Knee pain

[pfitz4883]

Hi all

Just looking for some advise

I had bilateral tibial tubercle transfer done a bit over a year ago and the screws were taken out about 6 months ago.

I was getting back onto a bit of light running and noticed about 4 weeks ago i was getting pain on the area of the tibial tubercle on my right knee. I checked it out more thoroughly and found that when i pressed over the part of the bone where the patella tendon inserts on the tibia, it was very tender (The rest of the tendon is fine). It also hurt when i went down stairs or did squats. I have stopped all running for the last 3 weeks but pain is still present with stairs and any squatting.

I am just interested to know it is a tendon problem or if is something to do with the bone (painful part feels like bone)? and what should i do about it?

Thanks
Pete

Similar Threads:

• knee pain, knee clicking / crunching, knee instability
• Medial Knee Pain Swelling around entire knee
• pain in left knee all the time have had complete knee replacement
• Pain in my right knee after left knee arthoscopy
• Medial Knee swelling with posterior knee pain

[karen.hankey]

Hi Pete,

It sounds like you have an inflammation of the quads tendon where it inserts onto the tibia, possible due to increased stress.

I would suggest ice after aggravating activities and when you start running again perhaps try interval training (so run for a specified time e.g. 1 min and walk for a specified time e.g.2 mins). Start with more walking than running and then gradually increase the amount of time running. It just sounds that you've taken on too much too quickly.

[nehakapoor]

hi,
this seems to be the inflammation of qauds......so u can take cold pack ,ultrasound with strenthening exs and do not exert too much.

[pfitz4883]

Thanks for the advice

[ginger]

fitzy, why did you have a bilateral tibial tubercle transfer, ie , what was the purpose of this operation /, what were your symptoms?, what was the explanation provided by your surgeon for effective elimination of these symptoms by using this extreme method.
I am interested in these answers because it would appear , from the brief info you have so far provided , that you have elements of the original problem , as was complained of before the operation .
Your problems as described could be easily and completely be described as referred events from your mid lumbar spine and therefore not problems of the knee at all .
More history please.

[Physio Bed]

Possible tendinopathy/tendinosis... Have you had an ultrasound/x-ray??

[pfitz4883]

I had the TTT because i had lateral tracking and patellofemoral pain. I also had a lateral release prior to the TTT that did not work. The symptyoms above that i had before the surgery are much better because of the TTT. The pain i am now getting is separate from the symptoms i had before although may be related, but i never had these current symptoms before the surgery. Sorry to confuse you.

[ginger]

Fitz, I don't have a lot of time to spend on a decent response to your query , but I feel compelled to offer a few brief insights that you may not enjoy, When being treated for any condition by a person with significant training ,, one can expect the treatment to reflect the style, training , skill and persepective of the doctor/physio/ therapist etc. In other words , you get the ideas and methods asociated with different streams of thought and action , rather than a conglomerate of all.
That being so , it is certain that the thread of attention true for surgeons is to treat with surgury, for massage therapists with massage, for physiotherapists with an appreciation of function or lack therof.
You have had a knee pain problem that is not uncommon ,( sometimes called PFS ) that is the result of two related neural mechanisms. Fistly , the Irritation present with a tight L3 facet joint, in your lower back has driven a sensory/neural pattern of behaviour. The pattern relates to inflammatory changes present at that facet joint and the nerve root adjacent , becoming part of the femoral nerve. This nerve , amongst other things , serves the muscles adjacent to your knee cap, known as Vastus medialis oblique (VMO ). Inhibitory effects of nerve root irritation has prevented full and normal recruitment of VMO, such that a tendency to drift lateraly occurred. This caused inflammation , pain swelling and further inhibition.
Your surgery was an attempt at solving this problem , by altering the angles associated with the pull of VMO over your pattella. While it is fair to assume there will be value in this to some degree, it is a bit like trying to get your computer to stop crashing ( insert appropriate analogy here, ie subtle effect of software) by rebuilding the key board in a better shape. In other words , the cause has not been addressed, only the symptom. Apparently, with little or no real understanding of that cause.
Your knee pain as mentioned, still bothering you, at the tubercle is no less and no more the same referred event that drove the patella to misbehave. If no one has dealt with your lower back , in particular at L3 and L4 , by dilligent manual movement therapy aimed at restoring normal movement and thereby removing the irritation at the femoral nerve root, then you will like as not continue to complain of the ORIGINAL problem, although modified by having surgery.
All too often I am witness to the inappropriate use of surgery to correct what could have been eliminated by a skilled pair of hands with the right understanding . I wish you well nevertheless.
I do recommend however that you find a good Physiotherapist, preferably Australian trained, to mobilise your lumbar spine thoroughly. Your complaint will almost certainly dissappear, provided that physio has good hands on skill , does not use modalities, offer you exercise as way to treat yourself or use ancient and useless methods like traction.
best of luck.