Cracking Achy Knee Pain or Chondromalacia Patella

Cracking Achy Knee Pain or Chondromalacia Patella –
Treatment and Prevention Tips from The Barefoot Running Doctor
By Dr. James Stoxen DC


Knee Pain
Cracking Achy Knees or Chondromalacia Patella
Tips to treatment and prevention from Dr James Stoxen DC “The Barefoot Running Doctor.” To view this discussion on Linkedin, Click Here
Question: If the quads are strong, how do you strengthen the hammies without messing up the patella?​
Knee Cap Pain!

AKA Infraptatellar Pain

My knees crack when I walk, run and especially when I walk upstairs or squat!

As you know, the patella is a pulley mechanism. I see so many coaches looking at hamstring and quad strength as the key to patella motion in the trochlear grove. note: The trochlear groove is the concave surface where the patella (kneecap) makes contact with the femur (thighbone). Also called the ‘trochlea’.

The way I see it is that the hamstrings and quads are in the middle of the kinematic chain or spring mechanism of the body. So therefore, they don’t influence. They are influenced by the way the mass transitions across the foot spring mechanism.

React!

I have treated thousands of patients with chondromalacia patella. The pain goes away without any training of the quads or hams. What I find is that on the involved side of infra patellar pain is an abnormal foot plant.

When transitioning the impact forces of the landing, the foot adjusts for the impacts two ways:

The 33 joints of the foot and ankle spread the force of the landing. When this happens the impact is received as a “negative” by the tendons of the landing muscles. The problem with the current model–the way most podiatrists, etc., look at the body–is they look at it as a rigid lever when it is not rigid at all.

It is a spring.

Safe and Unsafe Range

The foot rolls from supination to pronation. Have you ever heard of over pronation? That is where to foot rolls too far inward. When this happens, the limb internally rotates on impact. That does not put the patella in a good position to allow for stress and strain free motion.

We all know that if we have poor posture it is because the muscles don’t have a balance of strength with respect to what role they are supposed to play. We know that we can change the position and motion of bones by training. Is it possible to train muscles when the joints they affect are locked? No way

.


Over Pronated Foot

The problem with trying to adjust the position of the patella with the training of muscles above the patella is that the most common abnormalities of limb position that effect the glide of the patella come from below, in the foot and ankle.

Just think of how many times your athletes have sustained contraction of muscles from standing too long, flip flop shoes that reverse the arch spring and lock it prior to impact, curved footwear when they have a fairly straight foot, a lack of training landing muscles, training the foot and ankle only by running forward.

The foot is a 3-dimensional structure that has to be trained in all ranges of motion and without a binding or motion altering device. Why is it any different from the elbow joint where we demand form and technique be perfect during exercise to maintain limb alignment and prevent stress or strain. You need to check in with athletes to see what footwear they are wearing after practice.

I have treated some of the most amazing dancers who are fitted for $500 custom shoes for performances and wonder why they are still in pain. What did you do Saturday after rehearsal? I went shopping on the sidewalk with flip flops for four hours.

If I have an athlete with patella groove pain or infra patellar pain you should do a simple gait study.

Watch above at Dr. Stoxen evaluates a gait study with a patient at Team Doctors.

Get a $140 HD flip video camera. Video the athlete walking barefoot 10 steps toward the camera and back. Do this while the athlete is walking, fast walking, and running. Download it and watch the video frame by frame and you will see why the patella is not in the groove. It is obvious and enlightening.

 Here is a blog post you may like that talks about “foot lock” which is when joints of the foot are locked causing abnormal movement patterns (compensations) which effect patella position and a lot more! click here to view

If you hold a curl at 90 degrees of flexion for 30 minutes the muscles go into a spasm, the joints stiffen and sometimes there is pain and altered motion. Why wouldn’t you think this same locking would happen in the foot and ankle spring when you stand for 30 minutes?

It does!

Click the links below to release the Human Spring by doing deep tissue release:

Video Tutorial #77 Dr James Stoxen DC Demonstrates How to Self Adjust Your Toes
Video Tutorial #78 Dr James Stoxen DC Demonstrates Self-Help, Deep Tissue Treatment Of The Knee Popliteus Muscle
Video Tutorial #79 Dr James Stoxen DC Demonstrates Self-Help, Deep Tissue Treatment Of The Gluteus Medius Muscle of the Hip
Video Tutorial #80 Dr James Stoxen DC Demonstrates How To Self-Help Deep Tissue Treatment Of The Subtalar Joint Of The Ankle On The Inside
Video Tutorial #81 Dr James Stoxen DC Demonstrates How To Self-Help Deep Tissue Treatment Of The Ankle (Subtalar Joint Outside)
Video Tutorial #82 Dr James Stoxen DC Demonstrates Self-Help Deep Tissue Treatment Under The Big Toe And Second Toe
Video Tutorial #83 Dr James Stoxen DC Demonstrates Self-Help Deep Tissue Treatment Above The Big Toe And Second Toe
Video Tutorial #84 Dr James Stoxen DC Demonstrates Scissor Stretching Of The Feet
Video Tutorial #85 Dr James Stoxen DC Demonstrates Stretching Great For Mortons Neuromas And Narrow Heels
Video Tutorial #86 Dr James Stoxen DC Recommends The Best Shoes To Prevent The Foot From Deforming
Video Tutorial #87 Dr James Stoxen DC Demonstrates Self-Help Deep Tissue Of The Ankle Mortise
Video Tutorial #88 Dr James Stoxen DC Demonstrates Stretching Of The Foot While Sitting At Your Chair
Video Tutorial #89 Dr James Stoxen DC Demonstrates A Stretch To Increase The Flexibility Of The Arch Of Your Foot

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