Archives for: June 2009, 24
Patella femoral pain syndrome. I now have a name for my knee pain. SS took a course in joint dysfunction in the spring. He asked me lots of questions during the semester about what hurt and what didn’t because he was wavering between two knee problems that have similar symptoms.
The good news about Patella femoral is that it rarely, if ever, requires surgery, and it is the least debilitating of all the knee problems. The bad news is that it is the slowest and most difficult recovery.
If I have been sitting for a long time my knee hurts when I get up. However once I’m moving around, I feel little or no pain. My knees hurt going up and down stairs, particularly if I don’t keep my toes pointed straight ahead. (I am SO glad we built a one-story house.) It doesn’t hurt to run, swim, or ride my bike, but exercises that involve lunges are very painful. Not surprising to me at all is that it is aggravated by poor arch support and the tendency to pronate.
In May SS gave me six exercises to do. He said that with some physical therapy, you have to push through the pain. Patella femoral is not one of those conditions. He said that if any of the exercises made my knees hurt or pop to stop immediately. Two of them caused pain, so I just did the other four until he came home last week.
He watched me do the exercises and said my form was good on all but one of them. Someone will have to spot me on that one until the muscle he is trying to isolate gets stronger. The two exercises that hurt were for my quads. SS said that strengthening my quads is the single most important thing to do. He modified those two exercises in such a way that I’m working my quads, but not hurting my knee. Other muscles that impact Patella Femoral are abductors, hip external rotators, hip extensors.
It was gratifying to me as a Mom to watch him work, and to see how his manner was both firm and gentle. He found it helpful to spend an unlimited amount of time watching me move and modifying the exercises. He says he never gets to spend that much time with a patient in a clinic situation. I’m probably biased, but I think he will make a wonderful physical therapist.
He tells me that inflammation is not a factor in Patella Femoral Syndrome. I would concur that there has been no swelling or stiffness in the joint. However, since inflammation is such a big issue for Hunters, I can’t help wonder if there isn’t some low level of inflammation that contributes to the pain. Or perhaps physical therapists and naturopaths use different definitions for inflammation. I’m going to look into inflammation protocols.
What I am most curious about is which came first – the chicken or the egg? Or in my case - did arch problems cause my quad to deteriorate to the point that it couldn’t support my knee cap, or did weak quads and hip muscles cause me to walk awkwardly and affect my feet?
I suspect there may be a genetic component to this problem. My father told of his army days when he was marching across Italy and his feet and legs hurt so bad that he thought he couldn’t take another step. He stopped by the side of the road, stuffed dry grass under his arches, and felt immediate relief. My Mom’s knees hurt if she sits for too long. The pain has caused her to stop attending both Sunday School and church. It’s just too much sitting.
I’m hoping that if correct the underlying muscle weakness, I may find a permanent solution to both my knee and foot problems.
You probably know more about my knees that you ever wanted to know. I got off on this tangent because of a thread on the Forum. DD and I have tried some new recipes, and I’ll get back to blogging about beneficials and avoids next time.