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Author Topic: little help? possible maltracking problem?  (Read 1656 times)

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Offline AKH

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little help? possible maltracking problem?
« on: December 10, 2004, 04:13:33 PM »
hi all,

I've had a knee problem for probably around a year now. My problems started when I seriously sprained my ankle playing basketball. After a 2-3 months of rest and recovery from this injury, I started getting back into sport.  This is when I started to develop knee pain.

Now any form of running, jumping and sport (bball) induces pain, walking and stairs etc will also cause pain.  I can reduce the pain by using tight strapping just below the knee cap.  The pain is located below and under the knee cap.  There may be slight swelling but its definately not obvious.

I think the problem is either patella tendonitis or maltracking?

So what would be the best way of fixing this problem? Is there stretching exercises that would be helpful? I have good hamstring flexibility. However I believe a major cause of this problem is the fact that my ankle has a reduced range of motion due to cartlidge damage. This causes my ankle to roll inwards  :-/. I'm not sure, but I fear surgury may be the only way of fixing this ankle problem, which may be essential for stopping the knee pain?

I've tried some strengthing exercises, but these only seem to cause pain. It is quite possible or even probable that my VMO is relatively weak. However I don't know how to strengthen it without also strengthing the outer quad and the other knee does not have this same problem.

I've seen a couple PT's about this.  They have given some good advice -
stretch hip flexors,
stetch that band in the quad (although I can't really feel the stretch, I just feel it in my glute or hip joint),
squats (this causes pain and I dont think it really isolates the VMO - oh this PT seemed to think it was tendonitis),
straight leg raises (will this ever build strength?)

Any help would be greatly appreciated :)


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Re: little help? possible maltracking problem?
« Reply #1 on: December 10, 2004, 07:41:38 PM »
HI there AKH,

I have patella maltracking and I do leg raises till I feel I want to puke. It is a slow process but it does work. I have maltracking due to weak muscles (OS is hoping this is the cause) and I cannot fully extend my leg without horrible pain.

I am also trying to do short arcs- where you put a coffee can or rolled up towel inder the bad knee and lift your heel off the ground. I can only lift about an inch because it hurts so bad but adventually PT says it will get stronger and I will be able to do more. My PT says this is excellent to target the area around the patella.

Do you hear your patalla scraping or clicking or clunking?? Good indicator.

If your pain continues you should probably see an OS. They can help you determine if you have maltracking or tendonitis. Maltracking can turn into ugly problems down the road if not taken care of.

Hope this helps a bit

Offline AKH

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Re: little help? possible maltracking problem?
« Reply #2 on: December 20, 2004, 02:47:16 AM »
thanks for your help

I've being getting back into the leg raises. But I feel the primary problem is due to my foot being forced to roll inwards. So I will have to somehow find a way of stopping that.

My knees always used to make clicking noises, but lately there is a new cruching noise that aways occurs at the same knee angle and is associated with annoying pain.

I'm now sure that its a maltracking problem.


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Re: little help? possible maltracking problem?
« Reply #3 on: December 20, 2004, 03:04:32 AM »
If your foot is rolling you can get orthotics at the shoe store which might prevent your foot from rolling.

Usually does not help with the knee pain, but you have to start somewhere.

Offline AKH

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Re: little help? possible maltracking problem?
« Reply #4 on: December 23, 2004, 02:39:47 AM »
yeah I started using orthotics straight after I sprained my ankle. I believe the reason for my ankle rolling in is because I lost a lot of flexibility in my ankle after the injury and to overcome this loss of flexibilty my foot rolls inwards. I'm fairly sure that the loss of flexibility is due to cartlidge damage and not tight ligaments or muscles (when I do a calf stretch I get a feeling of compression in the front/right area of the ankle and not a stretch in the calf muscle).

I'm not sure if I can fix my knee problem without first fixing my ankle problem, and I don't know if I can fix my ankle problem without surgury.

Offline sweetheart0517

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Re: little help? possible maltracking problem?
« Reply #5 on: December 23, 2004, 06:32:20 AM »
I went to the Os thinking I had a ACL tear but come to find out i have a mal-tracking OS sent me off to PT and I did most of the exercises you described...straight leg raises, pro-stretch, stair exercises, a bunch of lifting exercises, and the I-T band stretch.

Have you gone to a doctor about this yet? If you havnt I would definately go to a doctor and talk to them about your pain, they will probably send you for x-rays and a Mri and off to a OS so you can get to the root of the problem.

As for if you believe you have a Mal-tracking problem, My OS told me that out of 100% of the people who have tracking problems 95% of them will be cured from the exercises done in PT. It just takes a answering your question yes they will definately build strength in your knee and most likely will cure your tracking problem...unfortunately it just takes a while  :-/ I know its frustrating to have to wait so long to fix something you want fixed fast but just hang in there everyday you go and every exercise you do your building up the strength in your knee and one step closer to getting better  :)......

Unfortunately I fell in that 5% range and am going in for arthoscopic surgery OS also thinks that I have meniscus damage so I dont want to scare you cause I am a completely different story....if you have any concerns about if your exercises are working you should talk to your PT, I asked mine about a million and one ?'s...thats what they are there for other then to guide you through the exercises  :)........

I don't know if this has helped at all but my advice to you would be to follow the PT program your going thru now and stay committed to doing them at home also...I wish you the best with everything and hope you feel better soon  :-*

Best Wishes
Lateral release 1-12-2005
Pt for what feels like forever...

Offline MHB

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Re: little help? possible maltracking problem?
« Reply #6 on: December 23, 2004, 08:03:16 AM »

Am a big fan of good shoes to wear post-injury. Some years ago, started long distance running without enough body frame density, had painful knee problems. A really good pair of Nike Air running shoes with a strong stabilization feature helped a lot with the "over-pronating" I was doing then.  And VMO isometrics made a previously invisible structure stand out like a cord. End of knee problems, thank goodness.

A few years later, broke a fibula -- ski tip caught on a small rock under the spring snow -- twisted the toe around clockwise until it broke the bone. The worst part of the injury wasn't the broken bone -- it was the damage done to the ankle, which got wiped. Swelled for a year, even though I could run on it.

Once more, same old Airs to the rescue. Was in graduate school then, had to walk across a huge campus night and day. When I wore the good shoes with the air cushion, was comfortable in spite of the swelling. When I couldn't wear them (i.e., uncasual dress required), I limped because the ankle hurt a bunch.

The injured ankle was weak, too. What helped that situation was the simple riser exercise -- you know, stand flat-footed, rise up on your toes, ease back down (stand on a book, heel hanging off, to add difficulty). At first, couldn't even get the injured ankle to work, but eventually things came round. Icing it helped a lot that year, too.

So, if you haven't, you might want to consider shoes, and best of luck for a speedy recovery of course.


PS If your knee is maltracking, ask a knee doc about performing the squats -- they put lots of pressure on the bottom of the cap and the groove surfaces. If the knee is off track while bent with all that weight on it, the pressure contact should hurt some. You might want to check to see if it's wise to do squats in a maltracking situation.
« Last Edit: December 23, 2004, 08:16:55 AM by HHB »
4/4/04 - Horizontal patella fracture
4/5 - ORIF 2 screws, figure8 wire, immobilizer, walker
4/16 -  cane
5/10 - no immobilizer
PT -- 5/17 to 6/8
OS Release - 7/12/04