Medial Knee Pain Alignment issue? Photos included

Just an update on the bow legging, I took some more shots- one with the foor turned out and the knee looked more inline- but not really more comfortable to walk that way. I also intentionally bowed my left femur in a little and it made the tibia look more bowed. I just hope I can figure this out.

Orthoics unfortunately do not help. My left is actually pronating much more from another shot I took- probably from right knee issues. I do notice the bowing more and I am not totally sure if I had that much before injury. My knee was absolutely 100% perfect in function before this happened. I could do anything and it never hurt- never even felt any sensation in the knee it was so darn good. 

Yesterday my ortho said the patella was tracking good. I was laying back when he ran that test. I did not demonstrate the image I posted because he said strengthen the medial quad. I had a "good" workout today before this photo, so I am geting upset that all this work has been useless trying to fix the main issue. At least the pain is not "as bad" with the increase in strength but forget running since walking needs to be the first step.

Hi, you mentioned that your left foot is over pronating more and that the problem is with your right knee. Have you considered leg length discrepency? Over pronation on one side can be suggestive of a longer leg meaning overcompensating on the left which may be a factor in your right knee problems. Just a thought ?

robert

Meant to say overcompensating in the right side. Not left

Do you mean the left leg is longer and conpensating by dropping the arch?

Probably. I can assure you the problem is altimately with the right knee. In isolation, or whatever, it is all right side related. Anything going on with the left is a result of compensations from the right side. Although one strange thing is when the right side feels better, the left kneecap starts to cause trouble.

Anyway, my legs are the same size, never a problem before with anything until overuse injury. In other words, it can be corrected as it is not bone related. I will say last summer when I tried to run it felt like I was stepping into little potholes with the right leg- it is not so bad now but I do not run anyway- that wold be insane right now. I only noticed the pronation after I took the photo. The injury came from getting up and down for 8 hours two hours two days in a row after being on my knees- I used my right/dominant knee to stand up each time. Muscles got tight, knee cracked (painlessly) as a result a couple time, and had pain since- also got pain at bottom of knee resetting some uneven tile- it is hard to pry them up after being set down.

12 days later my knee started cracking while walking. I suspect muscles shut down from pain and it was more downhill from there. I feel I got all my muscles back to where they need to be but my inner quad does not fire properly in relation to my other muscles. The inner hamstring and outter quad fire first upon contraction. The hamstring really shouldn't fire at all like it is, but as long as the inner quad/vmo does not, it will and cause tightness/pain and alignment issues. When I feel the vmo fire while walking, the knee pain goes away.

I should mention I have very high arches- definately not the foot causing it. They don't even sell supports for me in stores. My one foot does not register on the machine but this is not the issue.

I am trying to find the cause, not treat a symptom which is hard online, and hard apparently for 7 professionals that I saw. It would be like giving a lung cancer patient a cough drop because he is coughing too much- find out why. Two of the orthos strongly suggested quad strengthening, esp inner/vmo. That is the theory I have to go on as symptoms seem to help with this. 

My hope is that when the vmo fires, it will Relax the outer quad and hamstrings since they are acting like knee stabilizers- real crappy job they do however. When they do they are overworked and tighten, pulling everything out of wack. I can feel this tightness in isolation compared to the left side. When they relax I can feel my glutes work too- I've only worked my glutes hard for 12 months so that theory is crap too- strengthen the glutes and all will be good. They to start teaching physios about the quads again- everything needs to be looked at but 99% of them do not know squat about rehab when it comes to compensations from injury/muscle wasting. I had two of them tell me my quads were fine, even when I know for fact my vmo was all but dead! 

Hi Steve, it's just an alternate theory to check out that your legs are equal in length. Just thinking out the box for a cause of your problem.

robert

I tried the heal wedge and all that but it did not help. I just can't believe a muscle imbalance can cause pain and dibilitaion like this. With a clean MRI and a year of rehabbing and still a ways away from hopefully a resolution. Completely mind-boggling. I see people walking all crazy from other conditions yet they have no pain. I see people walking toed-out and yet no pain. I cannot make it from my bed to the damn bathroom without pain...and I bust my butt rehabbing and resting while I see 350 lb. people older than me getting around with no problem...my Mom had an mri and had a torn meniscus, two cysts, grade 3 of 4 arthritis, grade 2 mcl sprain. She had the meniscus clipped, did virtually no rehab and at 76 it getting around better than! I'm glad for her but W-T-F!

I understand your frustration. I'm a podiatrist in the U.K. and I was racking my brain out for answers. Let's hope it does improve.

If you have any ideas on flexion contracture I'd like to hear them. I believe that is a big problem that went unrecognized with all the 7 pros I saw. It may be muscular related as a few nights ago I was able to, with some awkward effort, get to full extension. But of course like everything it is temporary. This is really throwing my gait forward on one side. What blocks extension is hard to tell because that too seems to change- sometimes back of the knee, sometimes front. It isn't anything consistent. 

With the bed stretch- just move your femur around to change pressure points, and rotate your femur to get a different stretch- this will relieve pressure so you can do this longer.

My thoughts on physio are that I had 3 of them and all failed me- made me worse off! I also know 4 other people that failed physio in the last year with no success stories so physios are clueless imo.

The leg entension machine is the only machine I could get to hit my quads. Now mind you I believe I have rotational issues and no exercise including walking was hitting the inner quad. The leg extension did, athough painful to start. Some days I had to quit because I could not get the knee loose. 10 lbs. was hard!

Today I made it to 160 lbs. with both legs- pretty much even pressure on both. 

For you, start with short arcs near extension. Use your other leg to raise the bar to get you started. Turn your leg out a little if you need to hit the medial quad to start. Check your patella tracking and make sure it is not too painful or grinding too much. Go slow to start. I am sure these are not fr everyone but I can say the last two times I did these I felt much better but it takes time and strength. It will hurt to start if there is no muscle to support you- oh, place the bar a little higher than your ankle if you can adjust to take a little pressure off the knee. Good luck.

I tried 3 physios including sport- they all made me worse off. I am trying to get my inner quad going. I have strength in it now but I am lateral quad dominant. My hamstrings also fire better/quicker when I try to contract my inner quad/vmo. The few times in the last three weeks when I feel my inner quad firing while walking is when the verious pains go away and the imbalance seems to go away as well. Then the opposite kneecap starts to act up!