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Patella Pain - Bad Technique ? Help !

post #1 of 22
Thread Starter 
I am age 42, 6'4 and 220 pounds.I am sitting in a Vancouver hotel googling everything I can about patella tendinitis / bursitis ( which is infammed bursae sack on front of patella bone..which is really another way of saying tendonitis) in the hope that I will discover that it is indeed my grossly unrefined technique and classic beginner mistakes that are the causing of this pain.If I dont get confirmation that it is technique that causes this pain as oppossed to shot knees, it will look like curtains on my re attempt to enjoy this magical sport.

I skied 20 years ago in Australia and even at age of 20 or so I remember after 3rd or 4th day of grinding stoppages, leaning uphill, uncontrollable speed, just everything wrong, I got to point that when I squatted down to sit on quad chair I felt this debilatating strecthing pain across both kneecaps.

From 20 years of on/off squats and leg press and leg extensions I was thinking my outside quads to some extent may make my knee track outwards as I definitely have not, as most blokes havent, worked on my inside leg as much over the years.

But even so, I just wanted to hear from someone if it is indeed the case that tonnes of pressure on your quads and knees from too much speed / desparate stopagges can cause this pain.I know my quads burn like hell sometimes.

This whistler experience was first ski in twenty years.I strech every day of my life, soft sand run, u name it and would dearly love to get some advice.I was thinking of going to Fernie next week to get ripped apart at Harb skischool camp for a week.

But my question is whether this tendonitis is all due to a horrible technique and whether I can turn it around by starting from scrach.

Any advice would be welcome...am sitting here reading ski book after book in hotel

Cheers

AussieDaveski
post #2 of 22
well I'm of similar age and slightly heavier and I had some cranky knees (nothing debilitating though) yesterday after a ripping day at Stowe on Thursday.

I kind of write some of this off to being 42 I guess. Take Ibuprophen is what I do

Maybe get some video work done and check out your technique with an instructor if you think you're in the back seat or whatever. Then there's your skis, boots, tune, conditions etc etc
post #3 of 22
Yes, it can be knee pain from poor technique. I bet it's also magnified on hard snow yes?

I'll make a guess that this is what is happening: The patella is vibrating in it's track as you skid your turns across hardpack. This would not be so bad, but you're in the back seat, (quads are burning) so the patella is vibrating quite hard. The quads are behaving like a over stiff guitar spring. The quads should not burn -- if they did, there would be far fewer skiers.

I had similar problems when I started roller blading, especially on rougher pavement. Once I improved my balance and took the pressure off my quads, it went away.

Hips over feet.

Perhaps the Harb camp is a good idea.
post #4 of 22
Orthopod told me to build up the Vastus medialis, inside lower thigh. She wanted to send me to the weight room, but agreed that skiing could build it up. I upped my ski days and it finally stopped hurting.

Thats the type of doctor you need.
post #5 of 22
Don't overdo the front and forget about the back. I have always had patellar pain to an extent ... skiing doesn't normally hurt it, though.

Earlier this season I was having a lot of trouble (again, not so much skiing, but doing other stuff), even though I've been exercising my vastus medialis etc.

According to my physio, I wasn't doing enough hamstring work, though. So I started doing more hamstring exercises, and it helped a lot.

Good luck.
post #6 of 22
I have quite severe patellar tendonitis that is caused from the muscles on the outside of my legs becoming stronger (or being used more) than the muscles on the inside of my legs. I have this happen from carving and racing. Essetially, my knee cap ends up being pulled off the top of my knee slightly, so the tendon ends up enflamed. This is VERY painful. I saw a sports therapist for it and was given a series of excercises that would help would the muscles in my legs that were more lightly used. Since then I have adapted my leg workouts beyond skiing to develop all the muscles in my legs, and not just the ones I use to carve.

I have not found that the issue is technique related, although I can imagine that turns that put significant stress on your knees (rotary, resistance, etc.) cannot be good for it. Any twisting or sheer forces on your knees are bound to hurt something I would guess. Without seeing you ski it is hard to tell waht you might be doing to cause your knees to act up.

Later

GREG
post #7 of 22
Are you sure it's tendonitis? I've had this pain for years, due to overdeveloped outside quads, and lazy inside ones, and a tight tibial band pulling the kneecaps outward. My orthopaedic surgeon (who is going to chop my ankles up when I get back to oz) has an excellent model of a knee, and I had fun playing with the kneecap. After doing that, my taping technique improved! I had more of an idea what I was working with.

I control the pain from skiing (and stairs) by using brown tape (mostly only available outside the US, dunno if the Canadians have it) to pull and lock the kneecaps back toward the inside.

My doctor termed it Patella Femoralis though.

It gets much worse if I sit back at all. Fixing my technique improved matters massively, to the point where, so long as I tape, my knees are pretty happy campers.
post #8 of 22
I am stepping outside the bounds of my specialty (which I really avoid doing) but as a fellow sufferer I can offer a bit of advice. Most likely what you have is properly termed patellar tendonosis (not tendonitis) or patellar tendonopathy. It is a degenerative, not inflammatory condition (non-steroidals like ibuprofen are less likely to be of help), and is a kind of overuse syndrome. A good article explaining it and offering good advice can be found here:http://www.physsportsmed.com/issues/2000/06_00/khan.htm
post #9 of 22
Thread Starter 
Thanks for all your responses.Does sound like knee tracking more I think about which ultimately leads to tendon inflamation anyhow I think.Spoke to someone in Fernie today who thought that being tall, high arched and thin boned etc that my recently purchased Strolz were the worst boot to buy and was suggesting reservedly, as he hasnt see me ski yet , that bad alignment iwould be a major factor in knee pain, although I have gut feel its a combo of that and way I ski plus years of leg press andoutside quad work.I starting hip extension and groin machine today.Any suggestions on whats best execises for building up inner leg ??
post #10 of 22
Thread Starter 

Patella Pain

Quote:
Originally Posted by dp View Post
I am stepping outside the bounds of my specialty (which I really avoid doing) but as a fellow sufferer I can offer a bit of advice. Most likely what you have is properly termed patellar tendonosis (not tendonitis) or patellar tendonopathy. It is a degenerative, not inflammatory condition (non-steroidals like ibuprofen are less likely to be of help), and is a kind of overuse syndrome. A good article explaining it and offering good advice can be found here:http://www.physsportsmed.com/issues/2000/06_00/khan.htm
Thanks..read the article...doesnt really sound like what I have..least I hope not......I havent really done mucg jumping over years..just leg press, hammies and occassionally squating....I suspect is bad alignment and knee tracking..anyway Ill find out once and for all doing the harb school and getting boots aligned next week at Fernie
post #11 of 22
My sport doctor, who was the AIS guy for years, had me doing an exercise which DID fix it but I got lazy and preferred the tape.
It was a co-contract one, the most annoying sort for those of use who like to lift cars. PM me if you want the annoying details. It did work. but for me, the taping is a nice shortcut, and most good Ozzie physios can check and correct if need-be.

This condition is so common. I ski all day every day, and the tape, if you get it right, just totally militates against any pain at all.
post #12 of 22
btw I have also had iliotibial band soreness, mostly from long distance running in earlier days.

Forgot about the fact it does cause kneecap to pull to the side but that note jogged my memory somewhat about what the orthopedic guy told me when I was having problems with it
post #13 of 22
I use to have this type of pain. Much of it went away with proper footbeds and alignment and the rest went away when I started really getting forward, taking off the brakes and controlling speed with where I went.
post #14 of 22
Try looking up patellofemoral dysfunction. This is an irritation of the patella caused by patellar malalignment. It is made worse with increased strength of the vastus lateralis. But also an increased q-angle. A high q-anle individual has wide hips and knees that are close together. Taping, icing, NSAIDs, and strengthening the medial quadriceps all are good treatments.
post #15 of 22
Thread Starter 
Viking, I do have wide hips and my legs to go straight down.I am checking out q angle stuff on net now.Moe I investigate more I conclude I have knee tracking.Have started inner leg raises whcich blew me away..couldnt believe what a direct hit it was on inner thigh.Taping sounds like the go.Question is how much my new Strolz boots are making worse.They were $ 1100 and have been told by harb ski school in Fernie they are the worst...he reckons turf em and buy boot suited for me and get aligned
post #16 of 22
Yup. Summarised it well, Viking. (cept I don't have much of a q angle). I'd be lost without tape and Naprosyn SR 1000. Mainly the tape though.
post #17 of 22
Could it be that the area behind the kneecap is roughed up and needs to be smoothed? (forgot the technical terms) I had such a condition, there was pain and at times the leg almost seemed to lock up. Some arthroscopic surgery to clean things up and I am good as new.
post #18 of 22
Thread Starter 
Quote:
Originally Posted by XJguy View Post
Could it be that the area behind the kneecap is roughed up and needs to be smoothed? (forgot the technical terms) I had such a condition, there was pain and at times the leg almost seemed to lock up. Some arthroscopic surgery to clean things up and I am good as new.
I had meniscus trim and smoothing 6 months ago..think its wide hips and knee tracking..am seeing pysio guy who wrote FIT TO SKI in about 2 hours here in vancouver..will keep u posted
post #19 of 22
It'll be interesting to hear how the canadians tackle this. Aussies and the euros use tape a lot, but here in the US we can't even get the stuff, they only sell that tape you have to wrap around. Not the good sticky brown stuff.
post #20 of 22
Quote:
Originally Posted by ant View Post
It'll be interesting to hear how the canadians tackle this. Aussies and the euros use tape a lot, but here in the US we can't even get the stuff, they only sell that tape you have to wrap around. Not the good sticky brown stuff.
That stuff is amazing. About 15 years ago, I was having some pain in my left knee. This knee was dislocated or subluxed 8 times while I was a teenager; had a lateral release 22 years ago, which worked great.

I was having some pain, though, and went to physiotherapy at Georgetown University in Wash DC ... they taught me how to tape the knee like you described, with that intensely sticky and strong tape! I did it for a while, then was better (in fact, that knee hasn't hurt since then).

But now my other knee is hurting. I forgot how to tape it, and I can't even find anyone here to show me how. They all say, oh, just use a brace. And I ran out of that insane tape, too.
post #21 of 22
From what I am reading here the taping-up sounds very similar to your basic knee wrap used by bodybuilders in squatting. The tape just makes it easier due to adhesive but you can get the same results using basic knee wrap available at most gyms and places that sell gym supplies. It helps you do more weight and have less pain, but at the price of never really strenghthening that knee enough. Of course if you have professional body builder caliber legs and are squatting 1200lbs then thats a different story all together.

Here is some good knee info: http://www.bodybuilding.com/fun/drsquat12.htm
post #22 of 22
No, wrap will NOT do the same thing. What the rest of the world does is to MOVE bits, like the patella, using tape. Wrapping it just locks it down.

For some reason, in the US, you aren't allowed to have the tape that the rest of us use. It's made by various tape brands available here, like Leukotape, but you can't get it.

Braces are useless. If you need a brace, a brace won't help you. but proper taping of bones, ligaments, tendons and muscles will do a huge amount. But only if you can get the tape and have a physio or sports doctor show you exactly how to do it.

I've got serious patella femoralis, and in the US it means an operation or giving up. But with tape (and knowing how to use it) I'm fine. knee pain only happens if i haven't got my tape on.

But I have to bring the tape with me because americans aren't allowed to have it.
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