T Nation

Knee Problems


#1

When I'm on a bench and I flex and extend my knees while covering them with a hand - well on my left knee I can feel a little bit of popping and crackling, but hardly anything major, but on my right knee - well, damn if it doesn't feel like a sack of marbles in there - all sorts of grinding and popping.

Now it doesn't hurt at all...yet...but if this is symptomatic of something wrong in there I'd like to know now - I've never been injured in my 8+ years of training, but I don't want to be one of those guys 5 years from now who can't squat anymore because of chronic knee problems, all because he didn't get his knee fixed years earlier...so even though there's no pain associated with the grinding I feel, anyone have any idea what's going on? Is it possible it's the start of something bad? Any and all replies welcome


#2

I've got the same problems with my left knee-sounds like rice krispies in there. Started acting up after I started riding the security bike for a securuty cao. I work for this summer.


#3

Do a search for "crepitus" and read up.


#4

I'd guess it's either articular cartilage damage and/or your patella going slightly off track. in any case, I'd see an OS who works with athletes and get it checked out.


#5

In the short term, for relief you can stretch your rectus femoris and quads along with your Psoas and other hip flexors. There's an 'Iron Dog' column that outlines a good progressive strecthing program for those areas.

You may need soft tissue work to free up a quad that isn't firing, or you could need some recruitment work for certain muscles that aren't firing properly on your 'hurt' leg.

Also sounds like you have a strength imbalance between your legs. Try some of Ian King's Quad dominant unilateral exercises to find out if this is the case and use them to correct the imbalance. You'll find that stuff in the 12 week programs that Ian wrote for lower body.


#6
 My recruiter for the Marines has the same thing - because he's been running 5 miles a day for the last 8 years. He bent his knees to explain why the Marines now conduct most of their runs in bootcamp in SNEAKERS, and only an occasional run in boots.


 He said it was arthritis, and his knees popped like popcorn.

#7

This is a fairly common problem called Chondromalacia patella, or chondro for short. Basically the cartilage underneath your kneecap has become rough over time due to a unnatural gliding of your kneecap against the condyles of your femur.

Now before you get ready to jab a scope into your knee you should know that there are a couple of types of cartilage in your knee. There is the meniscus which is the shock absorber that sits between your tibia and your femur. There is also articular cartilage, which covers and protects joints.

Think of the cartilage on your knee as a paved road. Over time you have developed some pot holes. When you drive over a smooth road, you don?t notice anything. When you drive over a road with imperfections in the surface it can be an uncomfortable ride.

Pain will usually occur with squatting motion, climbing stairs, and sometimes after a period of inactivity (long drive, watching a movie).

The good news is that most everyone has some degree of chondro, some worse than others. Typically chondro is caused by a weak VMO (vastus medialis oblique) or the tear drop muscle in your quad. The knee cap is kind of like the rope in a tug of war. There is a constant battle going on in your knee between the VMO and the vastus lateralis.

There should be a distinct firing pattern of your quads beginning with the VMO and the other 3 muscles following suit. The VMO is strong, but lazy if the VL fires before the VMO its not strong enough to battle the rope back to the middle and the kneecap slides toward the outside of you leg. If the VMO fires at the same time or slightly before the VL then there is a standoff resulting in the kneecap tracking in the groove of the condyles like it should.

Sometimes there are flexibility issues involved as well. Watch out for a tight IT Band and hamstrings, as they are often culprits of a poorly tracking patella.

If there is no pain associated with the crunching be aware that you have the problem, and should begin to try and prevent any further rubbing.

Focus on VMO strengthening, stretch your hammies, and IT band. Severe cases can benefit from McConnell Taping to help unload the VMO and re-educate it.

They are working on surgical procedures to replace the cartilage, either with lab produced cartilage, or by growing new cartilage from a sample taken from the knee. Unfortunatly they are not very successful yet.


#8

wow, thanks for the comprehensive reply;
let me see if I can sum up what you had to say in layman's terms (for myself) minus the scientific jargon:

It's a fairly common problem, that most everyone has to some extent; if there's no pain, you're OK, just be aware that you have the condition, and watch for it worsening. Stretch. A lot.


#9

I've got the same symptoms as you domino. Right knee is worse too. I can hear it when I walk up stairs. I'm starting to feel some pain now and guess it's time to get it evaluated.
Thanks to Tree for that excellent explanation.