Knee Pain - Plica?

For the last 8 or 10 weeks, after a lower body session of some jumps and then squats, my left knee, right above and medial to the patella, has been really sore for any activity like squatting, lunging, step ups, etc. There is no pain doing sprints, or even jumping if there is limited knee flexion, but as the knee approaches 90 degrees the pain gets worse and worse. The knee feels the best in the morning, and gradually seems to get more sore and achy as the day goes on and after training, even if the training itself was pain free.

Before this session it occasionally bothered me, never in training, just would seem to get stiff if I was standing for long periods of time. I never knew if it was just general “patellofemoral pain” or some type of quadriceps tendonopathy.

Physio has been treating it like a tendonosis injury, having me do single leg squats on a decline board, but it hasn’t progressed much at all, and the rehab just seems to aggravate it. I would have thought that if it is the tendon that is the problem, that tension on it regardless of knee position should hurt it, but I can do things like leg extensions at the end range of motion with no pain at all, its only as the amount of knee flexion increases that it gets painful.

I have also got some ART done on the quad a few times, not sure if it has helped or not though.

The one thing that makes me think of a plica type injury is that if my knee is motionless for a short while, and then I try to bend and/or straighten it, there is a distinct “snap” sound that comes from the medial side right above the patella, where the majority of the pain is coming from. The snap itself doesn’t hurt most of the time, but it seems like when the knee is aggravated the snap will be painful. Before I hurt the knee, I occasionally noticed this snap, but it was never associated with pain, and since I hurt it the snap seems to be louder and happen more often.

Does anyone have any advice for this type of thing? Thanks in advance

I have injured knee past year during PE class. Fish oil seemed to help me alot. When my knee seemed to be ok, I started training and pain occurred again. That happed to me few times and pain occurred again and again for many months. So don’t push, it takes time.

Yeah mine will not seem to heal at all. Any others have advice for this?

how about a knee cap tracking issue, the cases I have heard of were treated with a short range squat with knees vertical of the ankle, Paweki would have more knowledge than me on how it is done properly

You may want to try these:

http://www.youtube.com/user/ARPWAVE1#p/u/45/AdiktY4NScg

http://www.youtube.com/user/ARPWAVE1#p/u/15/RLUquVSqpH8

You can alternate 1 minute of work and 1 minute of rest five times,and pick the exercise you seem to consistently get the most benefit from done once or twice daily . Avoid any movement which causes pain higher than first sensation level.

Yeah tracking has been mentioned as possibly the culprit of the “clicking” sound. One guy I saw said he thinks my medialis is stronger than my lateralis so it is pulling my kneecap medially, and said to try to target the lateralis with quad extensions with legs turned in. Obviously not the best exercise, but its pretty much impossible to preferentially hit the lateralis with any closed chain exercise.

Had X-rays done on it today just to rule out any osteochondral defects or anything like that, but all the joint surfaces are normal.

pakewi, thanks for the suggestions, but both of those squat variations produce quite a bit of pain, so I am not sure if there is something I can do to progress up to those?

Explanantions rarely help anything but some weak mind of ours.

Hit the antagonist muscles and do this :

http://www.youtube.com/user/ARPWAVE1#p/u/44/3G31Vi9GwJI

(1 min W +1 min) R x5

A minimum of Twice per day. No other LB movement until painless. Keep training all components UB only.

It is hard to see what is happening in that video - is he just holding an isometric contraction for 2-3 seconds and then relaxing for a few seconds? So do a series of contractions/relaxations for 1 min, then rest a minute, and repeat?

What about other things that are pain free (like sprinting)?

Yes. Do whatever is not causing ANY pain.

Okay thanks for your help!

OK so the knee still hasn’t really improved, and so I had a platelet rich plasma injection into the quads tendon on Friday. Was on crutches until today, and now supposed to take a week of relative rest.

Does anyone have any protocols after PRP therapy?

Epic advice.