pain started waking me at night and the doc advised no sitting indian style. It helped enormously. Also I agree re muscle imbalance, make sure the outer quadricepts do not overwhelm the inner thigh muscles. Bike riding can tend to over strengthen the outer quads. Try yoga chair pose with the ankles together and the legs pressing tightly together to strengthen the inner thigh. Also lay down on your back or sitting your fists or a ball in between your knees and squeeze. Good luck!</p>
<p>It’s pretty common for former athletes to have this. Your quad muscles were built up when you were playing volleyball and now are more lax causing the ligaments to loosen and thus your knee cap isn’t riding in the same path before. PT will work on strengthening your leg muscles again. The clicking is typically loose cartilage on your knee cap catching as you move. If some of that cartilage tears off, it can lodge in your knee joint and cause it to lock. They can go in arthroscopically and clean that out pretty easily.</p>
<p>^^^^^^^^
Agree with all of the above… Surprised, though, that the undercurrent of the thread is that surgery is somehow a “bad” option.
I agree that it should be a last resort, but knee arthroscopy with lateral release of the patella is a surgery preformed 1000’s of times a year in the US with pretty darn good results (when done for the right reasons)
In most cases it corrects an underlying “mechanical” issue with the knee. If OP isn’t getting better with conservative measures, I think that step would be logical.
Just wanted to represent the surgeon’s view… we aren’t so bad…</p>
<p>Sounds to me like PatelloFemoral Pain Syndrome. And treating the knee isn’t likely to fix the problem! Weak hips, tight adductor muscles (think groin), and flat feet all common causes for this patellar malalignment that is causing pain.</p>
<p>Our son has this issue mostly tracked back to extremely tight IT bands. He did PT twice, didn’t’ do the exercises prescribed, woudln’t take him back until he did. He still has issues, being a mean mom I ignore them after telling him to start the stretches he is supposed to do…it’s been 6 months, hasn’t tried a one :D.</p>
<p>I had this issue in college. I found moving from one sport to another make it worse for a while too. I finally had arthroscopic surgery after several knee locking incidences. I haven’t had a single problem since. Had the surgery in the morning, was out bar hopping the next day–but at age 20 we all probably bounced back from things a bit quicker :D.</p>
<p>Where do you live? I could make some good recommendations in MA for doctors specializing in knees. You need need to feel comfortable with the diagnosis, treatment options, and plans. Always good to get two top docs to agree on the diagnosis and plans. Necessary definitely before surgery.</p>
<p>My experience is the most specialized surgeons recommend surgery as a last resort. I would be leary of any doctor suggesting that immediately.</p>
<p>To echo what Hops_Scout said, obviously not every knee injury or knee pain is the same, but the top athletic trainers now believe that a significant cause of anterior knee pain lies with poor hip strength and mobility. This is a nearly universal weakness, but seems to be particularly prevalent in women.</p>
<p>Here’s a somewhat technical article on the topic along with a suggested plan of exercises from Mike Boyle (currently the strength/conditioning coach-consultant for the US Women’s Olympic Hockey team and the Boston Red Sox.</p>
<p>I can say that I started doing these sorts of exercises three years ago, when I could not even squat down because of knee pain when I bent my knee with weight on it – for example looking for something on the bottom shelf of the fridge (too much of which was also a contributing factor!). I also felt it walking up hill or up stairs. The knee pain disappeared completely. It’s not something I ever experience or even think about now. Whether or not hip exercises will completely cure any given knee? Who knows? But, really committing to this stuff would be where I would start.</p>
<p>Sorry for the delay in the response. Sundays are my day to read for Tues classes. </p>
<p>I’m not against surgery it just seems on other sites such as Webmd physical therapy, braces, shoes and modification to lifestyle are what doctor’s recommend first. I just thought it was strange my doctor would offer physical therapy before x ray and surgery after x ray. I will be starting hip and balance exercises this week but it seems like my physical therapist is trying to save me some visits since I can only go 30 times a year. I do my exercises every day and one my long days when I’m campus for 12 hours I do modifications to the sets and reps. I make up for it on the following days. </p>
<p>I decide to see the orthopedic doctor right away because I want to make sure I’m getting a proper diagnosis. Not in the MA area, I’m in WI. If I don’t like this doctor I plan on going to see the knee specialist in my area. I would only do surgery if the doctor thought it was necessary to do soon otherwise I want to see how far I can get with noninvasive treatments.</p>
<p>D1 and I both have this. D1 dislocated her knee for the first time at age 12 and had the lateral release surgery after the 4th dislocation (caused by her sister hugging her from behind, I kid you not.) She needs to have her 2nd knee done, she’s been lucky that she hasn’t dislocated that one yet. </p>
<p>I haven’t had surgery yet. But 49 years of maltracking have worn away a big strip of cartilage under the knee cap, left the remaining cartilage like a “shag carpet” per my orthopedist and has probably contributed to my plantar fascitis and continuing lower back problems. I only wear Dansko & Merrill shoes. </p>
<p>I’ve done cortisone shots, synvisc injections, physical therapy, knee brace, anti inflammatory drugs, but it’s a mechanical issue. </p>
<p>D has had this surgery. All of a sudden, her knee started dislocating. These were not precipitated by sports or anything else. It would just “give” when she was walking. We spent 18 months trying various things, seeing specialists, and hoping she would outgrow it. The specialists all said surgery was the only option and we bit the bullet when she was 10.</p>
<p>The surgery was not minor. Her scar is long, `8". They removed and reshaped the bottom of her patella, shortened one tendon/ligament (sorry, forget the dif) and lengthened the other. She has some pins too. She has some arthritis in the knee and they said it would get worse with age. Barometric pressure definitely affects it.</p>
<p>She was straight-leg cast for 6 weeks and required physical therapy to regain the use and bend of the knee. It’s amazing how quickly the muscles atrophy! She did have significant keloid and hypertrophic scarring. This has required cortisone injections and laser treatments.</p>
<p>It has not dislocated one time since that surgery 6.5 years ago. Great success! If I could do one thing differently, I would find out more about scar care before surgery. The surgeon didn’t mention anything and I didn’t know to ask.</p>
<p>^^^Wow! That’s so different from my D’s surgery & what has been explained for mine. D’s was completely arthroscopic & she has two tiny 1/2 inch scars on either side of the bottom of her knee.</p>