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Dear Dr. Walt,
I wrote last week regarding my tibial plateau fracture (from December). I thought I would rephrase my question, however, as it seems to be too vague to answer. Anyway, I am currently experiencing (and have been since February when I was able to straighten my right leg again) a great deal of popping and shifting in my patella due to muscle weakness. I am wondering if this will ever disappear or if this sort of popping indicates other damage. Perhaps cartilage damage? The kneecap pops even when I am just standing and then shift position. I have tried taping, braces, etc. and nothing keeps it from popping. It becomes very aggravating and painful and my leg gets tired if I'm standing or walking too long. The popping intensifies by the end of the day at times if I've accidentally been doing too much acitivity.
I'm currently doing phys. therapy, so I am hoping for the best, but it's still not back to normal. Any thoughts?
In Reply to: re: popping patella posted by tiffany on August 12, 1999 at 11:34:31:
In other words, your knee muscles have weaknesses and bad habits (co-ordination of the muscles). There might be some Feldenkrais movements to help your knee 'learn' how to move properly. Perhaps a chiropractor or physical therapist could help you with this.
In Reply to: re: popping patella posted by tiffany on August 12, 1999 at 11:34:31:
Hi, tiffany.
This is an additional problem (chondromalacia patella) that is a common complcation of the terrible injury you had to your tibia. Your doc should have explained this to you. A good Chiropracter might have some good suggestions for you.
Let us know what you learn.
Walt
In Reply to: Mistracking of patella due to weak supporting muscles and poor muscle memory patterns. posted by Lincoln on August 13, 1999 at 12:52:09:
Thank you, Dr. Walt and Lincoln for your replies. I have been seeing a phys. therapist for about a month now, but my knee is still rather ornery most of the time. I have a lot of trouble standing for very long with my leg straight. However, if I walk rather fast, I don't seem to notice the popping or pain as much. I understand about the muscle weakness, but I feel like there might be something awry within the knee as well--perhaps the cartilage? None of the doctors I've seen have suggested that as of yet, although I am returning to my ortho on Wed. for a follow-up. I am to the point where I actually want my knee scoped just to make sure there is no structural damage in the patella (besides the tracking problems). Is it possible that cartilage damage could cause the kneecap to pop in this manner? The muscles around my knee must be incredibly weak still b/c I can just shift the position of my knee while sitting or standing and feel a hard pop. It baffles me that the quad is still not strong, as I've been exercising in every capacity possible (aside from running) since Feb. when I was able to walk again to some extent. I wonder if my quads were "used" to the kind of exercise I did before (mainly running)and are not as receptive to stat. bike and weights. I really want to run again and the doctors say that I will, but it's already been 8 months! Is this normal?
Thanks,
Tiffany
In Reply to: I still have a few more questions about my knee.... posted by tiffany on August 16, 1999 at 09:13:14:
n/t
In Reply to: Muscle strength often comes slowly. Depends on genetics, diet, and how aggressive your exercise program is. posted by Lincoln on August 16, 1999 at 12:53:28:
Does being small-boned and thin make gaining muscle more difficult? My leg muscles were always quite strong prior to my injury, but I lost the quads rapidly and they have been returning at a turtle's speed. The knee itself generally feels inexplicably "weird" most of the time, my leg becomes exhausted and then the popping worsens. I am constantly flexing my quad and lifting ankle weights when I am not at PT or the gym. I guess it would be helpful to talkt to someone who has recovered from this injury and has been able to return to "normal" exercise routines. Any clue how I might be able to chat with someone? Also, do you have any diet suggestions? I don't eat meat often, and maintain a very lowfat diet overall. I do drink coffee on a daily basis, however, which I suspect might be causing some problems.
In Reply to: Re: Muscle strength often comes slowly. Depends on genetics, diet, and how aggressive your exercise program is. posted by tiffany on August 16, 1999 at 14:20:24:
"Lowfat" is not all it is cracked up to be. Read books like Udo Erasmus "Fats that Heal, Fats that Kill", Barry Sears "The Zone", and Mario DiPasquale "The Anabolic Diet" for a different perspective.
Ankle weights (and wrist weights) are not very effective and are potentially harmful, especially if used during running. They aren't heavy enough to make significant progress on strength but they ARE heavy enough to throw off your stride, which will cause joint damage. Most women can deadlift or squat lift a 50 lb. child using their legs with little exertion; what good is a 5 lb. ankle weight in comparison? My 105 lb. girlfriend - who is not terribly strong - can deadlift well over 100 lbs.
Personally, I'm a "Squat-O-Holic." I do front squats, back squats, partial squats, squats with chains, dumbell squats, one leg squats; you name it. It pays to learn how to squat properly, ESPECIALLY if you have bad knees. There is NOTHING more effective for overall leg strength than squats. Done properly it is a VERY natural movement - the human body was built to squat. I'd start visiting some weight-lifting web pages to learn more about squatting. Most of them are frequented mostly by men, but that's just a social phenom - women seem to be afraid of lifting iron for some reason. Oh well; their loss. See the link below on a refreshing perspective from advanced lifters on lifting weights for strength.
In Reply to: I still have a few more questions about my knee.... posted by tiffany on August 16, 1999 at 09:13:14:
Hi, Tiffany.
MY bet is that when you are "scoped" that they will find damage. Let us kow what is found.
MY recommendation would be for you to bless the years you were able to run and NOW put that behind you. You need to begin swimming and doing under water exercises.
Eight months is NOTHING when dealing with this kind of problem. Were this me, I would be seeing a Rolfer, a Chiropractor, an Acupuncturist AND learning to do either Alexander Technique or Feldenkrais.
Walt
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