Knee Pain

[ofireps]

Hello,

I am encountering knee pain for the past couple of years (in both knees). I went to the orthopaedist, and what he diagnosed is as follows:

Squinting patella
Limb malaligment (left)
increased Q angle (both sides)
J test negative
Grinding positive

He sent me to physiotherapy. My question is what should I do? which excersizes could help me reduce the pain (and maybe 'fix' my knees)? My physiotherapist only gave me 2 stretches(one for the hamstrings and one for an exterior muscle in the lower waist-upper thigh area's side), and they do not help..

Any ideas for which excersizes should help me?

Thanks a lot,
Ofir.

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[umerphysio]

hi,
you should start with isometric strengthening exercises.you need to increase your muscle strength. stretches are also necessary. you can apply ice or hot packs which can help to decrease pain. but only your physiotherapist can advice you about hot or cold after assessment. you can start exercises with static quads,ankle pumps and static hems.
best regards
Umer Physio

[ofireps]

hi,
you should start with isometric strengthening exercises.you need to increase your muscle strength. stretches are also necessary. you can apply ice or hot packs which can help to decrease pain. but only your physiotherapist can advice you about hot or cold after assessment. you can start exercises with static quads,ankle pumps and static hems.
best regards
Umer Physio

Thanks a lot.
Could you please describe what is the static hem? Secondly, if you could explain, how does the strengthening of the Quadriceps helps the problem?


Thanks again,
Ofir.

[umerphysio]

Thanks a lot.
Could you please describe what is the static hem? Secondly, if you could explain, how does the strengthening of the Quadriceps helps the problem?


Thanks again,
Ofir.

hi
static hems means static hamstring. in a weak joint we always focus to strengthening the muscles around it. there are many other things to do with your knee joint e.g

• Education
• Activity Modification
• Muscle strengthening/ stretching
• Bracing
• Patellar Taping

So i think you should make some visits to a physiotherapist near to you which will be more better option i think.
best regards
Umer Physio

•

[112inky]

Thanks for the wonderful tips and ideas Umerphysio. Does applying hot wax on the knees and joints decrease the pain? If so for how many days it can give a relief?

[umerphysio]

hi,
it would be better that you make a visit to a physio near to you and let him decide Hot or Cold? because in some conditions we do not prefer Hot as it could increase the inflammation.
All the best
Umer Physio

[112inky]

hi,
it would be better that you make a visit to a physio near to you and let him decide Hot or Cold? because in some conditions we do not prefer Hot as it could increase the inflammation.
All the best
Umer Physio

oh thank you ... i would consult with the physio....

[dhirenshivji88]

the increased q angle and patella maltracking probably causing pain and grinding or clicking mor epainful when descending stairs??decreased control eccentric quads. you may also have general weakness but more around your medialis vastus oblique (VMO) inner thigh muscle so the outer thigh muscle is stronger therfore pulling the patella laterally and making it maltrack try strengthing the VMO first google vmo exercises and youtube them. firstly you could work on static quads, stretch hamstrings if their tight using PNF i would also rule out any internal rotation at hip and tight lateral structures eg. TFl and ITB also its wothwhile looking at your ankles and arches of the foot to build a clearer picture.


Hope this helps!!

[ofireps]

Thanks for the reply. Yes, very very often I have these clickings in my knees, and it does hurt when descending stairs.....
I searched google for VMO Excersizes, as you suggested, and found this: (it does not allow me to post links, so if you search google for "The Number One Myth of Knee Rehab" it will be the first result)
By what I understood, it says that isolating the VMO and strenghthening it is not good. Why is that? They say that the pulling of the Patella is not because of the strength of the muscles. Is that correct?

[dhirenshivji88]

Thanks for the reply. Yes, very very often I have these clickings in my knees, and it does hurt when descending stairs.....
I searched google for VMO Excersizes, as you suggested, and found this: (it does not allow me to post links, so if you search google for "The Number One Myth of Knee Rehab" it will be the first result)
By what I understood, it says that isolating the VMO and strenghthening it is not good. Why is that? They say that the pulling of the Patella is not because of the strength of the muscles. Is that correct?

from my experienc eon placement as i am a second year physiotherapy student it is very difficult to isolate the vmo and some physicians say the vmo does not even exist try simple quad strenthing exercises, static quads x10 5 secs hold and slow release, Straight leg raises x5 do circles in air ensure leg is in full extension whilst carrying out slr to avoid patella shearing if unable to fully extend knee due to insuffeciency of the quads muscle or tight hamstrings google term if u cant understand sorry to much info to try and explain your knee would require a assesment to identify possible causes, could be tight lateral structures, weak VMO, decreased medial arch in foot creating stress on medial knee, hip internal rotation caused by weak glute med. the knee pain could also be from postural problems at lumbar and core instability. physiotherapist can use methods to reteach you to contract lower quad rather than upper (towards hip) to compensate when straightning knee, or patella mobilistations medially to help a lot of things can be done google patella maltracking etc and you will gain a lot of insight and see what wil work for you. sqauts are a great way to strengthrn the quads try a simple sit to stand when descending to sit down do not use ur hands and controll your sit down leading with your bottom making sure your knees are facing straighnt and not rotated and also that your feet are also straight and your knee goinf over your middle toe ensuring .

excuse my grammatical errors

[112inky]

this due to the age and habits. To awoid the pain doing excercise regularly and walking is remedy for this.