Before anyone replies with: “Go see a doctor!”, I promise I will if necessary. It’s just that I’d rather not spend a $30 co-pay for a doctor just to tell me to rest.
Anyway, here my problem:
My left knee hurts, NOT at the knee, but at the very top bump of the shin bone. This is just beneath the kneecap. I guess there’s about an inch of distance between the bottom of the kneecap and this spot, in case it’s unclear to everyone. I tried to research this online and learned that not everyone has that bump at the top end of the shinbone. I’m 41, so it’s not Osgood-Schlatter’s. I never had shin splints either.
It really hurts alot when any pressure is applied to that spot. It was excruciating when I pushed on the spot hard with my fingers. It doesn’t hurt much when I walk straight, hurts a bit when I walk up steps, and more when I walk up 2 steps at a time. It also hurts when getting up from a chair without using any support.
It started hurting during and after doing free weight squats. A few weeks ago, I started feeling just a bit of pressure in that area, after doing squats and lunges, but no pain. The last time I did squats was 10 days ago and it still hurts, although pain has subsided quite a bit since.
I also noticed a slight pain in the exact same area of my right knee. But the pain there is very slight.
Any idea of what this could be? I feel like I want to try squatting again, but I don’t want it to worsen again. My glutes and thighs are losing their shape, so I’m getting depressed.
The bump you’re referring to sounds like where the patellar ligament of the quadraceps attaches to the tibia. If you were to strain something doing squats, that’d be your huckleberry.
Cartilage damage perhaps, and/or arthritic in nature? I’ve got arthritic changes (I’m early 50s) and the cartilage isn’t necessarily in the best condition either.
Chances are, in either case they’d be conservative with medical treatment especially at your age - but if the pain continues / gets worse, you should seek attention.
Consider a short course of anti-inflammatories (Ibuprofen or whatever), and try icing your knee after exercise: either an ice pack, or freeze some water in a bathroom paper cup, peel back the paper, and rub the ice directly on the skin for a few minutes. If you do that, obviously move the ice around - don’t just rest it on a spot and let it sit there, you don’t want to risk frostbite. This was suggested by several physical therapists when I was doing PT for knee issues.
Anyway - don’t try to “work through the pain”, and if rest / ice / anti-inflammatories don’t solve the problem, time to see a doc and/or change your exercise regimen.
My guess would be patellar tendinitis – probably even patellar tendinosis. I’d see a sports medicine specialist or an orthopaedic surgeon.
A word of warning, though. If this physician decides to put you on ibuprofen, or if he/she doesn’t know the difference between tendinitis and tendinosis, then you might want to seek a different specialist. A lot of physicians haven’t kept up with the literature, so they tend to prescribe outdated remedies. (Ibuprofen, for example, can actually interfere with collagen development, and can therefore slow down the healing process.)
Could be a lot of things. Have you looked up patellar tendonitis? Sounds similar. I sure wouldn’t do more squats (I suspect you aren’t) until you get a bead on what the issue is.
I looked up patellar tendonitis, but there is no pain on the kneecap or tendon below. The pain is confined to the actual shinbone (the very top bump of the bone), which is sensitive to touch. It doesn’t hurt at all when I run. But when I squat or do a deep knee bend, the pain/pressure in that spot gets more severe the further down I go. Also, there is no pain when going down stairs, only on the way up.
I will definitely try icing it as well. I guess I will eventually have to get to an orthopedist.
Is your knee travelling past your toes when you squat and is it tracking directly in line with your toes? Tendinitis tends to be more if an overuse injury and heals with a couple of weeks off if that’s what it is. If you have the $$$ pick up a copy of Mike Robertson’s Bulletproof Knees. He sure won’t have you giving up on squats but it’s worth it for his explanation on how hip and ankle mobility affect knee mobility. I have to post and run at the moment but if I have time later I’ll post a brief explanation of that as I understand it.
I didn’t squat correctly in the past (years ago), but my form is much better now. My knees don’t go past my toes. But I’m not certain about the “tracking directly in line” part.
It will be 2 weeks since I did legs on Saturday. I will give it some more time.
It can be hard to determine the tracking yourself. You might need someone to watch for you. That was a big thing for me. My hip was tight on my left side and I wasn’t tracking correctly but I thought it was one side being weaker than the other. The other issue which affected me (YMMV and I’m not a doctor yaddayaddayadda) was that the muscles on the outer thigh were stronger than the medialis, the teardrop shape on the inside of the knee. All my sports: rugby, soccer, hockey, karate, were emphasizing strength at the upper part of the range. Once I started squatting deep like Olympic Weightlifters do my knees felt really strong. (I never really had many knee problems, my problems showed up in my lower back)
To go back to what I took away from Bulletproof Knees re: hip mobility (sorry is this too long, I read way too much on this stuff :)). The crib notes version of how Mike Robertson put it is, the ankle and hip joints are meant mostly for mobility vs. stability; the knee joint is designed for stability over mobility. Let’s assign arbitrary values of 100 to each joint for 300 total in someone with good knee function. Now take someone with less ankle flexibility, they score 85. If they have better hip mobility of 115 than they’re fine for movements that demand a score of 300 to safely perform the movement. But if they score 85 at the ankle and 85 at the hip and the movement requires 300 overall then the body will force the knee joint to provide mobility that it can’t supply. It’s a gross oversimplification but it forces us to look at how mobile hips and ankles can help protect our knee joints. Choosing the correct mobility exercises for each person is a job for a pro though.
The other thing I’m big on (again this applies to me, maybe it won’t be good for you) is single-leg movements. I do a lot of Bulgarian Split Squats and similar movements with the goal of eventually performing a Pistol Squat.
My pain continues. I tried to continue to try do squats once-a-week, but it became somewhat unbearable.
So I finally went to the Orthopedist on Monday. He x-rayed my knee and didn’t see anything wrong with the bone, although he said my kneecap is off to one side, which means I’m only using muscles from the inner part of my thigh. He said I’m just built that way, and there’s no way to correct this.
He said he believes that I have tendonitis. He sent me for an MRI, and I have to see him again next week to go over the MRI results. He put me on Naproxen 500mg at 2X per day.
He also said that I should never do squats or lunges again. Ever! :mad: He also said no step exercises or anything that involves bending the knee or weight-bearing on the knee significantly. Essentially, my leg training going forward should consist of an elliptical machine at a maximum level of 8, or a recalcitrant bike. That really sucks. If I get better, I don’t know if I’ll follow his advice. I’ve been doing squats and lunges for 15+ years without problems.
Did you mean recumbent bike? Though I personally rather like the term “recalcitrant” :).
Sorry they didn’t see anything easily fixable. Is this ortho a knee / sports medicine specialist? If not, you could consider a second opinion with someone who is a specialist.
As far as no squats ever, if your knees have truly given out after many years of stressing them, unfortunately that may be the correct advice. If you ignore that, you’ll continue to have knee pain that will just get worse.
Consider having a Functional Movement Screen done. They can track down any imbalance or faulty movement patterns which cause problems. Squats aren’t usually bad for anyone’s knees but it does require more coaching than many people realize in order to learn them correctly. Frankly, for strength building deadlifts will fit the bill. Maybe it’s worth focusing on them for a while.
Thanks for all the advice. I will eventually get a second opinion from a sports medicine specialist. And yes, I did mean recumbant bike. I have no idea how I came up with recalcitrant.
Not so. SWMBO and StepDaughter have both had knee issues where the kneecap was not aligned properly. Doc went in and basically slit some muscles on one side. While they were healing, the muscles on the other side pulled the kneecap back into alignment.
Hey, could I piggyback on this thread for a sec? I was actually thinking of posting one recently but I didn’t think it was really a big enough deal to do it. But as long as we’ve already got a “diagnose my knee pain” thread…
Mine is weird. It doesn’t hurt at all when I walk. It doesn’t hurt when I go upstairs. It hurts when I go downstairs. Like, if I step down on the leg that hurts, then put my weight on that one to swing my other one down, it hurts. It’s a sharp kind of pain right on the front of my knee, and it instantly goes away when I take my weight off it. I would think that it would also hurt when putting my weight on it to go upstairs, but it doesn’t. It also doesn’t hurt when I push on it. The only time it’s ever an issue is when I go downstairs. Since I live in a 2-story house, this is a little inconvenient (though really all it means is that I have to go downstairs slowly, one stair at a time).
Any idea what could be up? I hope this little hijack is okay.
Shoot, I already feel like I’ve talked too much in this thread but that’s the exact symptom I had for a while. It didn’t bother me much but I squat a lot and wanted to find out about it in case it was a problem developing. In my case it was tendinitis and the knee cap was traveling to far to the lateral side. I started hinging my hip back more when I squat and making sure my knees go over my toes and the problem was solved. That was a long time ago but I still try and use my hips a lot when I go downstairs though so that my knees aren’t shooting straight out in front of me too much.
Sorry, I had to vent. Going tomorrow for MRI. After a lifetime of ACL tears in both knees, I finally totally ruptured the right one. That was 10 years ago. Now, 10 years later, the knee swells up for no doggone reason at all and will not bear weight.
