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Author Topic: Trochlear dysplasia/patellofemoral constant ache/pain  (Read 769 times)

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Offline Karatejenny

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Trochlear dysplasia/patellofemoral constant ache/pain
« on: April 12, 2020, 01:28:22 AM »
Hi I was hoping for some advice on what to do. June last year I went to docs with knee pain, scan in September showed I have mild trochlear dysplasia in my right knee with a shallow groove, mild laterally placed patella with features of lateral patellofemoral impingement (fat pad impingement). By the time I saw the orthopaedic in December 2019, Iíd also been having pain with my left knee. He recommended physio therapy to strengthen my leg muscles and pull the patella across (I think thatís what he said). Iíve been at physio every 4 weeks since the start of January and so far I hope it is going well. My problem now is I still have a constant aching pain in my right knee. I have tried taking painkillers for it but it ended up me taking them all the time every day and upset my stomach, even with gastrointestinal tablets. I am continuing with physio exercises while at home but can anyone recommend anything for the pain? Iíd say itís like 3-4/10 all the time.
Thanks!

Offline Aly0108

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Re: Trochlear dysplasia/patellofemoral constant ache/pain
« Reply #1 on: April 12, 2020, 06:47:30 PM »
Karatekenny


Hi, did you check you pelvis ? Check you pelvis first, because it causes most of PFS.

Offline Karatejenny

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Re: Trochlear dysplasia/patellofemoral constant ache/pain
« Reply #2 on: April 12, 2020, 09:04:39 PM »
Karatekenny


Hi, did you check you pelvis ? Check you pelvis first, because it causes most of PFS.

Thanks for your reply, I havenít no, I think my MRI was only my knee area. What could I look for?  I will mention it to my physio next time they are open

Offline Vickster

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Re: Trochlear dysplasia/patellofemoral constant ache/pain
« Reply #3 on: April 12, 2020, 09:37:38 PM »
Has the physio tried taping the kneecap away from fat pad to see if that helps? And also to replicate what he is trying to achieve with the rebalance of the muscles?

If the fat pad area is sore or swollen, you could try ice massage.  Put some oil on the skin, take an ice cube and rub it across the oily skin (bio oil, olive oil or similar) for a few minutes (keep the ice cube moving all the time to avoid ice burns).  You could try Biofreeze too (not sure if it's available globally)

If you can't tolerate oral NSAIDs, ask your doctor about using a topical preparation, like Voltaren

You might find some useful info here
https://www.kneeguru.co.uk/KNEEnotes/primers/patella
and elsewhere in the learning portfilio :)
« Last Edit: April 12, 2020, 09:58:05 PM by Vickster »
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline Karatejenny

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Re: Trochlear dysplasia/patellofemoral constant ache/pain
« Reply #4 on: April 13, 2020, 02:40:50 PM »
Has the physio tried taping the kneecap away from fat pad to see if that helps? And also to replicate what he is trying to achieve with the rebalance of the muscles?

If the fat pad area is sore or swollen, you could try ice massage.  Put some oil on the skin, take an ice cube and rub it across the oily skin (bio oil, olive oil or similar) for a few minutes (keep the ice cube moving all the time to avoid ice burns).  You could try Biofreeze too (not sure if it's available globally)

If you can't tolerate oral NSAIDs, ask your doctor about using a topical preparation, like Voltaren

You might find some useful info here
https://www.kneeguru.co.uk/KNEEnotes/primers/patella
and elsewhere in the learning portfilio :)

Hi thanks for your reply. He did try taping last time but it didnít stay on with the exercises he wants me to do (squats and lifting leg) but he did mention that he could try different taping next time he sees me, although Iím not sure when that will be since my last appointment was postponed.
Thanks for those links, they help me understand it a lot more, I struggle with the medical jargon most of the time!
Thanks for the idea, I have tried icing it and using a heat pad too but it only lasts so long as the pad is on my knee, as soon as it gets back to normal temperature it starts up again. I will give the ice massage a go. Once the doctors is open again I will ask about the Voltaren, thanks

Offline Vickster

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Re: Trochlear dysplasia/patellofemoral constant ache/pain
« Reply #5 on: April 13, 2020, 04:39:01 PM »
What country are you in? In the U.K., you can get voltaren at a larger a supermarket or a pharmacy, no Prescription needed

Iím surprised youíre trying to squat with painful kneecaps?
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline Karatejenny

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Re: Trochlear dysplasia/patellofemoral constant ache/pain
« Reply #6 on: April 14, 2020, 12:42:08 AM »
What country are you in? In the U.K., you can get voltaren at a larger a supermarket or a pharmacy, no Prescription needed

Iím surprised youíre trying to squat with painful kneecaps?

Oh nice, yes Iím in the UK I will have a look next time I am out, thereís a pharmacy inside one of the supermarkets near me. Itís not too difficult on good day but from what I can remember the physio said heís focusing on building my quad muscles up first to see if it will pull my kneecaps back across? If that makes sense I hope it does. Before I saw this specialist one, another told me to just do leg raises and similar but I assume itís because he wants to focus on just the quads? Iím not sure, hopefully I can try arrange a telephone call or something to double check Iím doing it righ otherwise it is going to be a while until I can see a physio again at this rate!

Offline Userhere123

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Re: Trochlear dysplasia/patellofemoral constant ache/pain
« Reply #7 on: May 08, 2020, 05:47:33 AM »
Hi I was hoping for some advice on what to do. June last year I went to docs with knee pain, scan in September showed I have mild trochlear dysplasia in my right knee with a shallow groove, mild laterally placed patella with features of lateral patellofemoral impingement (fat pad impingement). By the time I saw the orthopaedic in December 2019, Iíd also been having pain with my left knee. He recommended physio therapy to strengthen my leg muscles and pull the patella across (I think thatís what he said). Iíve been at physio every 4 weeks since the start of January and so far I hope it is going well. My problem now is I still have a constant aching pain in my right knee. I have tried taking painkillers for it but it ended up me taking them all the time every day and upset my stomach, even with gastrointestinal tablets. I am continuing with physio exercises while at home but can anyone recommend anything for the pain? Iíd say itís like 3-4/10 all the time.
Thanks!
Hi
Did you get a chance to see your physio again?
I am having the same issue for past 9 months. I was going to PT for 6 months. Doing the exercises at home since lockdown started.
Mine was pfps. Lateral Patella subluxation and alta.
I have burning pain and swelling on the top right side of the knee. It burns throughout the day.
Doctors said only PT can help. Pt helps me to strengthen my weak glute muscles and quad muscles. So doing the exercises. You should check with your doctor or physio again.

Offline Karatejenny

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Re: Trochlear dysplasia/patellofemoral constant ache/pain
« Reply #8 on: May 09, 2020, 10:35:40 PM »
Hi I was hoping for some advice on what to do. June last year I went to docs with knee pain, scan in September showed I have mild trochlear dysplasia in my right knee with a shallow groove, mild laterally placed patella with features of lateral patellofemoral impingement (fat pad impingement). By the time I saw the orthopaedic in December 2019, Iíd also been having pain with my left knee. He recommended physio therapy to strengthen my leg muscles and pull the patella across (I think thatís what he said). Iíve been at physio every 4 weeks since the start of January and so far I hope it is going well. My problem now is I still have a constant aching pain in my right knee. I have tried taking painkillers for it but it ended up me taking them all the time every day and upset my stomach, even with gastrointestinal tablets. I am continuing with physio exercises while at home but can anyone recommend anything for the pain? Iíd say itís like 3-4/10 all the time.
Thanks!
Hi
Did you get a chance to see your physio again?
I am having the same issue for past 9 months. I was going to PT for 6 months. Doing the exercises at home since lockdown started.
Mine was pfps. Lateral Patella subluxation and alta.
I have burning pain and swelling on the top right side of the knee. It burns throughout the day.
Doctors said only PT can help. Pt helps me to strengthen my weak glute muscles and quad muscles. So doing the exercises. You should check with your doctor or physio again.

Hi thanks for your reply. I havenít managed to see the physio again since lockdown, and I have now seen/spoken to 4 different physios and had to explain everything all over again! I have been given different exercises from last time to see if I can do all round strengthening of glutes, quads and hips, hopefully to calm the pain down a bit. Iím hoping once lockdown is over I will see the same physio and not a different one! Has the pain gone down for you or is it just the same? Yes I think my doctor mentioned something similar about the patella alta on mri report. Does it affect your walking and exercising?

Offline Userhere123

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Re: Trochlear dysplasia/patellofemoral constant ache/pain
« Reply #9 on: May 11, 2020, 12:04:44 AM »
Hi I was hoping for some advice on what to do. June last year I went to docs with knee pain, scan in September showed I have mild trochlear dysplasia in my right knee with a shallow groove, mild laterally placed patella with features of lateral patellofemoral impingement (fat pad impingement). By the time I saw the orthopaedic in December 2019, Iíd also been having pain with my left knee. He recommended physio therapy to strengthen my leg muscles and pull the patella across (I think thatís what he said). Iíve been at physio every 4 weeks since the start of January and so far I hope it is going well. My problem now is I still have a constant aching pain in my right knee. I have tried taking painkillers for it but it ended up me taking them all the time every day and upset my stomach, even with gastrointestinal tablets. I am continuing with physio exercises while at home but can anyone recommend anything for the pain? Iíd say itís like 3-4/10 all the time.
Thanks!
Hi
Did you get a chance to see your physio again?
I am having the same issue for past 9 months. I was going to PT for 6 months. Doing the exercises at home since lockdown started.
Mine was pfps. Lateral Patella subluxation and alta.
I have burning pain and swelling on the top right side of the knee. It burns throughout the day.
Doctors said only PT can help. Pt helps me to strengthen my weak glute muscles and quad muscles. So doing the exercises. You should check with your doctor or physio again.

Hi thanks for your reply. I havenít managed to see the physio again since lockdown, and I have now seen/spoken to 4 different physios and had to explain everything all over again! I have been given different exercises from last time to see if I can do all round strengthening of glutes, quads and hips, hopefully to calm the pain down a bit. Iím hoping once lockdown is over I will see the same physio and not a different one! Has the pain gone down for you or is it just the same? Yes I think my doctor mentioned something similar about the patella alta on mri report. Does it affect your walking and exercising?
Hi,
I have something called  patella alta on my MRI. It means patella is on the top than usual. For me it's congentinal.
I have patella subluxation now. Since I have patella alta, the knee cap is not tracking properly. It's been 9 months and I have constant burning pain.

Offline Aly0108

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Re: Trochlear dysplasia/patellofemoral constant ache/pain
« Reply #10 on: May 11, 2020, 06:07:26 PM »
Karatekenny


Hi, did you check you pelvis ? Check you pelvis first, because it causes most of PFS.

Thanks for your reply, I havenít no, I think my MRI was only my knee area. What could I look for?  I will mention it to my physio next time they are open

When you walk your pelvis is not stable, pelvis can not stabilize you body, outside of one leg becomes tight because opposite glutes medius is weak. It is not knees problems. Root cause is your pelvis , hip. Strong glutes - strong knees. You have tight outside, you need strengthen opposite muscles adductors, not quads.

Quads and hamstrings are not root cause of knees pain, it is wrong theory.
First you need to stabilize your pelvis, what glutes are weak, to strengthen only weak glutes. Opposite of your glutes are adductors also to see what adductors are weak.

Offline Karatejenny

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Re: Trochlear dysplasia/patellofemoral constant ache/pain
« Reply #11 on: June 11, 2020, 10:06:54 AM »
Karatekenny


Hi, did you check you pelvis ? Check you pelvis first, because it causes most of PFS.

Thanks for your reply, I havenít no, I think my MRI was only my knee area. What could I look for?  I will mention it to my physio next time they are open

When you walk your pelvis is not stable, pelvis can not stabilize you body, outside of one leg becomes tight because opposite glutes medius is weak. It is not knees problems. Root cause is your pelvis , hip. Strong glutes - strong knees. You have tight outside, you need strengthen opposite muscles adductors, not quads.

Quads and hamstrings are not root cause of knees pain, it is wrong theory.
First you need to stabilize your pelvis, what glutes are weak, to strengthen only weak glutes. Opposite of your glutes are adductors also to see what adductors are weak.

I will ask my physios next time I see them, thanks
For this. So far I have now spoken to 5 different physios who all have different ideas on how to solve my problem! I have got rid of knee dips exercises and now back to leg raises and bum bridge on the floor exercises.

Offline Karatejenny

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Re: Trochlear dysplasia/patellofemoral constant ache/pain
« Reply #12 on: June 29, 2020, 04:49:47 PM »
Me again, Iíve been having more pain in my knees recently and itís all the time much worse than before. Iíve tried ibuprofen gel every four hours which seems to dull it but the pain is still there. Iíve tried icing but the cold makes it feel worse. Iím starting to feel like the doctors have got it wrong and it might be something else, Iíve been doing physio for nearly 6 months and they feel worse than they did last year when I saw the first doctor! Does anyone have any more advice? Iím going to try and get a docs appointment soon to see if they have any other ideas or refer me back to orthos.















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