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IT Band and Patellofemoral Syndrome: how did your knee pain turn into a ‘syndrome’?

Jogging
photo: Ed Yourdon

Over the years, the medical community has created a need to give everything that can go wrong in your body a name; e.g. lateral epicondylitis (‘tennis elbow’),  patellar tendonitis (‘jumpers knee’).  A lot of the pain related conditions were defaulted to something ending in ‘itis’ implying an inflammation of a particular tendon or bursa, but these diagnoses only really apply to people in the acute phase of pain or injury.  Quite often people continue to experience pain or dysfunction for months in the complete absence of swelling or inflammation.  Labeling a five month old elbow or knee problem a tendonitis is just not accurate or helpful to the person in pain.  The solution became to call them a tendonosis which acknowledges the tendon is not actively inflamed, but there is ‘disorder in the tendon.’

People tend to seek a diagnosis, but what they are really after is an explanation of why.  When it comes to persistent pain, a diagnosis just gives you something to tell your family or employer ‘what you have,’ but typically does very little to help you get rid of it and can even hinder your progress.  Most persistent pains in your body develop from a combination of mechanical, cognitive and emotional reasons and where it actually hurts is just the symptom at the end of a chain of events.  Unfortunately most doctors’ knowledge level on musculoskeletal pain is limited to the area where it hurts and not the chain of events that made it hurt.

I try my best to not tell you ‘what you have’, but instead explain to you ‘what is going on.’  It is usually way more information than you were anticipating, but makes all the difference when it comes time to convince you that you may have to change some of your habits. 

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Posted in Blog, Feet, Hips, Knees, Pain Tagged with: , , , , , , ,
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Why Knees Hurt


Me day after knee surgery 

What better time to write about ‘why knees hurt’ than a day and a half after knee surgery as I sit here jealously watching joggers bounce along the sea wall on a gorgeous Vancouver day.  I am hiding out from my three little kids today to give my meniscus a chance to calm down.  It was a relatively minor surgery, but my knee is very swollen none the less.  I can add this one to my list of injuries and operations that help me experience empathy for my clients instead of sympathy.  Unfortunately, over the years, I have been way too good at market research for my work as a physiotherapist!  This article will hopefully help prevent you from sitting where I am today, or at very least know when to take the plunge and have surgery on that persistent, nagging knee pain.

A little bit of basic anatomy will give you a better context to understand your knees and this article.

 

Your knees are simply big hinge joints that are built to flex and extend.  They are held together by four major ligaments called your MCL, LCL, ACL & PCL.  Sandwiched in the middle of the joints are two C-shaped cartilage cups called your medial and lateral meniscus; these act as both shock absorbers and stabilizers.  On the front of the joints your knee caps function to protect your knees and act as levers to help strengthen the pull of your thigh muscles.

knee muscular anatomy

 

When I assess people complaining of knee pain, my first goal is to determine if one of the above mentioned structures is physically damaged or is something simply disturbing the mechanics of the joint, creating friction and causing pain.  I would say that 90 percent of the time it is the latter. 

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Posted in Blog, Knees, Pain Tagged with: , , , , , , ,
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Basic Knee Anatomy

Here is my YouTube video outlining the basic relevant and functional
anatomy of the knee using an anatomical model.

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Posted in Anatomy, Blog, Knees Tagged with: , , , , , , , ,
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