Knee Pain

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   Our user asked: "I recently went hiking over hilly terrain for three days and returned sore, but not painful. The day after, my left knee developed acute point pain at the medial edge of my patella. The pain is most severe when walking down stairs, when I begin to bend the knee as my right leg comes forward. The pain is less severe when walking, but still occurs as I bend my left knee to bring my right leg forward. The pain is least severe when climbing stairs. If I cross my legs, the pain is much worse directly after. I can elicit pain if I push my finger over the medial edge and top of my patella. There is only acute pain, no aching. There is no redness, nor any obvious swelling. I've been taking 600 mg Ibuprofen 3x/day for 4 days and resting as much as possible with no improvement. If I am walking, I notice marked increase in pain over time (there may be no pain for the first 50 yards, but by 100 yards it is severe). If it continues, I will obviously go see a doctor, but I'm wondering if you have any idea what the pain may be caused by? I've had several knee injuries (torn medial meniscus, partially luxated patella) in my right knee, but no previous history in my left (the one now hurting). Any ideas? Thanks for your help!"

Ask a PT Response: "Hiking on uneven terrain could definitely put additional stresses on your knee. You mention pain at your knee with negotiating down stairs, bending your knee at the swing phase of gait, and with increase activity. You also mention you have marked tenderness at the medial/superior PF region. This pain could be associated with a number of things. The first thing which comes to mind is patellofemoral (the patella acts as a lever arm which allows the quadricep muscle/tendon to pull the tibia aligned with the femur resulting in the last 10-15 degrees of knee extension - without the patella terminal knee extension would not be possible). You mention a history of PF subluxation at the R knee. Perhaps you may also have issues at your left knee such as PF tracking dysfunction, quad weakness, anatomical deviation, decrease hamstring/quad flexibility etc. This could all result in additional streses at yor left PF region resulting in irritation to either the cartilage or the PF ligaments as a result of you hiking on uneven terrain. A physical therapist would usually recommend to his/her patient with PF pain a plan of care such as icing, patella mobs, knee ROM exerices and quadricep strengthening exercises. It may be a good idea for you to be evaluated by a PT so that he or she can determine what may be the etiology of your pain and develop an apporpriate plan of care based on your specific needs. Good luck and thanks for using CyberPT." 

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Ask a PT Members Profile Send Private Message Find Members Posts Add to Buddy List Senior Member Joined: Jul 07 2008 Status: Offline Points: 954	Post Options Post Reply Quote Ask a PT Report Post Thanks(0) Quote Reply Topic: Knee Pain Posted: Sep 05 2008 at 12:55pm
	Our user asked: "I recently went hiking over hilly terrain for three days and returned sore, but not painful. The day after, my left knee developed acute point pain at the medial edge of my patella. The pain is most severe when walking down stairs, when I begin to bend the knee as my right leg comes forward. The pain is less severe when walking, but still occurs as I bend my left knee to bring my right leg forward. The pain is least severe when climbing stairs. If I cross my legs, the pain is much worse directly after. I can elicit pain if I push my finger over the medial edge and top of my patella. There is only acute pain, no aching. There is no redness, nor any obvious swelling. I've been taking 600 mg Ibuprofen 3x/day for 4 days and resting as much as possible with no improvement. If I am walking, I notice marked increase in pain over time (there may be no pain for the first 50 yards, but by 100 yards it is severe). If it continues, I will obviously go see a doctor, but I'm wondering if you have any idea what the pain may be caused by? I've had several knee injuries (torn medial meniscus, partially luxated patella) in my right knee, but no previous history in my left (the one now hurting). Any ideas? Thanks for your help!" Ask a PT Response: "Hiking on uneven terrain could definitely put additional stresses on your knee. You mention pain at your knee with negotiating down stairs, bending your knee at the swing phase of gait, and with increase activity. You also mention you have marked tenderness at the medial/superior PF region. This pain could be associated with a number of things. The first thing which comes to mind is patellofemoral (the patella acts as a lever arm which allows the quadricep muscle/tendon to pull the tibia aligned with the femur resulting in the last 10-15 degrees of knee extension - without the patella terminal knee extension would not be possible). You mention a history of PF subluxation at the R knee. Perhaps you may also have issues at your left knee such as PF tracking dysfunction, quad weakness, anatomical deviation, decrease hamstring/quad flexibility etc. This could all result in additional streses at yor left PF region resulting in irritation to either the cartilage or the PF ligaments as a result of you hiking on uneven terrain. A physical therapist would usually recommend to his/her patient with PF pain a plan of care such as icing, patella mobs, knee ROM exerices and quadricep strengthening exercises. It may be a good idea for you to be evaluated by a PT so that he or she can determine what may be the etiology of your pain and develop an apporpriate plan of care based on your specific needs. Good luck and thanks for using CyberPT."

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