Advertisement - Hide this advert





Author Topic: Painless "scrunch" upon extension of knee beneath knee cap.  (Read 3604 times)

0 Members and 1 Guest are viewing this topic.

Offline ALRunner

  • Regular Poster
  • ***
  • Posts: 78
  • Liked: 1
Painless "scrunch" upon extension of knee beneath knee cap.
« on: April 05, 2007, 01:55:59 PM »
I've been dealing with runner's knee for some time. I can run and have been somewhat competitive with triathlon as late as last year, but I have tightness even with very little activity and if I really step it up the tightness turns into pain with all the typical symptoms of runner's knee/chondromalacia.

When i stop activity for months, as I did recently, my knee gets 100% asymptomatic (no pain, no tightness) with exception of something that remains whether I'm otherwise very or not at all symptomatic: a knee "scrunch". When I extend my leg with my finger over my knee cap I can feel it scrunch into place. The last sports doc I saw about this was very laissez faire about it--in fact they all have been, but the end result is that I cannot do substantial activity without my symptoms returning and I'm entirely positive that it's becuse this scrunch/roughness, when put under the stress of activity, works up inflammation in the joint.

I've had an MRI that showed zero problems in this regard but I'm increasingly ready to push for an arthroscope because it seems to me there HAS to be some roughage underneath the knee cap. What else could POSSIBLY be causing this roughage if not that? If I do a bunch of unweighted extensions, the scrunch is there on extension 60% of the time and there on the bending (heel coming down) 100% of the time, like something is just continually clicking against a ridge or something.

BTW, when I squat down onto my heels there is an audible click every time. This scrunching, though, is not audible, but surely related to the same matter.

I'm 29.

Offline caroljm36

  • MICROgeek (<20 posts)
  • *
  • Posts: 17
  • Liked: 0
Re: Painless "scrunch" upon extension of knee beneath knee cap.
« Reply #1 on: April 05, 2007, 11:18:50 PM »
Are you doing extensions on one of those knee extension machines in a gym?

I've had several orthos and therapists tell me NEVER use those, they just make the problem worse if it is patella femoral syndrome.  Even though you see athletes doing rehab this way on the TV sports all the time. 

What they tell you do do is straight-leg lifts (while lying back on elbows) and leg press.

Offline ALRunner

  • Regular Poster
  • ***
  • Posts: 78
  • Liked: 1
Re: Painless "scrunch" upon extension of knee beneath knee cap.
« Reply #2 on: April 05, 2007, 11:25:30 PM »
Are you doing extensions on one of those knee extension machines in a gym?

I've had several orthos and therapists tell me NEVER use those, they just make the problem worse if it is patella femoral syndrome.  Even though you see athletes doing rehab this way on the TV sports all the time. 

What they tell you do do is straight-leg lifts (while lying back on elbows) and leg press.
Agree with you on that--I don't do them. Currently do basically nothing for my leg, actually. When I say "extension" I mean an unweighted extension of the leg while, say, in a chair or something.

You know I've tried those leg lifts but always found my hip exhausted before my quad, which isn't surprising because it's responsible for the entire leg's weight and the weight of the lower leg is really so little, though if I put my knee on a towel I guess it might work better. When I do anything, it's one-legged squats not below 90 degree bend.

Offline kimmyxs

  • SuperKNEEgeek
  • *****
  • Posts: 558
  • Liked: 3
Re: Painless "scrunch" upon extension of knee beneath knee cap.
« Reply #3 on: April 06, 2007, 06:53:40 PM »
You may want to see an OS, but in all reality, almost everyone as they age has some scrunch under their knee.  Runners have it even worse and you may have some damage under the patella.  Beware though, pushing for an artho may cause more problems than you are trying to solve.  Those scope holes can cause scar tissue to adhere - very painful.  I have had two surgerys to clean up under that patella since i have recoccuring dislocations (eventually breaking the patella itself).  Before I had scrunchy noises and even after two debridements, I still have it.   If it isn't painful and an MRI doesn't show anything, I would work jog or run less.  I have been reelased to do any activity except jog and run.  They both cause joint damage that isn't really reversable.  All those days of hiking (including two trips up an down the Grand Canyon) and riding tirials on my motorcycle have caused my joints to age. 

6/03/89 - First Knee Cap Disclocation
7/05/89 - Returned to work
6/17/06 - Tramatic Knee Cap Dislocation and Vertical Fractured Patella
6/28/06 - ORIF - Screws - no wires
8/24/06 - Ditched the brace - start PT
9/20/06 - First spinning
1/15/07 - screw removal, LR , VMO Advanc  & patella cleanupl

Offline ALRunner

  • Regular Poster
  • ***
  • Posts: 78
  • Liked: 1
Re: Painless "scrunch" upon extension of knee beneath knee cap.
« Reply #4 on: April 06, 2007, 08:53:35 PM »
You may want to see an OS, but in all reality, almost everyone as they age has some scrunch under their knee.  Runners have it even worse and you may have some damage under the patella.  Beware though, pushing for an artho may cause more problems than you are trying to solve.  Those scope holes can cause scar tissue to adhere - very painful.  I have had two surgerys to clean up under that patella since i have recoccuring dislocations (eventually breaking the patella itself).  Before I had scrunchy noises and even after two debridements, I still have it.   If it isn't painful and an MRI doesn't show anything, I would work jog or run less.  I have been reelased to do any activity except jog and run.  They both cause joint damage that isn't really reversable.  All those days of hiking (including two trips up an down the Grand Canyon) and riding tirials on my motorcycle have caused my joints to age. 


Thanks! I will see an OS, but I am hestitant to get a scope, definitely. I never see medicine as a panacea. The unfortunate thing is that basically any activity causes pain--although very mild--but it's there. I can live with it, but want to ideally prevent the joint from going to hell too early in life. I could train for and run a marathon right now and the pain would never get more than moderate, but even if I run just 2 miles a few times a week it's still there mildly, so it seems that the only way to get 0% pain is to do 0% activity, whereas "100%" activity only brings the pain to 30% (if I thought 100% would be screaming in agony). Also, the same goes for cycling, not just running.

To aid in my description, the scrunch I describe is not the "creaking door" that many joints--including my good other knee--have, but a definitely kind of shift noticed at one particular point in the patella's motion.

Offline kimmyxs

  • SuperKNEEgeek
  • *****
  • Posts: 558
  • Liked: 3
Re: Painless "scrunch" upon extension of knee beneath knee cap.
« Reply #5 on: April 08, 2007, 04:38:24 PM »
I would guess that the OS will find that there is cartilege damage under the patella itself.  I have had the crabby looking stuff removed twice, but I still have significant crunchy noises there.  At least they no longer cause pain.  A good OS or sports doc who specializes in knees should be able to diagnose your problems.  I hate giving up on activities that I love.  I cannot wait to get back to bowling and biking, but the weather has hindered the biking lately.  I had a cataract removed so I have to wait one more week to bowl.  How frustrating.

Would I have given up activities that I loved when I was younger knowing what I know now - not on your life.  I guess I am just paying for it now.
6/03/89 - First Knee Cap Disclocation
7/05/89 - Returned to work
6/17/06 - Tramatic Knee Cap Dislocation and Vertical Fractured Patella
6/28/06 - ORIF - Screws - no wires
8/24/06 - Ditched the brace - start PT
9/20/06 - First spinning
1/15/07 - screw removal, LR , VMO Advanc  & patella cleanupl

Offline ALRunner

  • Regular Poster
  • ***
  • Posts: 78
  • Liked: 1
Re: Painless "scrunch" upon extension of knee beneath knee cap.
« Reply #6 on: April 08, 2007, 06:17:20 PM »
Would I have given up activities that I loved when I was younger knowing what I know now - not on your life.  I guess I am just paying for it now.
Glad to hear it. GOod luck :)