Hey all,

I've done the web searching and forum searching and I haven't found anything resembling my current knee issue. I've gone once to my PT and he couldn't figure anything yet, so I'm tossing it out to you all for any and every insight.

FYI, I'm a post-surgery athlete (badly dislocated patella in '95) with a pretty sound understanding of knee injuries who knows/keeps regular body maintenance (i.e., self-massage, foam roller, etc). Not trying to be the lazy moron who won't do his homework before posting.

Here goes; I thought it was hamstring tendonitis, but my PT doesn't think so.

1) Wake up with pretty sharp pain outside of right knee (not the surgery one) whenever I bend it. For example, raising leg to put on pants causes discomfort. Pain right at insertion of hamstring tendons to tib/fib area. Often continues down outside of upper calf.

2) Seems to alleviate during day with walking (I'm a school teacher, so always up/down stairs and around classroom).

3) Very clear, sharp pain/discomfort (in same area of knee) when doing seated hip stretch: http://exercise.about.com/b/2008/03/25/exercise-of-the-week-seated-hip-stretch.htm.

4) No discomfort in hip at all. No pulling/tightness in ITB.

5) Really flared up on Friday (10/23). No activity for past week other than walking around NYC and self-massage/foam rolling. Moderate improvement.

6) No mechanism of injury that I can recall (and I quit drinking years ago, so you know). However, two days before the bad flare up, I did a pretty leg heavy strength workout: front squats, goblet squats, and bodyweight squats/lunges/jumping lunges. Nothing but the usual nice 'good workout fatigue/slight soreness' next day. But I can't figure it would take 48 hours for ITB to inflame so badly...

WTF, right?

Sorry so long, trying to be clear. Thanks in advance for any help.

cb

judging by the use of the foam roller, i suppose you are aware of iliotibial band injuries. It sounds like it could be that, inflammation in the IB down by your kneed.

Sounds like you know way more than I about this stuff.

That said, I had Illiotibial Band syndrome off and on for a year back when I was in high school..symptoms sound very similar...also it seemed to come and go almost randomly.

Typically stretching the IT band and rest followed by very light exercise to work things back up to speed helped me out. It came and went for some time though. I had to take several weeks off it got so bad....

Good luck

JH

If the problem is from inflammation (you don't mention any specific injury) I suggest you try a homeopathic anti-inflammatory called Traumeel. It comes as a topical gel or ointment (the gel is nicer) and as tabs for systemic use. The tabs work wonders for me. No more NSAID's ever.

Regarding your muscle cramp during morning stretch. You probably know this already, but never stretch cold muscles. Be warmed up first.

Good luck - and let us know what you figure out.

Thanks, K, for pointing out that I didn't include possible cause. I've edited above to eliminate AM stretching silliness and describe potential mechanism. Thanks, too, for the Traumeel recommendation; I'll check that out immediately.

I'm thinking it must be some kind of inflammation, possibly ITB but below the knee. Whenever I do any kind of bent-knee hip stretch or pigeon pose, there's the distinct pull at the top of the outer calf and then much discomfort in the whole of the outer knee.

Additionally, I've noticed that, during self-massage (hehe), the peroneal nerve is much more sensitive than the other leg: can feel the nervy tinge down through leg and even radiate across top of foot. Can't replicate that sensation at all with the good leg.

Did 30 minutes of easy stairclimbing and some bodyweight core/upper yesterday, then iced at home. Sated the movement beast, but was definitely tighter this morning.

I appreciate the feedback and welcome any more thoughts.

Crispy: In your workout the day before, did you do hamstrings lying on your front?

On the nerve sensation down the foot. Any tingling in the thigh or pain in the back - in case there are two different things here.

RayMondo wrote:Crispy: In your workout the day before, did you do hamstrings lying on your front?

On the nerve sensation down the foot. Any tingling in the thigh or pain in the back - in case there are two different things here.

No front lying ham work: other than the above-mentioned movements, only light deadlifts (as part of complex warmup).

And no tingling in thigh/back. Only down through lower leg/across foot.

Thanks, man.

chris

Not by any means an expert here, but what you describe sounds like a pain I often experience. You said no tightness in your ITB, and the pain is apparently not at the ITB insertion anyway. I'd rule out ITB syndrome. Sounds like maybe your hamstring has gotten tightened up from the hard workout (quite a bit more intense than usual for you?), and is getting inflamed (for some reason, i've noticed, inflammation seems to show a preference for occurring near insertion points rather than just anywhere in the muscle or tendon) in protest of the stretching that naturally occurs during normal motion.

The fact that it gets alleviated during the day from walking around seems to suggest the whole problem is just tightness that eventually loosens up. If your hamstrings are too strong or tight relative to the quadriceps (like mine are), that can create an improper pull on the knee causing pain from the slight torque, and more so if one bundle of hamstring muscles is pulling harder on one side of your knee than the other bundle pulls on the other side.

Not sure the best thing to do about it. Once it loosens up the problem is gone, only for some reason it returns next time you rest, so how do you make it stay away for good is the question. I'm still kinda figuring that out for myself. I guess you want to lengthen the muscle, but obviously stretching it while it's cold is inflaming it, so warm up first and be gentle with the stretching and focus mentally on relaxing it so that it's more likely to stay lengthened rather than tensing up in reaction to the stretch. Massaging stuff like this seems to maybe help me too.

seanpeckham wrote:...
...The fact that it gets alleviated during the day from walking around seems to suggest the whole problem is just tightness that eventually loosens up. If your hamstrings are too strong or tight relative to the quadriceps (like mine are), that can create an improper pull on the knee causing pain from the slight torque, and more so if one bundle of hamstring muscles is pulling harder on one side of your knee than the other bundle pulls on the other side.

Not sure the best thing to do about it. Once it loosens up the problem is gone, only for some reason it returns next time you rest, so how do you make it stay away for good is the question. I'm still kinda figuring that out for myself. I guess you want to lengthen the muscle, but obviously stretching it while it's cold is inflaming it, so warm up first and be gentle with the stretching and focus mentally on relaxing it so that it's more likely to stay lengthened rather than tensing up in reaction to the stretch. Massaging stuff like this seems to maybe help me too.

I very much go along with the stretching. Increasing ones flexibility protects against injury. Take at look into some basic Yoga. Since I've done it, I remain injury-free, and now able to get back into playing competitive Badminton at 55. (See what a supple body can take without injuring oneself. Take a look at the sport here)
http://www.youtube.com/watch?v=NHVrC6D8 ... re=related
http://video.google.co.uk/videosearch?q ... nton+move#

Make any new stretching gradual, warming up with walking and rubbing the limbs first. For the hamstrings - lie on one side, put lower leg into Z-shape for balance. Bend knee of upper leg, point it to ceiling, then raise from the knee, supporting behind leg (at back of thigh, then back of calf) with upper hand. Ease down. Gradually repeat, extending the straightening over a period of weeks. Do 3x day. Don't be impatient, just feel the tension but don't go beyond.

Your hamstrings will become more supple and stronger and you'll be able to fully straighten the whole leg at 90 degrees from the floor, and even be able to pull your toes toward you, extending the calf and achilles. Whereas most people can only get a 45 deg flex in the leg before coming up tight. If you do a desk job, the hamstrings will lose their natural extension, so don't sit too long.

And of course eat v. healthily. If its manufactured food in a box, its not half as good as fresh. To protect the joints, get your Omega oils 3 & 6. Eat massess of fresh food. Stuff that has just grown. More tips if you need, just PM me.

sounds like ITB to me. the fact that it does radiate distally down lateral aspect of calf likely could suggest a lumbar sensory radiculopathy. i good idea would be to get a little steroid injection into the area of discomfort for diagnostic and possible therapeutic purposes. good luck

Just a quick update for all of you kind enough to offer advice/insight.

Went back to the PT, but this time I saw the head bringer-of-pain herself (she runs the practice): Distal inflammation of ITB. Looking back, it's pretty clear that I wasn't doing nearly enough maintenance to offset the strength and endurance work. Shameful.

But now I've been brutalizing the legs on the roller, and have even started using an old BPA Nalgene bottle for extra fun. Works amazingly well, though it is truly a whole other level of pain.

Am loosening up pretty nicely and starting to slowly work back into things. More intelligently, this time, I swear.

Thanks again all.