Are your vastus medialis, hamstrings, and calves tight/shortened/knotted? It's really amazing how muscle issues can cause a lot of mystifying pain. Trigger Point and Referred Pain Guide and Vastus Med Trigger Point Diagram
Male, Presenting Problem Since: 6 monthd, Symptom Behaviour: yes, Symptoms Worse (24hr Behaviour): Worse when standing, Aggravating Factors:: Standing, Easing Factors:: sitting, No Investigations, No Diabetes, No history of High Blood Pressure, No Medications, No Osteoporosis, No Hx of Cancer, No Unexplained Weight Loss, No Bowel/Bladder issues, Other Info: no
This problem is baffling me! I have a inner knee/top of shin ache on both knees but it only occurs when standing. It is only on the inner part of my knees and feel relatively near the surface as opposed to inside the joint. It is fine when running and cycling. It feels like the some soft tissue is being stretched and pulled and even torn but only when i stand.
The location of the pain is right across both knee joints on the medial side and also at the top of the shin bones on the inner side.
I have tried strecthes, off the shelf orthotics, but no reprieve. any ideas?
Thanks
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Are your vastus medialis, hamstrings, and calves tight/shortened/knotted? It's really amazing how muscle issues can cause a lot of mystifying pain. Trigger Point and Referred Pain Guide and Vastus Med Trigger Point Diagram
Hi Yes i guess they are a little knottewd and probabaly shortened as i do mostly a desktop. Not sure what would be good set of exercises to help this? many thanks for amy suggestions
Sound a bit like a tendinopathy at the common insertion for medial hamstrings, gracillis and sartorius. If you are referring to the medial aspect of the poximal tibia I'd look at these muscles and see which one is the tightest/most TOP.
For tendon pain/attachment issues, I don't like to stress the structures by starting off with stretching. I like foam rolling, because you can get that release of muscle without aggravating the attachments. Most fitness supply and running stores carry foam rollers. You can also order them online. Or you can make a PVC one, with yoga mat glued on to pad it.
Here's a webpage with vid of a foam roller lower extremity routine. Lower body foam roller routine | Combat Sports Clinic
You say that its fine when you are running or cycling, do the shoes that you wear during these activities differ significantly from those used when the pain comes on?
Have you ever been prescribed orthotics or told that you over-pronate?
It's not uncommon for these insertional tendinopathies to "ease off" for a period once you get moving, but if the exercise pushes the muscle to fatigue I'd suspect it starts getting sore again.
Also agree with violablue. You won't get far working on the site of pain. Taping across the distal muscle belly, not unlike you would do for a medial patella glide with PFP taping, can have some good short term effect in inhibiting the muscle, but I'd be working the medial thigh muscles to unload the tendon. Not sure if you can get the roller in there?
Good luck.
Hi thanks for your reply. I have been told that i overpronate actually and i did once try orthotics but they made the problem a lot worse.
The shoe i wear for running and ccling arent significantly different.
Once thisn i have also noticed is that when the pain comes on i find myself rubbing the very top of my medial shin as this has some mild pain too
many thanks again
Rob
I just ask because a lot of these trainers offer good arch support and it sounds as though standing in a trainer is not as painful as standing in regular shoes. Where the orthotics that you used cut to suit you or were they over-the-counter ones? Sorry for all the questions .......