My Knees!

[miraclegro]

I have never had any knee problems at all...until now.

A friend thinks it is tendonitis - it is the outer edge of each knee and it really bothers me after skating....

I realize i changed boots about a year ago from Harlick to Klingbeil and there is a heel height difference, but could it just be my age (47?) or because i am trying so hard to get lower on the sit spin and the jumps? Strange thing is ...it is not one knee but both!

Any advice? - Miraclegro

[CanadianAdult]

There's a name for it which I've forgotten, but I have this condition/syndrome. Basically your outer quad is stronger than the inner, and it pulls your kneecap to the outside. It's not something that will go away by itself.

See a physiotherapist. They can diagnose, set you up with a strengthening plan and also talk to your coach about what you can and cannot do. You can keep skating though!

[renatele]

CanadaanAdult: did you have patellofemoral syndrome in mind?

(I have to run now... wanted to add though that I have the patellofemoral syndrome, and there are some easy to do exercises to help with it - I do second the visit to the PT though to get the knee troubles diagnosed)

[froggy]

you may have iliotibial band tightness, go to your doctor to get it checked out and dx and then make sure you see a good PT that can set you up on a good stretching and strengthening program. iliotibial band tightness is common in athletes esp. sports that involve a lot of knee bending like runners.

good luck hope you feel better

[froggy]

CanadaanAdult: did you have patellofemoral syndrome in mind?

(I have to run now... wanted to add though that I have the patellofemoral syndrome, and there are some easy to do exercises to help with it - I do second the visit to the PT though to get the knee troubles diagnosed)

with patellofemoral syndrome that most common complaint is actually knee pain anterior of the knee, as opposed to miraclegro's complaint of lateral (outside) knee pain which occurs with iliotibial band tightness

[renatele]

with patellofemoral syndrome that most common complaint is actually knee pain anterior of the knee, as opposed to miraclegro's complaint of lateral (outside) knee pain which occurs with iliotibial band tightness

True. Well, both conditions benefit GREATLY from PT, and the exercises are the type that can be done not just in the gym.

[doubletoe]

I get the same thing, and was told by my PT that it's because my quads are stronger than my hamstrings and therefore pull unevenly on my knee (especially outer quads, which we use so much in skating). I first got this problem in my left knee from practicing too many sitspins, so now I limit the number of sitspins I do. I also get it in my left knee when I do too many axel takeoffs, so now I am limiting those as well. It's the push onto the LFO edge that seems to be the culprit for me. Hamstring strengthening exercises help, and really deep quad stretches DEFINITELY help.

[CanadianAdult]

CanadaanAdult: did you have patellofemoral syndrome in mind?


Hee! That would be the right knee. That one hurts below the kneecap. I have an old injury there. I had tight IT band syndrome so badly that I ripped the IT band partially off the left knee on a jump one time. Yes both knees are messed up.
I love my physiotherapist. The most important part is keeping my physio talking to my coach, so that when I say that I am unable to do something, it's not because I'm not slacking off, it's because it's on my limitation list.

[sk8tmum]

Chrondomalacia patella ... from what i remember from the warm and fuzzy orthopedist who diagnosed me at 13, and said i wasn't 'worth' treating because i was a chubby and uncoordinated kid who was never going to be an athlete :( - it's chronic inflammation under the kneecap caused by a mistracking kneecap. And I get much the same symptoms described here, and, yup, changes in heel height can trigger it, because they change the way I bend and move that kneecap around. Treatable .. with a decent physiotherapist, which i found out when I was a chubby and uncoordinated adult.8-)

[doubletoe]

Chrondomalacia patella ... from what i remember from the warm and fuzzy orthopedist who diagnosed me at 13, and said i wasn't 'worth' treating because i was a chubby and uncoordinated kid who was never going to be an athlete :( - it's chronic inflammation under the kneecap caused by a mistracking kneecap. And I get much the same symptoms described here, and, yup, changes in heel height can trigger it, because they change the way I bend and move that kneecap around. Treatable .. with a decent physiotherapist, which i found out when I was a chubby and uncoordinated adult.8-)

Actually, that was my diagnosis as well (refer to my other post above). I was told my kneecaps were tight and that was a contributing factor. I still blame axels and sitspins, though. ;)

[sydnevogel]

Make sure you are doing proper off-ice exercises. Get into a good circuit training habit. So many injuries come from over-training a new skating move without doing the proper strength training for it. Everything in moderation though. Be consistant about your off-ice training routine.

[miraclegro]

So, this isn't super serious, then? I just have to get to the right Physiotherapist (what is the diff. between that and a Physical Therapist?)

and get some good exercises...?

[lov2sk8]

A good exercise is the single leg squat. Do it in front of a mirror bare foot, make sure your foot, knee and hip line up. It helps strengthen all your stabilizer muscles.

[doubletoe]

By the way, whatever you do, don't self diagnose or take the word of someone who doesn't understand the mechanics of skating. For example, the first PT I went to had me doing quad exercises and it made my knee hurt worse than ever. I knew I already used my quads a lot in skating and this just felt wrong, so I quit her and went to a PT who is also a skater. The skater PT knew exactly what muscles I used and for what, and she suspected poor hamstring to quad strength, which is apparently common among skaters (since we use our quads so much). She tested my relative muscle strength and confirmed that my hamstrings were weaker than my quads, and prescribed me hamstring strengthening exercises and reduced use of the outer quads (i.e., no sitspins or axels for awhile). It worked. But every body is different, so just be sure to have the physical therapist measure the relative strength of your inner quads vs outer quads and your quads vs hamstrings to make sure you aren't being given the wrong exercises!

[lov2sk8]

It helps to find a trainer who is sport specific. In other words you prepare your body for your sport. Figure skating has a lot of counter body rotation deep knees and centrifugal force. You need to find someone who understands the kinetic chin and how it is linked to your sport.

[miraclegro]

Well, that oughta be fun in this little town of limited choice....

[jenlyon60]

At a minimum, try asking around as to what trainers/physical therapists any of the local high school or community college athletic teams use. Those trainers may not understand the physics of skating, but they will generally be more tuned into stresses of athletics and the frame of mine of athletes than just picking a therapist from a list provided by your insurance provider.

[sydnevogel]

miraclegro,

One thing that can really help you is a full body work out on an exercise ball. It can be difficult, but so helpful for all those little muscles that we don't even think about. When I was competing, there were three things that really helped me when I was in top shape...the Nordic Track, Jump Rope, and exercise ball.

[froggy]

So, this isn't super serious, then? I just have to get to the right Physiotherapist (what is the diff. between that and a Physical Therapist?)

and get some good exercises...?


in the states we commonly say phyiscal therapist in a lot of countries outside the US a physical therapist is referred to as a physiotherapist.

[skatingatty]

miraclegro,

One thing that can really help you is a full body work out on an exercise ball. It can be difficult, but so helpful for all those little muscles that we don't even think about. When I was competing, there were three things that really helped me when I was in top shape...the Nordic Track, Jump Rope, and exercise ball.

You're the Sydne Vogel who competed in the 90's and was jr. national champion? Cool that you are posting here! Are you skating in adult events now? I enjoyed watching your performances on TV and still have a video of '96 nationals somewhere. :)

[Isk8NYC]

miraclegro,

One thing that can really help you is a full body work out on an exercise ball. It can be difficult, but so helpful for all those little muscles that we don't even think about. When I was competing, there were three things that really helped me when I was in top shape...the Nordic Track, Jump Rope, and exercise ball.Hey Sydne - Welcome to SkatingForums!
Thanks for the advice - I'm reinflating my exercise ball now.

[NCSkater02]

A good exercise is the single leg squat. Do it in front of a mirror bare foot, make sure your foot, knee and hip line up. It helps strengthen all your stabilizer muscles.

I have experience with chondromalacia in my right knee. Doesn't bother me on a regular basis anymore. However, my Ortho doc told me no squats, stairs, or running. Since he's 6'8" and played pro football, I tend to listen to him.

Go see an orthopedist and get an expert opinion, and don't self-diagnose. You could make it worse. Now, you can go in and say "I've been doing some research...."

[pille]

I had the same thing earlier in the summer, went to my dr. and got diagnosed with patellofemoral syndrome. It took me about 2 weeks of physio and daily specialized exercises/stretches, and it slowly went away.

It all started with me falling really bad on one of my knees. The dr. thinks from there I started walking a little differently to compensate for the sore knee. I refused to go to the dr. at first, because I didn't think there was anything they could do. After falling down the stairs at home (the pain got so bad I could not control my muscles), I decided that this has to end!

When I started physio, my knee caps would not even move when the knees were relaxed. It was bizarre.

Honestly, go get some help, because it will not stop on it's own.
Good luck!

[Query]

I've pain in one knee - not much, about 1 or 2 on the scale of 1-10, and it only hurts when I stand on that leg and bend deep, or rock forwards to my toe, but this is the first time I've had a joint pain, so I'm looking to treat it right before it becomes chronic.

Yeah, I know, stop my whining, take two aspirin, and get back on the ice. Lots of people skate with shattered bones, detached tendons and ligamants, artificial knees and hips, missing disks, etc., and they don't complain. But, pain is evil, not because it hurts, but because it says something is wrong with what one is doing.

I tried cold, hot and cold baths, and layed off it for over a week.

It started after a lot of practice on (mostly forward outside) 3 turns - which has the motions that generate this problem. No special reaction to inside or outside sideways knee pressure. Initially was under the knee cap, and just below the knee (don't know whether it is in the patellar ligament or the quadriceps). Now is only under the knee cap.

Presumably a minor league sprain or strain from overuse, or something like that. I figure a doctor would just say that a lot of people in late middle age get arthritis, and that adults shouldn't skate, so haven't bothered.

The obvious next step is to start progressively exercising it again, stretches and strength, and getting back on the ice. Does that sound right? I'm going to try ibuprofen too, but hate the idea of using drugs long term. Are there over-the-counter joint drugs that actually work, and do they interact badly with ibuprofen? Any other advice?

[Sessy]

could try taking glucosamine, if it's cartillage or something... at least that takes on the problem, not the symptom. downside: pretty pricey stuff.

[Mrs Redboots]

Glucosamine sulphate - at least 1000 mg a day.

Tiger balm for short-term care.

[SkatingOnClouds]

There was a good thread on knee problems recently, it is currently on page 2 - I don't know how to make a link in here, maybe someone else could do it?

It sounds to me that your problem might be similar to those discussed in that thread.

My doctor reckons glucosamine doesn't work for everyone, it works for about 1/3 of people who take it. My problems turned out to be misaligned patella due to weakness of one set of quad muscles and also some quad muscles being too developed compared to my hamstrings, so glucosamine wouldn't have helped anyway.

[miraclegro]

I just re-read some of the threads, and had forgotten about this one. It is very STRANGE,but those knee pains were BAD and now they are completely gone....wonder what it was.....maybe just too much going on at one time? How bizarre!

[momsk8er]

Mine come and go too - but I'm never quite sure what causes them to go away. I know they usually come from too much side pressure on the knee - either from a fall, or from rotating the leg too far without rotating the hip. I used to get the problem doing certain Tae Kwon Do kicks, so I stopped doing them.

Tried all your methods last night - ice, heat, glucosamine. And a little walking. Seems to be feeling somewhat better, but still hurts. Not sure if I should skate today.:(

[Query]

Internet articles say glucosamine is not FDA tested or approved for anything - so it is like an herbal medicine. That incidentally means its side effects and drug interactions are unknown.

I just consulted a pharmacist about it, who said it is nonetheless quite commonly used, and many people say it has worked. She suggested I try glucoseamine+chondroitin (for cartilage), or ibuprofen for inflammation - but not both, on the general principle that it is safest to take as few types of drugs as you can.

I guess it is pretty important for me to figure out which is my problem, since the theraputic progressive strength and flexibility exercises advocated a for a few days after muscle and ligament injuries might make a cartilage problem worse, like one poster mentioned. Since it is supposed to be very important to get inflammation down as quickly as possible, I will start with ibuprofen, followed by some exercise, and move to the glucoseamine if that fails. If that fails, I guess I need a ATC/PT (certified athletic trainer and/or physical therapist) or sports doctor - but I bet minor pains are hard for them to diagnose, unless I've lost most of my cartilage or something else easy to detect.

The pharmacist said glucoasmine is put in the same pill with chondroitin, also supposed to help cartilage. It is less often put with MSM (Methylsulfonylmethane), and one brand puts it with other things like 5-Loxin (AKBA).

All are over the counter, and she viewed all of them as relatively low risk, at least at the indicated dosage levels.

(Everyone knows excessive doses of ibuprofen are lethal; one doctor told me any medical intern sees a few athletes die of it. I assume the same could be true of the other drugs.)

I hate drugs, but it seems worth a try before going to an expensive ATC/PT or sports doctor.

I do know someone who had knee replacment surgery with poor results. Her ATC/PT said she might have delayed or eliminated the need for surgery with regular physical therapy, involving stretching the joint to reduce the stress on the cartilage, and that is being done on her other knee. Apparently knee replacement surgery is pretty major stuff, and they cut a lot of muscle tissue doing it.

Why can't we just buy new clone bodies?

[Mrs Redboots]

It is, indeed, a complementary medicine; nevertheless many GPs in this country, including my own cousin, swear by it! Although it apparently only works for about 4 people out of 5, and you need to take enough - at least 1000 mg daily.

[Query]

FWIIW, a person I know with degenerative osteoarthritis (diagnosed by x-ray) was also advised to do exercises - 1 and 2 leg presses on a back board, with progressive intensity.

If you go looking, you find very mixed reviews of whether glucoseamine and Chondroitin work.

A 2006 study funded by NIH found no improvement relative to a placebo. (Government funding matters - most medical studies are funded by groups or companies that have an economic stake in the outcome, and both study techniques and publication probability may be affected.)

And some animal tests showed glucoseamine may complicate diabetes.

Yet, many people have claimed they work for them. (That is true of just about any treatment. If you do something, and something gets better, that doesn't prove the thing you did made it better, but you probably assume it did.)

So how are those of us who are ignorant supposed to make decisions?

Anyway, here are some articles about glucoseamine and Chondroitin:

http://www.quackwatch.com/01QuackeryRelatedTopics/DSH/glucosamine.html

http://www.ubsportsmed.buffalo.edu/education/glucosaminepills.html

http://www.consumerreports.org/health/free-highlights/manage-your-health/arthritis-therapy.htm

[Mrs Redboots]

Chondroitin isn't thought to be effective; what you want is glucosamine sulphate. I have no idea whether it works or not, but I do know that my mother, my father, my husband and myself ALL have far more pain when we don't take them than when we do - and my mother and father are both pretty badly arthritic. They take 2000 mg a day; husband and self, trying to stave off arthritis and degenerating knees, take 1000. And we surely notice when we don't take it!

[Mrs Redboots]

Following up my own post (sorry!), I have just come across this in December's GI News (http://http://ginews.blogspot.com/):

Glucosamine has been found in some studies to have a better effect than placebo in reducing joint pain from arthritis. This has led medical practitioners working in the area from having a healthy scepticism, to actively promoting the product. However, since that happened, there has been one major meta-analysis (a combination of all the major studies done on the topic), to show that it may not be as successful as is often proposed. It is possible though that this is because of a wide variation in effect between different individuals.

The bottom line that comes out of this is that some individuals may, and do, indeed get significant relief from arthritis and joint pain from the use of glucosamine. Variations in the active ingredient in different formulations may make comparisons odious, so potential users are advised to seek reputable manufacturers. The combination of glucosamine and chondroitin is also thought to provide best benefits.

Another over-the-counter preparation with published benefits for joint pain, is a substance known as SAMe (s-adenysol methionine). This is promoted more as a mood enhancing substance – for which it also has some evidence – and is sold in products with names like ‘Mood Enhancer’ and ‘Mood Lift’. Again however, while there is reputable published support for SAMe, the results may be in the eye (or knee, or hip) of the beholder.