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dlm303
18th March 2003, 14:31
Has anyone had patello/femoral disorder? I'd appreciate hearing about anyone's experience. My orthopedist just diagnosed me and I'm starting physical therapy tomorrow.

Tal S
26th March 2003, 01:46
Is it a joint/bone problem or a soft tissue one? What are the symptoms?

Tal Stanfield

dlm303
26th March 2003, 15:20
It's a joint problem. When the knee bends (in my case, both knees), the patello slides to the outside instead of staying centrally located over the joint. It causes pain and instability and can sometimes cause soft tissue damage (although it appears that I have avoided that).

Tal S
26th March 2003, 23:20
Hi Debra:

I posted because of curiosity about your problem and the possible similarity to what I have suffered from in the past: chrondromalacia, a condition whereby the patella is pulled out of alignment by an imbalance between the vastus lateralis and the vastus medialis. For reference, these muscles are the two largest of the quadraceps group and they are on the left and right sides of the front of the upper leg, respectively (when looking down at your own leg).

For me, the cause was years of weightlifting doing wide stance squats and the like. The condition is also referred to as Runners' Knee. If your situation is due to a similar cause, you might rehab the leg by yourself by doing narrow stance lifts like leg presses for 8-15 reps, and even light (15-20 reps) leg extensions, making certain NOT to lock out your knees at the top of the movements.

I paid alot of money to one of the best knee specialists in the country to find all this out. Maybe you can benefit from my experience, and good luck. If you need any information on exercise selection and frequency, please ask. I have been a certified trainer in years past, as well as having had experienced a plethora of sports and martial arts related injuries with no lasting ill effects due to proper care and all importantly, REHABILITATION.

Tal Stanfield

Bruce Mitchell
27th March 2003, 01:20
Hi Debra,
I had/have this condition as well. In my case it is a genetic flaw that causes my kneecaps to slide to the outside. It makes a person more vulnerable to dislocations of the patella. After three severe dislocations on my left knee (My kneecap was literally on the back side of my knee) and breaking off a thumb nail size piece of my patella during one of the dislocations I had surgery to correct the condition on one of my knees (the other one is still buggered but does not give me as many problems). This was back in 1994, I travelled from California back to Massachuttes to be treated by Dr. Joseph Sklar, a truly gifted surgeon. He did what is known as a Fulcerson (sp?)shift with a lateral release to re-align my kneecap. It involves cutting out the portion of the shin bone where the pateller tendon attaches, moving over (so the patella tracks straight) and screwing the bone back into place, and then cutting (releasing) the tendon on the outside of the knee to minimize pull in that direction. Basically you have your leg broken surgically, and put back together.

The bulk of my physical therapy focused on balancing out the pull of the vastus medialis and the vastus lateralis ( as Mr. Stanifeld described).

It's a tough surgery to go through (minimum six mionths on crutches and a full year of rehab). At the time I went through rehab the physical therapist said that the only thing worse is total knee replacement. But that was about nine years ago now, my knee no longer hurts when I go up and down stairs,and I can train all day with minimal (compared to before) soreness.

I would add that since the surgery I have added regular weight training to my exercise routine (3X per wk) and have found this to be a vital part of my success in recovery. It has also been the best tool that I have found for pain management and to halt the unset of arthritis in my knees. I want to still be doing martail arts when I'm old and bald and toothless, so I see a lifetime commitment to maintaining my knees as a must.

Good luck, and don't settle for anyone but the best surgeon you can find.

dlm303
5th May 2003, 19:59
Bruce,

Thanks for the reply. My kneecaps also slide to the outside. It's good to know that surgery helps, although my plan is to avoid it if at all possible. I've completed eight weeks of physical therapy (basically all weight training) and there is definite improvement. Since I'm also planning to practice until I'm old (but hopefully not bald!), I'm going to continue the weight training.

Thanks again.

Joseph Svinth
6th May 2003, 03:17
http://www.merck.com/pubs/mmanual/section5/chapter62/62f.htm

Note that orthotics may help. (I like orthotics.)

dlm303
6th May 2003, 15:16
Strangely, I do not overpronate. In fact I underpronate, so I don't think orthotics are a feasible for me. Thanks for the tip, though. One thing that has helped is wearing a neoprene sheath during my classes.