Help Physios please

In desperate need of some help and advice to solce knee problem which is worsening. Saw a physio who diagnosed patella tendonitis. He gave me squat exercises to do, to bbreak down muscles and rebuild them apparently, but situation has got worse not better.
Now struggle to run for bus and cannot climb stairs without pain just below knee cap on the left.
Also get a constant clicking half way up side of left calf. Waiting for appointment to see physio but running out oftime to fix problem before I go abroad...
Any help gratefully received...

Benny,
what caused the knee pain?any swelling?

Palying football caused it and running. No swelling. Just constant pain...

pain just below the kneecap, pain on running and stairs. i imagine that jumping is probably quite sore aswell.

does sound like patellar tendinitis. maybe some patellofemoral aspects to pain aswell.

it may be that you are too acutely painful to start squats or any form of strengthening.

have you been resting, icing, taking anti inflammatories?

strengthening in important but its only part of management of an issue like this and you have to balance and progress exercises with pain response taken into account.

other things that a decent physio should take into account are biomechanics, muscle imbalances around the hip and knee, flexibility, core stability.

you havent given a timeframe for injury, when did it first occur, how, how has it progressed? what exact treatments have you had, what type of squats are you doing ie on a decline board, emphasis on the lowering phase etc.. are you trying to avoid aggravating activities while rehabbing..

Thanks for reply. much appreciated.
Injuryt about 18 months old I would say. Played through pain for a while, then after visiting physio, stopped playing about five months ago, stopped running as well. Been resting not much icing. anti inflams occasionally.

Squat excercises were on a decline board, with weights 2 times 15 a day. briefly seemed to help but now much worse...

I presume there is no quick fix for this. but not sure what to do apart from not exercise...

Benny,
From the diagnosis,there is an inflamation!and such exercises at this time will rather worsen the pain.
(1)First of all,I would have put you on our antinflamatory/analgesics agents through iontophoresis,for 5 sessions,and advice you to restrict movements to the said knee.
(2)Imobilise the knee for 15 days.
(3)Reasses you,and depending on the findings,then probably put you on some exercises.
WITH ALL DUE RESPECT YOU CANT USE SUCH EXERCISES WHICH ARE ALREADY IRRITAL TO TREAT SUCH CONDITIONS!Am more than willing to help you.Get me on +267-7256-3894 or [email protected] please let me hear from you.Chao!

Have you done any myofascial release on the gluteus medius and IT band? To me, this is a very good place to start in order to take some pressure off the knee.

Best,

mark

Hi Im preparing for NPTE EXAMS ,i would like to do group study. so if any one r interested can mail to me. I stays, in chicago, schamburg. hoffman estates.IL [email protected]

Interesting Post Benny... are you a physio yourself, or did you come to this site to get some help diagnosing your problem?

I want to ask physios out there what they would think of a service that allowed patients to enter in the symptoms they are experiencing and allow the patients to 'self diagnose' their conditions? Would this be something you disapproved of or would you support it?

Would you be happy to contribute to such a system which allows the general public to gain physio knowledge on their own?

I'd be interested to hear what therapists response would be if something like that were developed. Just hearing Benny's "cry" for help made me think something like that could be achievable.

-Chris
Mavenlive Physiotherapy Software

if this has been going on for 18 months, immobilizing and anti-inflammatories will only help temporarily, it WILL come back.
I think your physio had the right idea to start strengthening the tendon/muscles because it is a long term solution, it is just that it was obviously too much too soon.
You need to be able to exercise target muscles (VMO/GLut med/patellar tendon) without irritating the tendon (sounds like patellar tendonitis to me too). Getting a jumper's knee brace will help you do that. I might also try transverse frictions once the inflammation calms down as well.
If you find that it doesn't get better with physio, strengthening and bracing, I would suggest shockwave therapy (Extracorporal shockwave therapy) We use it a lot at our clinic for chronic tendon issues, it has a very high success rate.
Cheers,