Saturday, July 18, 2009

'Why do I have knee pain?' Take 3

This is the fourth in an ongoing series of advice columns featuring your questions about common running ailments, with answers from certified chiropractic sports physician Scott Greenapple of Greenapple Chiropractic Sports & Wellness on Park Road (full bio here).

If you have aches, pains or anything else you're wondering about injury prevention, send me an e-mail and I'll work with him to provide you with some guidance. Meanwhile, let's get to today's question ...

Q. I've had recurring pain in my left knee. I can walk fine. I can even run. But it hurts when I bend it and then stretch it out. The cartilage in the middle burns for about five minutes and then stops. It's the worst at night when I curl on my side for a long time, then try to stretch out my leg. The burning is horrible. I am not very athletic and never had an injury. What could this be? --Karen

Dr. Greenapple says: There can be many reasons for your knee pain, but a few come to mind based on your symptoms. When the knee remains bent it pulls on the patellar tendon. This is a tendon that comes from your quadriceps muscles (thigh muscle) and attaches to the kneecap. If the Quads are tight or have scar tissue preventing them from stretching properly, they shorten -- which puts a pressure and pulling on the patellar tendon called patellar tendonitis. You may also have a tear in the cartilage (possibly the meniscus) that gets "caught up" when the knee goes from bending to straight. Does it click, pop, or lock up? These can be signs of cartilage issues. The best and most definitive answer would be to have the knee properly evaluated by a sports physician. Most knee pain without trauma can usually be dealt with and "fixed" with proper therapy, and rehab exercises. The knee is a joint between the hip and the foot, and the entire kinetic chain should be looked at for biotechnical faults and proper muscle balancing and strengthening techniques.