Tendonitis in the knees?

[oobinsnaffa]

I saw my chiro last week about some knee pain that I've been having, and he had me in for a couple treatments. My inability to get downtown during the day makes it hard for me to get in to see him multiple times a week, though, so I'm turning to the wise people here for some advice, if you have any, to supplement what I'm getting from him.

The backstory: I'm deep into a huge weight loss (30lbs so far!), and I don't want to lose momentum because I have a long, long way to go. It's a slippery slope for me, and I'm still working on beating the demons in my brain that are constantly coaxing me back to sitting on the couch and eating ice cream. I eat best when I'm active, so I'm trying to avoid total rest to keep my eating under control.

The pain: It's in both knees, but definitely stronger in my right. The pain only presents itself in cross-training with particularly deep knee bends like squats or lunges, and occasionally when going up/down the stairs (especially if I'm carrying my 30-pound toddler). It doesn't hurt at all during or after running or floor hockey, unless I am doing the aforementioned cross-training stuff. I feel it along the inside of my kneecap, near the middle and more towards the top. My chiro is pretty sure that it's from using old shoes for cross-training - the shoes have been replaced, and the new ones help a bit but haven't eliminated the pain. I have been icing my knees after activity, too, but I haven't been doing ice massage... would that be better?

I am a complete fitness newbie, so any advice is appreciated... if I have to totally rest it, then I will, but I would clearly rather not.

[Avis]

I'm no expert, but I'll share from my experience. First, stop doing squats and deep knee bends--they are hard on knees, esp. if your knees are already sore. Second, if you can, consider consulting with a physio-therapist, who perhaps can give you an evaluation as well as an at-home plan for treatment. I like my physio, because in addition to his hands-on treatments, I get practical stretches and exercises to do daily. Third, knees are complicated, but when I was having knee problems (one-sided, luckily), my physio told me to stretch my quads (muscles on the front of the thighs). He did some work on the knee, too, but I think it is my quad stretching that keeps that knee healthy.

Just some thoughts--none of this may apply to your situation.

[oobinsnaffa]

Oh, and I forgot to add... no redness, no swelling (not even after cross training where it hurts), no tenderness or pain to pushing on/around the sore area while the knee is straight or bent, and no soreness at all to bending the knee either to kick myself in the butt or to hug it to my chest.

I have another chiro appointment on Tuesday, hoping to bump it up to Monday. It's spring break, so I can get 2-3 appointments in next week.

Avis, thank you for the input. I am thinking about consulting a physiotherapist as well, because a) I have really crappy extended health benefits, so splitting my allotted cash over two practitioners would be beneficial to my bank account (especially when I'm on a tight budget!), and b) I can pick one closer to home. I love my chiro and will stick with him because his interest lies mostly in sports stuff and biomechanics, but getting downtown with kids in tow is a pain in the ass! And interesting thought on the quads... I am just starting to regain some fitness after many years on the couch. I wouldn't be surprised if there was some muscle imbalance going on.

[ceileigh]

Do you have pain in your knee if you sit for an extended period of time? Or is there a chance it is the popliteal that is tight? i get pain in my one kneecap that is not knee at all but the popliteal needing some stretching. i also had 'theatre knee' years ago. That one hurts only when sitting (hence the name) or in deep knee bends. For Theatre knee my physio had me lie on the ground and do straight leg lifts, lifting one leg up so the heel of the leg I was lifting was at the level of the toe of the other foot. I'd do 15 reps, 3 sets. Then repeat with the toe of my foot pointing in and repeat again with the toe of my foot pointing out. I still do these with both legs. Seem like nothing but they work to strengthen the muscles supporting the kneecap and totally got rid of the problem. For the popliteal it is about stretching the calves and then that specific muscle.

[fe.RMT]

Do you have pain in your knee if you sit for an extended period of time? Or is there a chance it is the popliteal that is tight? i get pain in my one kneecap that is not knee at all but the popliteal needing some stretching. i also had 'theatre knee' years ago. That one hurts only when sitting (hence the name) or in deep knee bends. For Theatre knee my physio had me lie on the ground and do straight leg lifts, lifting one leg up so the heel of the leg I was lifting was at the level of the toe of the other foot. I'd do 15 reps, 3 sets. Then repeat with the toe of my foot pointing in and repeat again with the toe of my foot pointing out. I still do these with both legs. Seem like nothing but they work to strengthen the muscles supporting the kneecap and totally got rid of the problem. For the popliteal it is about stretching the calves and then that specific muscle.

popliteal tendinitis would exhibit symptoms behind the knee (deep in the soft area at the back of the leg). You will never stretch that muscle because you can't hyperextend the knee. One the leg is straight, that's it. You would need to get the leg beyond straight to stretch it, and not just beyond straight, but also rotated. The primary action of that muscle slight tibia/femoral rotation to unlock the knee.

given the area described it sounds like the quadriceps tendon. But obviously without an assessment it is impossible to say. It could also be patellafemoral syndrome (or both)

[oobinsnaffa]

Thanks for the input, fe.RMT. I am seeing my doc on Thursday to get a referral letter so my insurance will pay for a pitiful number of visits with my RMT, so I'm going to see if I can get in with her soon, too. I also found a link to the U of C's sports medicine acute knee injury clinic, so I filled out their online evaluation form and apparently I qualify for their services and they'll be contacting me with an appointment in the next week or so. Until then, I'll just lay off anything that makes it hurt.