Chronic inside upper knee/thigh pain

[Roberts]

Well I'd like to share my latest guess of what is happening.

When I developed pain in my buttock/hip area I tried to carry on walking through the pain (as obviously it is hard to carry on with daily life sitting on the sofa) and by doing this I developed a limp which meant that I avoided using the muscle that was giving me pain (glut medius, piriformis?). As this carried on for such a long time maybe my body adjusted to this limp and the pain and thus decided not to use this muscle anymore to break up the pain cycle (neurological pathways?). So now I can use this muscle/s but my body has taught itself not to use it anymore in my normal body biomechanics, resulting in pain to my knee as it is not being supported properly.

So my plan, after reading someone else recover in the same way, is to get taught pilates which along with strengthening my very weak core, will also train correct neurological pathways.

I wonder if this makes any sense?!

Is the term neurological pathways also to do with the term getting muscles to 'fire' in the correct order??

[Canuck Physio]

Although I have no direct experience with pilates, I think it is a higher level program that may or may not solve your problems directly. I feel you have significant postural and muscular imbalances that need to be solved first. Yes, it appears that your muscle recruitment patterns are altered, this is the bodies way of protecting itself, however it is now time to solve this problem.

Without full assessment I couldn't say what your real problem was.

I am a muscle balance and function practitioner, normally in this situation I would provide specific postural and muscular balance program, as I believe based on what you are saying that these are your problems.

Will keep in touch later this week, Regards

[Roberts]

I did think that pilates theory was good but agree that I would probably struggle with the exercises.

I have started doing clamshell strengthening exercises for my left glut med and have been practicing standing whilst recruiting my glut max and med. I can feel that this supports my knee better. If I move to standing on just my weak leg the glut med fatigues very quickly and starts to shake.

[Yarok]

hi

agree its a lumbar and pelvic imbalance, and pain in your knee can be reffered from a lumbar spine, SIJ, hip, or/and from trigger points ie glut med, tens fl, ili tibial B,hamstrings, vastus L, as well as from calf area.
all the best

[Roberts]

Is the best way to sort out lumbar and pelvic imbalances, to do strengthening exercises? As it is a weakness in these muscles that has caused the imbalance?

I saw a physio up near london who specialised in pelvic biomechanics and it was he who got rid of the pain in my left buttock/hip with the muscle energy technique (to release spasm in my piriformis). He also said that I had a forward rotating right ilium and I had a muscle energy technique to perform to rotate it back. 2 other things he gave me to do were a neural stretch and a glut med strengthening exercise.
But this was also when I started getting the knee pain. My problem is that I was getting treated for a pelvic imbalance yet my knee pain got no better.

I guess I have no option but to try this treatment again.
Its just that any glut med strengthening exercises then aggravate my knee even more. Could this be that I am tiring my glut med so my biomechanics are even worse and therefore my knee gets sore quicker?

I am going to try very gradual increases with my clamshell exercises to see if I can build up strength without hurting my knee. Does this sound like a good idea?

Thanks for your help

[Yarok]

hi

thanks for respond

ur saying exercises for glut med make the knee worst?
can u describe them if i missed them somewhere in previous posts.please

re;pelvic imbalance- balnce can be disturbed and caused by various factors ie, central neural control, peripheral coduction (sequence,recruitment timing), muscular weaknes, to short, to long muscles, joint problems, to tight to elastic, state of soft tissues (miogelosis, trigger pints, adhesions)etc etc

sorry but it's complicated,

fingers crossed

[Roberts]

It is the clamshell exercises that aggravate above my knee.
Basically any exercise I do that involves muscles in my left leg ends up with my knee getting sore.
To be pain free I have to avoid all rehab, but this will get me nowhere in the long term.

Do you think that as I initially had a sharp pain in the muscle above my knee that I could have strained one of my quad muscles?

[Roberts]

I have seen the knee specialist today and he confirmed that I have wear and tear under the knee, chondromalacia and that I am in a vicious circle and I just have to keep on trying to strengthen the thigh muscles, so I have been referred back to the nhs physiotherapy so I can keep on trying!

But I will try and strengthen my core for the time being, then work on my knee.

[Yarok]

hi

i hope u are in good hands,
i still think a good hands on session makes a difference, massage with neuromuscular techniques on gluts, ilitibial band, quadriceps should be very helpful, followed by exercises.
all the best

[Roberts]

I have just started seeing a lady who has done sports massage training plus myofascial release and trigger point stuff.
By neuromuscular techniques do you mean massage like this or should I be looking for something else as well?

I have also worked out today that when I walk I don't put all my weight onto my bad leg and that my pelvis is tucked in sideways so that my abductors don't have to do any work. I must have subconsciously been walking like this to avoid stressing them as they used to be painful when I walked. I think my pelvis has gone wonky from limping for so long.

[Yarok]

i hope
ull be well, neuromuscular i meant pretty same : ie postisometric relaxation, ischemic pressure, isolitic contraction, positional release, etc

u need a proper training, as well

happy easter

good luck

[Roberts]

Hi, I'm still struggling and thought I'd return here to post my latest diagnosis and see if anyone here could help me any further!

I went to see a sports dr up in london who is involved with the england rugby team so I figured he should know what he is talking about. He didn't think that there was anything wrong with my knee but thought that I had patellofemoral pain secondary to quad tendonitis, mainly at my vmo insertion to the patella. He reckoned that a year ago I must have irritated the tendon by attempting to rehab my weak glut med in the one legged squats, and then I have been continually causing micro tears in the tendon ever since which is why the upper inside corner of my left knee kept on swelling and getting hot and painful.
I agreed to have a cortisone injection and this seemed to get rid of the swelling. I was then told to get on with vmo strengthening exercises but this is where my problem has been. I can't make progress and if I over do it I am in pain to walk for a few days. I am doing straight leg raises and attempting static quad contractions.

One of my concerns at the moment is that when it gets sore the area of skin where the vmo attaches to the patella, goes bluey purple a bit like a bruise, though it doesn't hurt to touch.

I am seeing an nhs physio at the moment but I think they are just about to give up as I'm not improving. I want to see someone who has experience with quad tendonitis but I don't know how to find this person.
I'm assuming scar tissue in my tendon is an issue and reckon that cross friction massage would be helpful alongside physio but I don't know who to see.

Any recommendations on how to find an experienced physio or any ideas on why I'm not making progress would be greatly appreciated.

Also my vmo has really wasted away now and my thigh is half an inch smaller than my good leg.