Knee Pain

[patatty]

For the past year, I have been having intermittent knee pain on my landing leg. I know that it's from underrotated flat-footed jump landings, but I have been trying to be much more careful, and it' not going away. The pain is located between my thigh and my knee cap, and it only hurts when walking up stairs or raising up on my left leg from a semi-lunge position (such as pushing onto a deep left forward outside edge - I'm a CW skater). I did some bike riding on an old bicycle recently and pushing onto my left leg felt really bad. I always feel like there's a weakness there, but I seem to be able to do most functions ok. I have done some research on the internet to find out what it is, but nothing seems to match up. Most things talk about knee pain near the shin. I can walk, run, and do most skating maneuvers just fine, but I know that something isn't right. Have any of you experienced symptoms like this?

[coskater64]

PT/Sports medicine doctor...sounds like a good plan.

[sexyskates]

Fewer axels,Glucosamine, weight training and ice everynight. I get this too from practicing my "not there yet" axel too many times. A sports Doc, and a P/T to show you which exercises you need to do is a great idea. When I get serious about doing my "knee exercises" most pain goes away quickly.

[RachelSk8er]

Based on the symptoms, it sounds like patellar femoral syndrome. Google that :)

I totally get how it feels, not really a sharp pain that prevents you from doing things, it's just nagging/annoying, right? I have the same issues--pain going up/down stairs, sit spins, axels, any other time I do a lot of bending (esp in my L knee)--so hydroblades, etc--it's in both knees for me but the L is much more because of use in skating. It gets stiff sitting at work and starts to hurt. I'm ok with *some* running, i.e. I can handle 30 min or so at a 9-10 min/mile pace on a treadmill twice a week or so, any faster or more frequent or running on pavement aggravates it.

I'm actually starting to work with a personal trainer. A lot of my problem is the huge imbalance in leg strength--strong/overdeveloped quads, weak hamstrings--common in skaters, as well a overuse, maybe a little age thrown in. And am swimming laps daily rather than running. This is the first week where I've swapped out the running for swimming and it's helped tremendously in terms of when the pain shows up.

[kimberley801]

I'm actually starting to work with a personal trainer. A lot of my problem is the huge imbalance in leg strength--strong/overdeveloped quads, weak hamstrings--common in skaters, as well a overuse, maybe a little age thrown in. And am swimming laps daily rather than running. This is the first week where I've swapped out the running for swimming and it's helped tremendously in terms of when the pain shows up.

I had the same thing. I did some hamstring/knee strengthening excersices, work a soft knee brace, and the pain went away. Not to mention my legs got stronger too!! Running is great for overall leg strength as long as you don't do too much too soon.

[patatty]

Thanks for the advice. It does sound like what you described. I'll try to find a sports doc to check it out and hopefully give me some exercises to fix it. I usually wear a neoprene knee sleeve when I skate, and that helps a lot, but it hasn't cured it.

[herniated]

Hello my friend. You know my answer... Dr. Hot...:lol: I get the same thing from time to time and he works it right out. The first time.

[fsk8r]

I've been having similar pain recently (CW skater so my left knee as well). I tracked it down with my coach and am currently blaming it on an imbalance in my thigh muscles. I broke my knee cap 7 years ago and the PT/physio did great wonders to get me walking again (and back on the ice) but they don't quite get you back to 100% and I was left with a slight imbalance between my adductors and abductors (inner and outer thigh muscles). If I don't land square and properly check my turns I can twist the knee and it sets of the pain cycle again. Recently I've been trying two footed squats to help get my sit spin lower, and that extra work along with probably a few dodgy landings and a couple of unchecked 3 turns have managed to trigger the pain cycle again.
The best advice was that of my coach who reminded me that my physio exercises had concentrated a lot on balance exercises. I was shocked when I tried them again about how poor my one foot balance is (eyes open and eyes closed, wobbly surface for extra hard work). Doing this a couple of times a day has strengthened the leg no end and helped correct some of the imbalance (and I'm doing 1 legged squats now to get the sit spin and not two legged, when the left knee is feeling stronger I might move it back onto squats as I'd like a back sit as well, but I'll let it recover now).
If you do think you've a possible muscle imbalance I recommend trying the balance exercises as it helps train them to work together again. (if you think it's a hamstring/quad problem then there are other exercises to strengthen the offending muscles). Doing the balance exercises on their own shouldn't hurt the knee too much (although if it hurts stop) but might be something to do without going to see the doctors and may be able to help if it's not a more serious complaint.

[herniated]

I also agree with the muscle imbalance thing. Since I started working on balance boards and then the Bosu ball for my balance my knees have been giving me less trouble. Also, when working out at the gym on the leg ex.tension machine I work one leg at a time - each leg the same weight and the same reps.

[fsk8r]

I also agree with the muscle imbalance thing. Since I started working on balance boards and then the Bosu ball for my balance my knees have been giving me less trouble. Also, when working out at the gym on the leg ex.tension machine I work one leg at a time - each leg the same weight and the same reps.

What sort of balance board do you have and is it a proper bosu ball?
I've currently got a rebounder I use for balance exercises, but am interested in whether a balance board or a bosu would be better. (I might use them more if I can get it in front of the TV and I don't have enough space in my front room for the sofa, TV and rebounder!)

[sexyskates]

You can buy balance boards and other sports training equiment at
www.fitter1.com

[jenlyon60]

The leg extension machine can put a lot of improper stress on the knees, so be very careful with the use of it. It's best to set it to constrain the range of motion so as to not extend fully and not flex all the way either.

Leg presses (especially single leg presses) are very good. Also "step-downs", which are like standing sideways on a step or 12-inch high platform/bench, and bending the leg on the bench so that you just barely touch the heel of the free leg to the floor (like touching a hot plate). My trainer has had me do a lot of these, building up from a 6-inch height after I was released from PT for my knee surgery last year, to an 11 to 12-inch height.

It's important to make sure that as you do any of these exercises, that the knee stays in line with the toe, and doesn't cave inwards (towards the big toe) or go outwards (outside the little toe). If it's doing either of those, that will put stress on other parts of the knee, potentially causing more damage.

[herniated]

What sort of balance board do you have and is it a proper bosu ball?
I've currently got a rebounder I use for balance exercises, but am interested in whether a balance board or a bosu would be better. (I might use them more if I can get it in front of the TV and I don't have enough space in my front room for the sofa, TV and rebounder!)

Don't really know what a rebounder is but my balance board is a flat wooden circle with like a half circle on the bottom of it. I've moved on to the Bosu ball and yes it's the name brand 'Bosu' because I basically got too good at balancing on the board and had to go to the Bosu. The Bosu is MUCH more challenging and really showed me how unbalanced my body was. Just be careful when using either and make sure you have something to hold onto just in case you lose your balance.

Jenlyon60.. I agree with the leg extension machine. It can be a tricky device. The knee joint is 'supposed' to line up with the 'joint' of the machine but that never worked for me. When I'm 'lined up' my knee kills! Every ones body is so different. Now for me I like the leg press but it puts too much pressure on my lower back!! I'm a certified trainer and one thing that I've learned is everyone is different.

Getting back to the Bosu. OMG, when I first stepped on it I was like a beginner. Very humbling.

[RachelSk8er]

I had the same thing. I did some hamstring/knee strengthening excersices, work a soft knee brace, and the pain went away. Not to mention my legs got stronger too!! Running is great for overall leg strength as long as you don't do too much too soon.

I really feel like I'm getting more out of swimming than I did out of running. My knee issues had started in HS when I was running on the cross country team and skating on a senior synchro team. I realized that in college when I swam about 8 hrs/week with the club swim team, skated 6 hrs/week and walked about 2 mi/day going to class, etc (didn't lift a single weight either, was in the best shape of my life, and didn't have to watch what I ate because I couldn't eat enough to keep weight on back then), I had no issues with my knees whatsoever. When I get into these phases where I want to run again, since I've always dreamed of doing a marathon, is when they start to bug me.

So anyway, thanks to skating and having strong leg muscles, breast stroke is my strongest stroke. Doing a lot of breast stroke kick actually makes my thighs KILL, and it seems to be helping to strengthen the sides of my knees a bit where I tend to have some weakness. Plus my time is so limited with work and law school that even 30 min in the pool on my lunch hour is just as effective as 30 min on a treadmill followed by some weights.

However, I do have a really good interval workout on the treadmill that I like for skating--it really trains you to push out the end of a program when you're getting tired (I don't need it so much with my 2:10 freestyle but it was great in synchro when I was doing programs that were 4:30). I think I'll stick to that maybe once or twice a week just to mix things up.

[doubletoe]

A lot of my problem is the huge imbalance in leg strength--strong/overdeveloped quads, weak hamstrings--common in skaters, as well a overuse, maybe a little age thrown in.

Yep, me, too! I had very similar symptoms and it came from doing too many axels and too many sitspins (I rotate CCW and it was my left knee that was bothering me from the sitspins and the axel takeoffs). I went to a good PT who is also a skater and she immediately suspected an imbalance between quad and hamstring strength, since that is a common problem among skaters. She measured the relative strength and. . . Bingo! So then she made me start doing hamstring exercises and it was amazing how quickly it started getting better. I was also forbidden from doing more than 5 sitspins per day and I still try to limit the number of sitspins I do. Whenever it starts bothering me again, I back off on the sitspins and axels for a few days.

Go to a doctor and get it diagnosed, since--as Jenly pointed out--everyone's body is different. Then go to a *good* physical therapist and be sure to explain the mechanics of skating if he/she is not a skater. We do the equivalent of leg presses with every stroke, staying over one hip at a time so that we mostly use our outer quads and glutes. With the outer quads pulling on the top of the knee, the opposing inner quads and hamstrings need to be strong enough to keep the pull even. Otherwise you get knee pain.
Ask to have your relative hamstring & quad strength measured with an actual machine, and also have your inner vs. outer quad strength measured, since that's another imbalance that is common among skaters (although I didn't have inner quad problems myself). The first PT I went to (who was not a skater) just measured my relative quad/hamstring strength with her hand and did not catch the imbalance. So, unaware that I already did the equivalent of leg presses every time I skated, she had me do leg presses to work my quads and it just made my knees hurt worse! 8O BTW, if they determine that your inner quads are too weak compared to your outer quads, they will probably have you do leg extensions (probably two sets of 10-15 reps each).

[daisies]

I was just diagnosed this morning with the same muscle imbalance, which was causing pain in my knee. Not a sharp pain, just a really annoying and ever-present achy pain. The doctor's exact words were, "Your hamstrings are terrible!" Alrighty then!

I'll be starting six weeks of PT next week.

[patatty]

I have a feeling my imbalance may be the opposite. I have huge hamstrings, and doing some of the quad exercises mentioned on this thread have really helped, especially the standing-on-the-stair one, and one-legged squats. I'm hoping my issue can be resolved with exercises and not staying away from skating. I'm sorry so many of us have knee issues!

[katz in boots]

I have also been told I have an imbalance between quads and hamstrings, but wasn't told what to do about it except to make sure I stretch them well.

Any ideas on exercises for the hamstrings?

[doubletoe]

I have also been told I have an imbalance between quads and hamstrings, but wasn't told what to do about it except to make sure I stretch them well.

Any ideas on exercises for the hamstrings?

These are the ones my PT gave me. I was supposed to do the balance ball exercises every day, then she had me do hamstring curls on the machine twice a week.:

- Hamstring balances with balance ball: 3 sets of 15 reps
Lie on your back on the floor with both legs extended and feet resting on top of a big balance ball. Lift your hips, keeping legs locked out straight, and lift one leg up off the ball. Hold, then replace it with the other leg. You'll find the balance challenging, and it works the hamstrings.

- Hamstring curls with balance ball: 3 sets of 15 reps
Start in the same position as the hamstring balances, but this time dig both heels into the top of the ball and pull the ball as far towards you as you can. Now push it back out so you end up back in your starting position.

- Hamstring curls (using a weight machine or lie chest down on the floor and use a resistance band tied to a table leg): 3 sets of 15 reps per leg

ALWAYS stretch the hamstrings well after doing these exercises. Strengthening and stretching have to go together.

[renatele]

Few more exercises I have been given (these are for after the strong pain -inflammation - goes away):

at the wall, put a balance ball between yourself and the wall, and squeeze a smaller ball between your knees. Do slow, controlled, up to 90 degree squats.

If you like leg press, you can do it too - just don't up the weight to your limit, and squeeze a ball between your knees as well.

I find that I *must* stretch the inner thigh area well, or my PFS flares up. Seated "v" stretch works pretty well :)