Thread: Knee pain

I have a whole NEW kind of knee pain now!

I have tenderness in the ligaments along BOTH my inner and outer knee area.

On one leg, there's a spot about an inch below the kneecap, along the front inner edge of my shinbone (a ligament attachment?) where there's an actual swollen bump that's very tender. I don't really have pain with activity... yet!

Is this familiar to anyone?

I'm guessing rest, ice, compression & elevation are in order, along with an anti-inflammatory. But it's always nice to hear from someone who's recovered from a similar injury.

Growing pains? sorry, couldnt resist.

Hm, could it be an inflammed attachment? Or a shin splint? Have you tried to push on the bump to see if you can squeeze any potential inflammed fluid out?

Without actually seeing it it's difficult to guess. But if you can run your fingers along the shin bone and feel "bumps" even swelling - then it may be shin splints (and they hurt like MOFOs!).

Feel better, sorry I couldnt be of more help... at least we can be there for each other on Bhuz.

Thanks for the fellowship, David!

Originally Posted by david

Have you tried to push on the bump to see if you can squeeze any potential inflammed fluid out?

As I was driving to the studio, I realized *exactly* where this came from.

Elliptical trainer, after a long break. Always does something like this to me -- footpads too wide or narrow, maybe?

I'm teaching too many hours at the moment, too, so it kept getting MORE irritated every day. I'll rest up over the weekend.

Did you fall on it? If not, get some rest, take some ibuprofen and read a big juicy novel.

I have knee pain all the time too, but nothing is inflammed. I'd definitely take care of that and get that looked at before it progresses. And yes, definitely take it easy and rest it!

I would say from a physical therapy perspective that short of a full evaluation it sounds suspiciously like an irritation to the pes anserinus which is a group of tendons that wrap in a "c" shape around the inside of the knee to attach to the upper shin bone. This area tends to irritate from weakness in the inner thigh and inner quad muscles or from a poor positioning of the knee that causes an excessive rotation out at the hip or a lean in or out at the knee stressing the area into a sliding shear force. (this is of course if the swelling is purely orthopedic in nature). The best early treatment can be ice massage or packs. Straight knee, inner thigh, outer thigh and hamstring strengthening. Crossfriction massage (going crosswise over the area with moderate pressure to tolerance for 3 to 6 minutes until local soreness subsides). If this doesn't help in 3 to 5 days it would be advisable to get a more thorough evaluation. I sincerely hopes this helps and if you have any more questions..email me direct and I would be happy to chat more. Aunna

Aunna, you rock!!

I think that my inner thighs and quads are underdeveloped relative to my outer quads. (and my hams are weaker than my quads, and chronically tight). I also tend to be a bit knock-kneed, so I think you're right on the money.

I like to use Nautilus-type equipment, but I have access to free weights as well. I know how to work my hams and outer quads, but how do I focus on the inner ones? With adduction excercises? (after the pain and swelling are down of course).

Meanwhile I'll ice it and see a massage therapist.

Thank you!

Aunna - that was PUUURDY amazing. I'm copying and pasting that into my "notebook"-word document.

Update -- I gave myself my own rendition of what I thought a 'friction massage' should be and I'm feeling SO much better today!

Physical therapists are wonderful, and I think they're underappreciated. I once heard someone telling a friend that a yoga teacher was "practically the same thing" as a physical therapist. Ummmm -- NO!! Even an RYT only HAS to have about 20 hours of anatomy instruction-- and let's not even talk about the saturday-afternoon-workshop yoga certs out there. *pant pant*

PTs have YEARS of graduate work. Today the trend is toward a Dr. of Physical Therapy degree, even. They know their stuff, musculoskeletally speaking!

I guess people get confused because there's a phyical therapy assistant certification available at the community college level?

a little far fetched here, but could it be your hamstrings? It doesnt sound like it, but just putting it out there, try giving them and your calves a really good stretch, see if that relieves things

I have to agree with you there, Lauren. I just saw my first physical therapist and she has helped me within two weeks more than any doctor has in seven years. I actually believe that by the end of the summer I may be completely pain-free.

So hurrah for physical therapists.

Lauren, you mentioned that you are slightly knock-kneed. How are your feet? I have high arches and my feet roll in, causing me to stand knock-kneed (unless I have the help of my orthotics). In my yoga practice, I have to really concentrate on keep my arches lifted and strong inner spiral on my legs to protect my knee joints by getting them in alignment. Just a thought!

I'm glad you got some relief from your massage!

Originally Posted by omchantress

Lauren, you mentioned that you are slightly knock-kneed. How are your feet? I have high arches and my feet roll in, causing me to stand knock-kneed (unless I have the help of my orthotics). In my yoga practice, I have to really concentrate on keep my arches lifted and strong inner spiral on my legs to protect my knee joints by getting them in alignment. Just a thought!

I'm glad you got some relief from your massage!

Yay, another yogini!

My knock-knees gave me a LOT of trouble when I first started teaching yoga -- it's harder to stay focused on my own alignment when I'm teaching. I've had it under control for a couple of years now -- or so I thought.

I'll try focusing on the inner spiral - -that's more of an Anusara principle, my alignment comes from Iyengar -- but it's all yoga and anything helpful is appreciated!

This reminds me, I have a book specifically on knee health and yoga, I'll dig that out and browse through it again.

Lauren, I just got back to cruising the thread and am so glad that you are feeling better and that I could be of assistance! To further answer your question..straight leg raises are great but with a slight turn out at the hip and special concentration on having the knee locked throughout the controlled motion and by trying to contract the area of the quad just near the upper inward side of the kneecap before the rest of the full muscle. (It is kind of a mind game at first but will come just like a difficult belly dance movement with practice). When that is fairly easy you can also do a lift directly to the inside while sidelying with the other leg bent out of the way but it is crucial that you don't jolt the motion or allow a knee bend-out during the motion because that can stress the area that was irritated. As another option you can do bridges with a ball squeeze, pilates hip circles with an emphasis on locked knee control, or use a standing pulley /nautilus with very light weight and pull the locked knee across your midline in front of the other leg (like drawing a line in imaginary sand with your heel in front of your other toe).
Hopefully that isn't overkill and makes sense in writing form but I really like to give options. Do the ones that feel pain free and that you like. -Aunna

Woman knows what she's talking about!

I hung out recently with my cousin who is a P.T. in Carolina Forest, SC and we were discussing what makes it difficult for some people to do turns and makes them dizzy! Fascinating...[don't ask me to repeat, I wouldn't know what I am saying or be able to repeat what he said!]

"Physical therapists are wonderful, and I think they're underappreciated. I once heard someone telling a friend that a yoga teacher was "practically the same thing" as a physical therapist. Ummmm -- NO!!"

SO NOT!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
come one!! i used to see the MOST AMAZING PT for FOUR years until a knee injury was completely healed. In the meantime I sometimes had minor other problems - it took her never more than 20 min to figure out what was wrong. like when I thought my hip joint had gone sore and had horrible pain walking she knew within minutes it was a muscular issue and she stretched it out so the pain was almost gone within minutes.
I know she had to study to get a degree (with a thesis to be written), she has years of practice - and as much as I respect yoga, it does not come ANYWHERE close and I wish nobody they rely on a yoga teacher only when they got joint problems.

PHYSICAL THERAPISTS ROCK!!!!!!!!!!!!!! :)))))

ps. as for the four years to heal: Seeing her meant I was able to do sports and dance again after 2 or 3 months. The rest was only to have it completely gone. someone else might have stopped the treatment, but I m glad I didnt.
pps. I saw a top notch sports injury expert doctor first who specifically directed me to her - so I did not mean to say seeing a doctos is pointless or anything like that..

Oh and Lauren - please take good care of your knee(s) and get well soon :)))

this might sound funny but one way to have healthy knees is to walk backward.

my mum saw this on tv on some afternoon women show some physio people were giving tips and they explained something about the way the knees move when we walk backward is helping blah blah blah but my mum didn't really understand or remember the reasons. anyway my parents have been doing it at home or in park a few minutes every day it helps. my dad has really bad knees from years of carrying wood up and down stairs (he worked as a carpenter) and now his knees don't hurt as much. i believe it too because i used to have knee pain now and then and ever since i started working on the plane i never have knee pain and i think because we always have to walk backward so as to face passengers. hope this helps.

wow this sounds like great advice!
I will feel awkward in the park though! And a few minutes is enough?

i don't know how long should be enough. my mum didn't say, she's very forgetful. i see my dad walking at home sometimes and he only does a few minutes at time. probably all the old people in the park knows about this and are walking with my dad because my parents like to share what ever good things they know. perhaps you can tell the people in the park too if they stare at you!

Oh I'll absolutely do that!! (tell them)
That would be a fun side effect - "converting" front walkers. Like my own little sect, and I'll be the guru of the whole fun thing.
A magical healer, after all! :)

It sounds like it might be bursitis, I have it bad just below my right knee and it flares up pretty bad at times.

It was a lot worse when I first started several years ago and my quads and inner thigh muscles were very weak and not helping support my movements. Lots of ice and leg strengthening exercises helped. Now I've got much stronger quads and calves but still am careful of what movements I'm doing and wear supportive braces when it feels weak.

Originally Posted by dinavienna

"Physical therapists are wonderful, and I think they're underappreciated. I once heard someone telling a friend that a yoga teacher was "practically the same thing" as a physical therapist. Ummmm -- NO!!"

SO NOT!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
come one!! i used to see the MOST AMAZING PT for FOUR years until a knee injury was completely healed. In the meantime I sometimes had minor other problems - it took her never more than 20 min to figure out what was wrong. like when I thought my hip joint had gone sore and had horrible pain walking she knew within minutes it was a muscular issue and she stretched it out so the pain was almost gone within minutes.
I know she had to study to get a degree (with a thesis to be written), she has years of practice - and as much as I respect yoga, it does not come ANYWHERE close and I wish nobody they rely on a yoga teacher only when they got joint problems.

PHYSICAL THERAPISTS ROCK!!!!!!!!!!!!!! :)))))

PT the same as yoginis???

PTs rock??? Yes!

The two are not even close. No disrespect to either - they both are specialized in what they are trained for. That's like saying bellydancers are strippers!!

oh sure - yoga can do wonders. And I believe it is great in PREVENTION of injuries. Good for body and mind - all if done well, of course.
But once you have a sports injury that is not something to be healed with 2 days of rest I'd be absolutely worried about everybody who's not seeing a pro! (And that need not always be a medical doctor - I was in perfect hands with my PT; also had it been something serious I'm sure she would have sent me to a doctor right away.)

I have been helped on several occasions by the realignment exercises suggested in the book, "[ame="http://www.amazon.com/gp/product/0553379887?ie=UTF8&tag=amysfavorit-20&linkCode=as2&camp=1789&creative=9325&creativeAS IN=0553379887"]Pain Free[/ame]". There are several other books and also DVDs by the same author(s) for specific topics, such as Pain Free for Women and Pain Free at your PC.

Update -- my knees are waaay better. Yay!

By the way, some of the best yoga teachers are ALSO physical therapists (Julie Gudmestad, Judith Lasater) and yoga therapists sometimes have both sets of training.

But there are also yoga teachers who've had NO training at all, the field isn't regulated any more than teaching bellydance.

A combination of both worlds sounds excellent!
At least where I live physical therapy can only be practiced after formal/standardized education. Very reasonable, but I wonder if that would not be almost as important for yoga.
I have not learned it for long now, but I think poor education in it could potentially be very dangerous for the students!
I am so glad your knees are better :)
The pain-free read sounds really good!!
I might check out the pain-free at the PC first!

I agree 100% that yoga is great for prevention, a preventive medical treatment if you prefer. Just like cardiovascular is great to prevent heart disease; on the other side, however, if you get heart disease or a heart attack, cardiovascular exercise will not help at that point, but proper medical care and good medicine. I think of physical therapy the same way.

I see them as two completely different disciplines that sometimes overlap.

Yoga can sometimes be part of a rehab program, but that's very specialized. I hate when I'm teaching a yoga class at a health club where people are looking for a physical challenge and a deep stretch and some guy who can barely stand up straight wanders in because he heard yoga is good for back pain.

A few highly qualified yoga therapists could certainly work with him one on one, but walking into a health club yoga class = disaster.