T Nation

knee problems


#1

Over the progressing basketball season I've developed some kind of knee problem where it feels like there are pins screwing into my kness when I bend down into a squating type position. This has disabled me from doing any squating type movements, thus I would like to know some alternative exercises for the 'quads.' The only thing I can think of is leg press and leg extensins, however I don't have access to a leg press machine.


#2

If you have joint pain, why in the world are you trying to find ways to work your legs? Trying to work through pain will only make an injury worse. I know a swimmer who "worked through" some shoulder pain, only to find later that her competitive swimming days were over because she had aggravated the injury so much. Don't be stupid. Stop doing leg work for a while,ice your knees, and have your team's trainer look at them. If the pain doesn't go away, go see your doctor.


#3

Yeah man don't mess around with that stuff. A few years ago I hurt my knee, thought I could work through the pain. Turned out I had severed my ACL, and had been grinding cartilage while I tried to decide to go to the doc. Several knee surgeries later, I can definitely say don't screw around with that stuff. Get it checked out.


#4

sounds as if it could be a patellar tracking dysfunction. Have the trainer or a physical therapist look at it. They can prescribe some rehab exercises that should help to alleviate the problem. ice would also be good to releive swelling.


#5

Basketball is notorious for creating "itis" in knees (tendonitis, bursitis) as well a patello-femoral pain. First things first. A regular family physician visit will result in a prescription anti-inflammatory and most likely an "itis" diagnosis unless you have some other positive indications of ligamentous or cartilage injury. Try RICE (rest, ice, compression, elevation) for a couple of weeks to see if it resolves. You can also do some light stretching for the quads to get some tension through your quad tendons (assuming it is tendonitis). Train everything else that is not painful throughout this time. You can also take an over the counter anti-inflammatory (advil, ibuprofen, etc.). If it does not resolve, a sports medicine physical therapy referral may be beneficial as well as ART which does wonders for soft-tissue injuries.


#6

J,
Answer some specific questions and get back to me as soon as possible.
1. Where is the pain? Be as specific as possible.
2. What is your max squat and deadlift?
3. What is in season conditioning/injury prevention program like?
4. Assess your quad and hip flexor flexibility.
5. How much abdominal strength do you perform.
6. What was your physical preparation like before the season?
Get back to me as soon as possible. I'll have more questions at that time.


#7

The pain is on the inside top of the knee where the quad muscle appears to end/connect with the knee. My max squat and deadlift are about the same and I'd guess that they'd be around 300, I haven't tested them in over a year though. I don't really have a season conditioning/injury prevention program, coach just got us running and practicing a lot at the beginning of the season, we usually play 4 times a week on average, sometimes as much as 7 times a week if there are a lot of games that week or a tounament,(I play highschool basketball by the way), before the season I was lifting 4x a week, now Im doing 3x a week with slightly less leg work. For abdominal exercises I usually do 1 exercise after each workout for the abs. Before the season I was in good shape, however I had been playing soccor before the basketball season began.


#8

J,
For a basketball player your deadlift should be 15-20% higher then your squat. Questions:
1. If lying on your stomach can your heel touch your glute? How close is it? Does your back arch the closer your heel gets to your glute? You might need help with this 2. How much muscle mass do you have on the medial aspect of your knee? (vastus medialis) 3. When you sit on the end of a bench and extend your lower leg, how does your patella move? 4. Is this your dominant leg? 5. Previous injuries? 6. MRI or X-rays?
Get back to me.


#9

J,
At a glance, it seems you have patellofemoral syndrome. Stronski was trying to get you to test your range of motion in your knee. I'm going with him. I think your quads may be tight and are causing your knee cap to be raked across your Thigh Bone. This will cause a wearing of the cartilage under your knee cap that helps "lubricate" your knee joint. As a result, you feel pain on your thigh bone were you have pain receptors (you have none on your knee cap).

The best thing is rest, Ibuprofen (loaded over five days), ice and stretching of the quads. Throw some Chondroiton in to help regenerate the worn cartilage if you want, but stay away from glucosamine. I've had this problem too (can you tell?).

You can't stop playing, but you'll have to cease a lot of your other activities to allow your knees to heal. Failing that, there's a wonderful thing called Viox (ask your doctor).

The really bad news is, if I'm right, this could hamper you for the rest of your life. Start stretching and don't stop.

Keep in mind it's hard to make an accurate diagnosis over cyberspace, so go see your doc or therapist. Good Luck.


#10

Lying on my stomach my heel is about 6 inches from my glute, my back does slightly arch the closer my heel gets to the glute. For muscle mass on my vastus medialis i can clearly see the muscle definition when the leg is flexed, the front of the leg looks porportional to the back.My patella does appear to move when extending my lower leg while sitting. I have this problem in both knees however the dominant leg is more afected by the problem. I have no previous injuries and have had no mri's or x-rays
My brother has this same condition and he went to the doctor,who gave him orthos, however this didn't help him at all.


#11

J, my guess is that you should lay off quad dominant movements like squats. Reverse-hypers, glute-ham raises, romanian deadlifts, stiff-leg deads, good mornings, all will strengthen your posterior chain and take stress of your knee ligaments and tendons...


#12

Take pnfdog's advice and concentrate on hip dominant leg work for awhile. Also, Stronski was right, you're quadricep flexibility is horrible. Start a good stretching program. Stretch you quads and hip flexors. If you need help with this, let me know, otherwise, a good trainer will be able to help you.


#13

J,
The fellas are correct. Use the NSAID if you have to. Don't depend on it to get you through games/practices. You have to decrease or eliminate your other activities that may further cause your knee pain. Weekend basketball, volleyball, gym class, any activity where you may be falling or kneeling alot, like wrestling. Even just horsing around. You may not feel it initialy, but if you are as symptomatic as you say you are you'll feel it the next day and your practice/game will suffer because of it. Fix the problem. Begin the glute/hamstring and stretching work immediately! Also, I suspect that when you land from a rebound, layup, block shot, etc... you are not getting sufficant hip flexion. In other words you are landing stiff legged. Stick your butt out when you land, activate your glutes and let the glutes absorb your bodyweight.