Mystery knee pain. I am truely baffled. Please help!

Question
John,

I'm a 24 year old male, 5'9" and 170lbs. I've always been a fairly active person who exercises often and keeps myself in shape. In the past year and a half though I've had 2-3 month long stretches w/little to no physical activity, where I will start back up again for a month or 2 and then stop. So sporadic exercise. About a month ago I started jogging and hitting the elliptical 4-5 days a week for no more than 20 minutes at a reasonable pace, nothing too strenuous. (I'm kind of flat footed/very low arch and have gotten shin splints in the past, so I've learned my lesson about pushing it too hard too soon).
  So after about 2 and a half weeks I start to have a very very slight pain in my knee. Hardly even noticeable. Feels a little sore when I go down stairs especially, but not up stairs. I stay off of it for 4-5 days, it doesn't seem to go away or get worse, so instead of running I hit the elliptical which seemed okay and I felt no increase in pain during or after.
    The following few days after the pain in my knee increases and gets progressively worse every day. Not only was noticeable when going down stairs especially, but also up and after a few days it began to hurt all the time, becoming especially stiff, sore, and painful in the morning when I would wake up. Even while doing minimal activity except casual walking and not exercising at all.
    The pain is focus in one spot. At the top of my left knee cap where the quad hits the knee cap on the upper left side and upper center. It hurts to touch it and sometime it feels like its localized in certain particular spots in those areas. When comparing knees, the left knee, at the top seems very very slightly inflammed, but hardly noticeable unless looking very very closely.
 After about a week of getting progressively worse, the pain and discomfort got BAD. It was difficult to walk on normally and became very painful to bend. Severally restricts the full range of motion.  It was so confusing because the pain kept getting worse even though I walked less on it, took advil 3-4 a day, started icing the knee 4-5 times a day, and even started using a heating pad. Its strange too because it will hurt less or more during different parts of the day. Typically more when I wake up and less after walking.     
     It's been 2 weeks (maybe more now) since the pain started and almost a week since the pain really plateaued and the pain has only subsided slightly. It still hurts a lot and it doesn't seem to be getting better fast at all. I can walk close to normal but I can't run or walk very fast and I can't walk down stairs normally. My full range of motion is really limited and bending it causes a lot of discomfort.       

Sorry if I've written a lot. Its causing a lot of discomfort and frustration.  I'm on the verge of seeing a doctor and getting an MRI.

Thanks.


Answer
Hi Aaron
Your description tells me you have a case of chondromalacia and can be corrected without seeing a doctor.I have helped many many individuals and i was my first client years ago.If you have a great deal of patience and consistent workout ethic you will do fine.I have put together and copied some case history with prescription,testimonials on how to get started.Stay off the elliptical and stick with the stationary bike as i mention in the attached case history.If you have any questions just get in touch Aaron.

All the very best

John



Hi Pettina
Just what i thought.I have copied a recent case history on the problem and a prescription on how to take care of it with some follow up testimonials from scott lowell and another youn lady.Pettina,the most important thing is patience,consistincy.Everybody heels at different rates depending on the severity of the situation.My self it took 8 months.If you have any questions just get in touch,and keep me posted on your progress like scott did.Also start taking 500mg of vit c with your three meals a day.This is like gold for active people and athletes and yoga instructors.

To a successfull rehap

John



Subject: Knee recovery

Question:
Hi John,
Its Scott Lovell here again.  Thought I would give you an update on the
knee.  I am into the full swing of refereeing and now doing up to 4x90
min games per week.  Great newsw is I have absolutely no problems at
all.  Am back to normal - jogging, running and sprinting.  Thanks again
for all your advice.  I feel well and truly back on track and actually
feel fitter than ever.  Absolutely no soreness at all now, so you can
imagine I am really happy about it.  I obviously keep up the bike riding
during the week, to ensure no reoccurance

Cheers,
Scott

Subject: runner's knee

Question:
Dear John,

Your program is working like a charm, I felt such a huge noticeable  
difference when walking up stairs. Thanx. My question is how much running
is a little running? I ran 1.5 m 2x on my on and with the running class
I ran 3m. This is in a one week span. I also did 5 spin cycle classes
this week. I tried the kickboxing but it messed me up. So I won't be
doing that any time soon. I'm trying hard not to gain weight while I
rehabilitate. I have quite a bit of a metabolism problem. What do you think?
-------------------------

Followup To

Question -
Dear John,
 I suspect that I have runner's knee. I've been stepping 2 to 3 times
a week for the past three years. I would sometimes have pain around the
knee especially if the next day after class I would wear heels. I
didn't think much of it until recently. Two months ago, I started running. I
loved it so much I was running 6 miles 2x a wk and then 1/2hr with my
running class.  The day after one of my runs I had excruciating pain
about 2 inches under the knee between the knee and the ankle.  It stop me
in my tracks for a few minutes and I had to walk very slowly. The next
day the pain was gone. I done some digging, it looks like I could do
some spinning and I need to do some quad strengthening. My question is
how do I do it? Take a spin class first then do my quad work or in the
reverse? When is it ok for me to go back to running? Do you think my case
is severe? I also found out that my pronation is off and my feet do not
rotate enough. Are there special running sneakers to help me? I run in
reebox speed runners for men because they are so comfortable. Do you
think these are good enough for me?

Answer -
Hi Revel
Pain 2 inches below the knee would be pantella tendonitis.Your case is
no severe and you will be fine and you can continue to run a little as
you work on my prescription for rehap.as explained in the attached
letter from a privious client.Your running shoes are just fine.Don't
change.Start adding 500mg vit.c to your 3 meals a day to assist recovery and
don't ever stop the C.Follow my program and keep me posted how it is
going.You will be is good as new in no time.The key is patience and focus
and consistency Revel.I would lay off the steping for a few weeks till
you get well into my program.Let me know if you have any questions.

To a successfull rehap.

John


Scott Lovell Asks in Category Jogging & Running ...

Subject:  Knee soreness
Private:  no

Question:  Hi,
I am 30 years old and have never really had any knee problems.  I am
very annoyed because I feel I have brought this on myself.  I run about 3
times a week, usually on a treadmill.  2 weeks ago I was doing some
lunges with hand weights at the gym.  Admittingly I strained a little and
had probaly used weights too heavy.  3 days later I had a run at the
gym and after 20 mins my knee was really painful.  I iced it up that
night and the following day and then it felt fine.  I have no soreness
walking and none on a very hard workout on the stepper.  2 weeks later I
had a light 5 min run and suffered no pain, then did a 30 min step with
no pain and no sorenes the next day.  2 days later I did a fitness test,
running 3.2km in 12 mins, then 2x100 meter sprints after it.  During
this I felt no pain, but an hourr later I could feel the pain and its
pretty sore again.  2 days since that, my k nee is feeling fine again.  
Does it sound serious?  Have I just pushed it too quickly?  I'm seeing a
physio in 3 days to be cautious.  The pain feels around my knee cap
really - never suffered this before?

Answer:  Hi scott
Great discription of your situation.Thanks for that.Sure makes my job
easier.You  have a slight case of chondro malacia.It isa disintegration
of the patella and femoral cartilage surfaces,resulting in uneven rough
gliding motion between these structures.Any disruption of the normal
smooth gliding motion of this structure will result in cartilage
damage.This is why your feeling where you do.Bottom line not serious but could
be if you don't adress it now.Your knee tracks like a train on the
railrod tracks,and it got out of the groves,jumped track do to some of
those exercises you just did.
To fix this there are 2 things you need to do.First start riding an
exercise bike for 30 to 40 min.3 to 4 times a week.Not a regular bike
except for rec purposes.You want a med to high spin with med to hard
tension.This will retrack the knee and also sand down the back of the knee
cap and smooth it out and also strengthen quads.Second start doing leg
extensions,curls,adductor,abdductor work.Thats it scott,cancel your
physio save $$$.Your situation does sound miner since it goes away quickly
so you should respond rapidly.I would continue with this routine as a
way to stay ahead of the curve as they say.To stay active you have to
incorporate prevention consistently or things will catch up with you,and
that is a promise.Hope this gives you a plan to work with.Let me know
how it is progressing and if you have any other questions.

To your success

John







Only those who risk going to far can
possibly find out how far one can go

                                      T.S. Elliot