Riding the Pain Train

August 21, 2007 in Injury, Rehabilitation, Training Articles

Well today sucks. I guess if you’re Floyd Landis and you know that your hip is going to fall off anyways, then training when it hurts isn’t too bad. My knee hurts. It’s warm, and when I put my hand on my left knee, I can feel it crackling and grinding. When I saw a physical therapist previously about this issue, she said that I had “patella femoral crepitus.” Really it’s patella femoral syndrome (PFS) – “crepitus” is simply a symptom. Although there is some debate about the specific physiological components of PFS, many conclude that it’s a common injury, often felt when running, walking down stairs, standing for long periods of time, etc.

In my case, the pain is caused by a number of reasons. My quadriceps are awfully tight, which causes my patella, or kneecap to be pulled over to the side. Additionally, another structure called the vastus lateralus (VL) may not be properly compensated by the Vastus Medialis Obliquus (VMO) on the inside of my knee. Your VMO is the teardrop shaped muscle on the inside of your knee, and I believe mine are overly weak. What’s happening inside my knee is that my patella is not tracking properly in the articular cartilage, or the shiny groove between my femur and the large bone in my lower leg, the tibia. The patella is grinding up against that groove, creating inflammation and pain. Unfortunately, the articular cartilage has no blood supply, and therefore cannot heal well at all.

Several things are good for this kind of injury: stretching the quadriceps, iliotibial band (IT band) stretches, squats, and lunges. The stretches will serve to keep the tissue surround the knee loose, while lunges and squats will help to build up strength.

A few excellent sites I have found that explain both the symptoms rehabilitation:

The Steadman Hawkins Clinic

The Sports Injury Bulletin