Knee Cap Injuries?

[mikeyjk]

Hi All:
I'm new to fencing in the Denver area, and recently, I've been the unfortunate victim of a weird kneecap injury. It doesn't hurt much, but it's a lingering feeling that seems to stay at the lower portion of the kneecap. I believe I may have over committed my knee past my foot in a lunge, but I don't recall feeling when it happened. I just woke up the next morning, and the pain was there.

Any ideas? I went to a clinic, and they did all the knee rotation drills to see if it was a ligament tear or strain, but found nothing that was hurting me. They have recommended seeing a knee specialist, but I thought maybe some of you might have some ideas?

Thanks, guys!

[Katman]

I think you should listen to the doctors and go see a specialist. Rotation exercises aren't meant to find pain, they're meant to see if your knee is still stable and healthy. When they did these exercises, did they perform them on the injured one as well as the uninjured one?

There are four liagments you need to worry about in your knee and one tendon (that one extends from your rectus femoris [I just know I'm mispelling these ] down to the tibial tuborosity and is responsible for holding your knee cap in place; should there be a disparity of strength in your quads, it's possible to pull your own knee cap out of socket). The specalist should do some tests on both knees then recommend an MRI if he feels you need one.

So yah, go see the specialist.

[npkeith]

What sort of pain/discomfort/oddness is it? Did you warm up/stretch before the injury occurred? Is the pain in or near the kneecap itself (does it move when you move the kneecap) or is it in the bump of bone on your shin, just below the kneecap? How old are you?

The area you are describing is the point where the patellar tendon leaves the kneecap and heads for the tibia (shinbone) Is is possible to tear that tendon (which would be bad). If you can still pull your leg straight, and it doesn't buckle under you when you try to stand with your knees bent, then you probably didn't. You may have pulled or strained it, in which case the usual RICE (Rest, Ice, Compression, Elevation) treatment should help. Seeing a sports medicine specialist is a good idea too.

Good Luck!
KeithNP

[mikeyjk]

Thanks for the replies! I'm 25, and in good shape, and I stretch pretty well. The pain is in the little section of knee that exists between the bump of bone on your shin and just below the actual kneecap. I can stand with my knees bent with no problem. The oddness is that I can put weight on it, but on a scale of 1 to 5 (1 being perfect shape, 5 being my knee will collapse if I put weight on it), I'd say it's a 2. It's not bad; it just lingers. I'd like to say it almost feels
"funnybone-ish" instead of painful, but there is a a slight tinge of pain.

The general practioner compared both knees, and didn't really find anything different between the two.

Any ideas?? Could it just be a possible minor sprain?

[Army Fencer]

(Disclaimer: I'm only a first year med school student.)

No nerve run through that region like the elbow when you hit your funny bone...

Based on your description, the only thing I can think of is that it's an ACL or a PCL issue, but you'll have to get it crecked out. It could be cartilegenous...

Let us know how it turns out!

[Artisan]

In this article:
http://www.podiatry.curtin.edu.au/en...ondro.html#one
OR try if the long url fails:
http://snipurl.com/457i
click here

There is a good discussion of a syndrome that I have experienced to some degree, and which mentions fencing specifically as an activity that can induce the problem. I can't say thats what you have, but its a good read with cool grisley photos of knee surguries.

This site will help with the latin names for the anatomy:

http://www.mythos.com/webmd/Content.aspx?P=MUSCH1&E=27


With fencing, the larger outer upper quads can develop considerably and the inner quad (the bulge over the upper inside of the knee cap) less so, causing the kneecap to track improperly. The therapy in less severe cases is to develope that muscle to help keep the knee cap aligned.

[noodle]

i recently had the exact same problem and was diagnosed with chondromalacia patella. its generally a runner's problem but translates to fencing very easily, especially with the pressure applied on the front foot via the lunge. it could also be jumper's knee, which is something a little different. check out the links in the post above me. odds are thats what your problem is (here's the key thing, does it only really hurt when walking downhill, downstairs, or when standing up from sitting down in a chair or the ground? if so, thats probably the problem)

[npkeith]

Army fencer- I think there'd be more instability if there was a cruciate injury, not to mention more pain. (I would be surprised if a GP missed a cruciate ligament injury - the drawer tests are so simple anyone can do them.)

Chondromalacia Patella sounds like a good bet. (chondro- = cartilage, -malacia = softening of, Patella = kneecap -> softening of the cartilage of the kneecap)

Mikeyjk-
lay off it a while, see the knee guy, do what he says. Practice your bladework for a while.

[sabreur]

First, see your doctor.

Second, I have a similar problem, and I wear the CHOPAT braces, which help me a great deal.

Website is (somewhat predictably) http://www.cho-pat.com/

I wear "dual action knee straps" on both legs.

Good luck and cheers, MR

[JEC]

Originally posted by npkeith
I think there'd be more instability if there was a cruciate injury, not to mention more pain. (I would be surprised if a GP missed a cruciate ligament injury - the drawer tests are so simple anyone can do them.)

I am sorry to differ from you, but I have seen it several times including my own GP and even the PA. My tored ACL was not painful, and instability of the joint also depends of many factors. One of my friends has no instability at all, but he was in excellent shape. Some ligaments are more laxed and give you equivocal responses.

If you live in Denver, where I practice sometime ago, I know that there are several Sports Medicine Clinics, such as the one at UCHSC. Consult a professional that works with knees.

[npkeith]

I stand corrected. I hit the books this morning. Everything I've seen seems to say MRI is the best bet for a diagnosis (for chondromalacia patellae or tendon injury)
-Keith

[thebigriddle]

You put some stress on the tendon and it responded with pain because you are use to the stress. The force on the knee should be directly under the ankle and into the foot. Most of forget when we lunge our foot is coming down on to the ground. The ground will apply a force back. Lunging is actually good for knees if done correctly. Strech out the muscles is really important so is warming up. Warm up first, do some light jogging, fast walking, light foot, jumping rope. Also if you have weak hamstrings this might be a problem. The quads tend to be stronger then the hamstrings. So when you land you put stress on the ham, but to stop that you tighten the quad. Work on muscle strengthing, if you use weight this helps because it will also strength tendons, ligaments and bones as well. Just know you limits.

[Army Fencer]

Originally posted by npkeith
Chondromalacia Patella sounds like a good bet. (chondro- = cartilage, -malacia = softening of, Patella = kneecap -> softening of the cartilage of the kneecap)

Didn't know the name of that, even though I was thinking along those lines. Thanks, Keith.

[JEC]

I agree with MRI being the way to go, but it only goes as far as who interprets the study. Start with the basics, get a good sports medicine doc who will know where to send you for an MRI.