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-   -   knees...help! (http://board.crossfit.com/showthread.php?t=55976)

Karin Franklin 03-01-2010 10:45 AM

knees...help!
 
My knees have been a problem since mid-November. One day they started hurting, both of them (and oddly enough i hadn't exercised at all for 3 days previously...and my knees felt just fine the days before) and it's never gone away since. It's mostly an achy feeling around my knee caps when i walk, stand...anything....and the exact location seems to move...sometimes it's on the outside (lateral) and sometimes the inside. This was never a problem before November. It's been bad enough sometimes that when i go to sleep i end up dreaming about my knees. But it hasn't been that bad since December. On the other hand it doesn't seem like it's going away any time soon. Sometimes my right knee feels like it's a little swollen on the inside but i can bend and unbend my knee and it doesn't make any weird clunking sounds or anything. Never locks or gives out. I went to my regular doctor in December and she sent me for X-Rays. All she said about the results of that was that it was "normal". I haven't had insurance since the first of the year and may have to wait till June to have insurance again. I've tried ignoring it and exercising anyway (squats and rowing seem to make things a lot worse so i've been avoiding them like the plague...other things i can get away with in that they don't seem to make things much worse...if i don't exercise for a few days things aren't any better, either.) . I've tried not exercising (for a couple weeks at a time, twice) and that didn't fix it. I don't have a foam roller thing but i've tried doing something along those lines with a tennis ball. It's not that squats or whatnot hurt that much to do (more of a vague ache, really) but it seems to make things worse later.I've tried stretching a lot (my flexibility probably leaves a bit to be desired...)and that didn't seem to help either. Tried glucosamine and fish oil... Tried elastic knee braces... Gobbling a bunch of ibuprofin seems to help and i've been doing that for months but i know that's not very good for me (risking some rather serious complications, in fact). Do you think this is a patellar-femoral issue? What am i supposed to do if i can't see a doctor for months? Should i stop exerising altogther (i really don't want to do this...lately i've been doing deadlifts - they don't seem to bother the knees), kettlbell swings and a bunch of upper-body stuff... I really just don't know what to do anymore. What the heck did i DO to myself?

Rob Young 03-01-2010 11:45 AM

Re: knees...help!
 
Hey Karin,

First thing I would say is do NOT stop your training!!!

Next you should take care of any possible inflammation you might have in that area, by using ICE (its your best friend). 5 minutes of direct ice contact is like 15-20 min using an ice pack, so I recommend you fill a few Dixie cups with H20, stick them in the freezer and when they are ready just peel away some of the cup and massage your knee with the ice (5 min ea knee). Do this a few times a day if possible.

Now there is no quick fix, but you need to look at the areas directly above and below your knee and I am will to bet it all that your culprit is there!!! Things to consider....
-Tight calves
-Tight hams
-Tight quads

All of these will apply direct tension to the patella and cause discomfort. Especially if they are already tight, you have movement dysfunction and then they are placed under load...make sense?

Kelly Starrett (KStar) does an excellent job of explaining some PNF (proprioceptive neuromuscular facilitation) methods you could use to stretch out those hams, calves, etc...but first you need to assess what it is thats tight, so you know how to address it. Check out the CF Journal for his vids pertaining to this....its the best place to start!

I did :)

Hope this helps.....

Karin Franklin 03-01-2010 04:19 PM

Re: knees...help!
 
Thanks, Rob, i will definitely look into that...

And since i failed to mention it...i'm 33, female, 61 inches tall, about 125 lbs. and i work in a grocery store produce dept./cashiering/etc. And the knees haven't been an issue previously, even a couple years ago when i was 50+ lbs. overweight.

Steven Low 03-01-2010 07:43 PM

Re: knees...help!
 
Have you been to physical therapy?

Karin Franklin 03-01-2010 07:59 PM

Re: knees...help!
 
Steven: Nope. No insurance ATM :(

Steven Low 03-01-2010 08:06 PM

Re: knees...help!
 
Can I get some pictures of where they hurt?

What movements hurt?

What was your routine like before you were hurt and/or what movements you were doing?

Previous injury history?

Any other orthopedic dysfunctions like flat feet or whatever?

Need more information.

Karin Franklin 03-01-2010 10:27 PM

Re: knees...help!
 
1 Attachment(s)
Okay, i think i attached that pic correctly...Not a picture of my legs, btw...

What hurts? Standing and walking, to some degree. Climbing stairs, squatting. Nothing is really all that painful to do but things like squatting make things more irritated later.

My routine before...CrossFit...a fair amount of lunges and squats and all that. I also did a lot of inline skating this summer. None of this seemed to bother my knees at the time...

No previous injuries.

No orthopedic issues that i know of. I suspect my posture and/or gait could be factors but i'm not an expert here...

Karin Franklin 03-01-2010 11:22 PM

Re: knees...help!
 
Oh and that's a left knee. And they both hurt in the same places. Sorry, i realized after i posted that it's not easy to tell what leg you're looking at...the original had two legs so it was more obvious...

David Csonka 03-02-2010 01:07 PM

Re: knees...help!
 
I had a bout of serious patello-femoral pain after running a race last year. Here is what I did to "cure" it.

Took glucosamine-chondroitin supplements. Jury is still out on these, but they may help. They contain the building block compounds for joints.

Try to avoid situations where you are sitting for hours. The sitting position stretches the tendons over the patella and increases pressure against the irritated cartilage, without releasing it. This is usually referred to as the "movie sign" since sitting in a movie for several hours can leave you with hurting knees. I experienced this myself, in the theatre, and on an airplane, and bus ride. It was a rough holiday.

Iced my knee several times a day, especially after workouts. Stopped taking NSAIDs since they inhibit the healing process, and prevents you from utilizing the "pain feedback" from an injury. Pain tells you that what you are doing makes the body angry, right?

I concentrated on improving my squat technique, and building up a balanced strength between my hamstrings and quads. When one of the muscles is overpowered, it has the ability to pull your knee out of alignment in the femoral groove.

I concentrated on increasing overall leg flexibility, this included calves, quads, hamstrings, and gluts. All of the major leg muscles and tendons connect around the knee. When any one of them is seriously tight and inflexible, it has the ability to pull your knee out of alignment in the femoral groove.

When the knee is pulled out of alignment during running or leg movements, it can cause irritation against the patellar cartilage. This is probably what causes patello-femoral pain.

I also took a good long look at my running style, form, and shoes. There is a mountain of evidence that demonstrates that running in thickly padded shoes, with a heel strike, is the real reason that runners suffer from chronic knee pain and injuries.

Consider doing some barefoot running, in grass if you want, on a regular basis. There is a theory that avascular (no blood vessels) cartilage can only heal under pressure, and the pneumatic pumping action of the knee joint while running (properly) can send nutrients into the patellar cartilage. Though, if you run in a manner which hurts your knees, I imagine the process is inhibited. (Basically some scientists found they could grow cartilage inside a hyperbaric chamber)

Anyway, once I started doing some light running again, barefoot or with minimalist shoes, my knee finally felt 100% again. Before that, the other stuff I had been doing had alleviated most of the pain, but still had some minor nagging reminders every now and then.

Best of luck to you, I hope you get well!

Steven Low 03-02-2010 06:58 PM

Re: knees...help!
 
It really looks (at least on the upper portion) like some patellofemoral.

Not much is in the area below medially except plica.

Looks like the whole knee area is destabilized I suppose.

The above is good + add in soft tissue work (foam /tennis ball is all well and nice but not as effective as soft tissue work). Part 4 in here wfs:
http://www.eatmoveimprove.com/2009/1...-dysfunctions/

Take out the ibuprofen and add back in the fish oil @ .5g EPA+DHA per 10 lbs body mass per day.


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