Knee Update

After the backpacking trip last week, in which we did 75 miles on the AT in just 4 days(18, 18, 19, and 20 miles), my left knee got pretty sore. My right knee, which has given me problems the past several years, held up pretty well. The day after we got off the trail, we walked up to Brasstown Bald, a .6 mile paved path up. That hurt a lot, both up and down. It was all lateral pain. I did a self exam the day after that, and it was definitely sore in the lateral anterior patella and femur — classic signs of patella fermoral syndrom, likely caused by a tight ITB.

So I set up a time to go see my old PT, and he did exams of both knees, as well as my SI joint and R hip, which have also bothered me off and on a bit. I didn’t see him for another 4 days, and most of the discomfort in the R knee was gone, though in some of the exam I could feel it a bit.

I basically need to do much of the same stuff I used to do on the R knee on the left now:

  • ITB foam roller
  • ITB stretches
  • patella stretches, in both the medial and inferior directions

Beyond that, on both legs, I need to work on my hip adductor and abductor strength, stretch my hip flexors, in particular my psoas, stretch my groin, etc.

And overall, I could really work on my core strength, both front and back, to help stabalize the SI joint. And work on step downs.

I certainly can’t complain about the right knee and how well it did. It is certainly not 100%, and probably never will be back to where it was when I did the really long races. And I still wonder if there is a little scare tissue under the portal from my last surgery…

Here are the measurements:

Left Knee Right Knee
top of patella 13 3/4 13 3/4
2″ above 14 1/2 14
4″ above 17 16 1/4
6″ above 19 18 3/8
8″ above 19 3/8 19

So this shows size-wise, I still have some work to do. I don’t feel that it is weaker, and on my compex electro-stim unit (yes, I still need to blog about that)!, the milliamps I am sending in to the quads to get similar contractions are almost even… I’m only 1 or 2 ma below on the L side (meaning it is stronger). But when I do exercises like the step-downs, it is clear that the R side is not as stable. That may be supporting muscle weakness more so than quad weakness.

Here is a post with a similar table from September of 2005.

And to compare the two side by side:

April 2008 Sept 2005
Left Right Left Right
top of patella 13 3/4 13 3/4 13 1/2 14
2″ above 14 1/2 14 14 1/2 14 1/4
4″ above 17 16 1/4 17 15 3/4
6″ above 19 18 3/8 19 18
8″ above 19 3/8 19 21 1/2 19 3/4

So this shows some progress on evening things out…. (I’m thinking that 21.5 number on the L side in 2005 is not right!)


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