Remedial & Sports Massage for Knee Pain
Pain in the knee due to rotation of the Patella and subsequent grinding as it moves in the Femoral Groove beneath. Pain felt in the centre of the knee beneath the patella when, for instance, climbing stairs.
Typically caused by tightness in the Ilio-Tibial Band (ITB) pulling the inferior corner of the patella laterally at the Tibial Tuberosity and/or weakness in Vastus Medialis Oblique (VMO) allowing the medial superior corner to drop.
Generally, an easy but painful fix with massage to release the ITB and strength exercises for the VMO. Taping knee to reposistion the patella enables rehab exercises to be carried out pain free. However, acute cases will require longer to recover owing to the damaged, inflamed tissue requiring time to heal once treatment and rehab commences.
Interestingly, my first sighting of an instance of rotation in the opposite direction; the superior medial border was elevated. Resulting from an impact to the medial aspect of the knee. Tightness through Gracilis & the VMO, eased with a few minutes treatment. Much easier and less painful than similar treatments of the ITB. Orientation of the patella returned normal.
ITB Friction Syndrome
Client presented with crippling knee pain six days before the Melbourne Marathon. Two weeks before race day she broke down at 15km mark with crippling pain in the right knee. GP advised she could not run the event and to take rest. If determined to run, a pain killing injection on the day of the event was offered.
Sx/Ax: Lower back & glutes tight+++. Both hips, TFL & inguinal crease pain++++. Right ITB tight+++. Lateral aspect right knee pain+++. Medial aspect of right scapula pain+. Right patella tracking correctly. Slight inflammation & heat on lateral aspect of knee. No pain in centre of knee.
Suspected ITB friction syndrome.
First Rx (Monday): Lower/Upperback, Glutes & Lower limb Rx. Cupping QL, Glutes & Piriformis. Myofascial Stretch spinal erectors. Myofascial Release ITB...seriously painful bruising inflicted. TCM herbal patches supplied to clear bruising. Client advised to rub down lateral aspect of right thigh daily from Greater Trocanter to Knee using 50mm dowel. Technique demonstrated. While client in habit of pre and post training stretching, clearly no where near enough being done.
Second Rx (Thursday): Lower back Rx and light Lower Limb Rx. Cupping left and right Glutes, Piriformis, TFL, Greater Trocanter and distal aspect of right ITB. Integrative Fascial Release for left and right hips and adductors. Lymph node drainage...not full MLD...nodes, cisterna chyli & thoracic duct only.
Client ran event (Sunday). Half marathon, in lieu of full marathon, without pain killing injection. She reported good form, no pain and took 15min off her personal best.
Awaiting signed photograph of client crossing the finish line.
ITB - Illio-Tibial Band
TFL - Tensa Fascia Latae
QL - Quadratus Lumborum
Sx - Symptoms
Ax - Assessment
Rx - Treatment
TCM - Traditional Chinese Medicine
MLD - Manual Lymphatic Drainage