[jonasr]

[Also posted on UKClimbing]

My wife has recently been diagnosed with a patella tracking abnormality, whereby her kneecap is not moving correctly over the underlying bones and cartilaginous areas.

Most specialists have told her to give up rock climbing, ice climbing, mountaineering, hill walking, snowboarding and pretty much all the things she loves to do. This is obviously devastating for her, but not something we are immediately agreeing is the only solution.

Physiotherapists are working on strengthening the muscles in her knee to coerce the joint to move correctly and this should give her a 50:50 chance of being able to participate in the sports she loves within 3-6 months, albeit with continued paid and the risk of degenerative effects.

We would really appreciate any advice from medical specialists and/or climbers with comparable conditions, regarding other courses of action to help her continue to climb.

Many Thanks.

[chappers]

you can not underestimate the power of getting the rest of the leg stronger. ask my brother

he has had a total of 7 operations on his knee to repair a torn ACL, Medial etc... he did the lot.

its three years since the last op and he is stronger than ever (adventure racing most weeekends and a seasons skiing on the bad boy) he spends his life doing exercises, squats and all sorts. when he is not doing anything he is stood on one leg lowering up and down.

he has the benefit of a physio for a mother but all you need is his motivation to get better.

[Greencar]

I have been diagnosed with the same problem. I was told to give up climbing and skiing by a few consultants but then I found one that was more agreeable to my needs. I had an arthroscopy 2 weeks ago and the back of my patella and the cartilidge was damaged due to the bad tracking.
They removed the damaged cartilidge (same op as I had 10 years ago aged 13). I am now awaiting a mobile MRI scan to examine my knee in movement in order to plan for further surgery to sort out the tracking.
Strengthening the knee really helps, as does a good physio. Mine has been giving me alot of hands on treatment to try and release the muscles and ligaments that pull the knee cap out of place.

[wannaclimb8a]

bit of advice when it comes to knee injuries-take it slow cos if you dontyou end up in a world of pain for a few years like i did.
i shattered a piece of my knee cap which decided to stick in the patela tendon and cause it to snap and damage all the ligaments at the same time!!after about a year in plaster on and off,phsio,cortisone,operations ect the knee stopped hurting and i decided it would be ok to go against the doctors advice of just steady walking and played a game of football!well as you can probably guess i ended up back in plaster and another op when the tendon severed slightly!!took me 2 years after that to walk properly and be without pain!!its pretty much ok now but does ache every now and again especially when its cold.

so basically tell your wife to listen to the doctors and take it easy so she dont end up losing 3 years of her life like i did!!!


rich

[grimer]

I think i may have something similar, based on a casual diagnosis by a GP friend, and have been concentrating on doing leg-strengthening exercises. Did the surgery help? Was it a minor op?

[wannaclimb8a]

mine was basically to reatach both ends of the snapped tendon back together but i also had lots of bone chisseled off to and lots of fragments removes.mine was due to a rugby accident when i hit the post which shattered the patella then i twisted on landing causing the snappage and the ligament damage.only evidence of it now is a big boney lump below the knee cap and a scar from keyhole surgery-and also a lack of adventure anymore when it comes to highball bouldering lol
whats your symptoms?do you get and crepitus when moving your knee joint between fully straight and fully bent?does it hurt more when in normal motion or with side loading ect??
knees are one of the worse things to heal they take ages if not rested properly


rich

[Houdini]

I sympathise with your wifes' condition.

I suffer from something similar in my left knee.  My patella has been out of position for 6 months following the nipping and inflamation of the 25 odd liquid-filled sacs that cushion the space between your femur and tib/fib.

They inflamed to such a degree that the tendon was half torn from it's attachment point on the bottom half of the patella.  It's not so fat now, but grinds and clicks alarmingly, the tendon has yet to fully re-aquaint itself with the cap.

It's a surreal suggestion - that climbers should wear sensible footwear - but I can't emphasise enough the importance of owning and wearing at least one pair of sensible shoes.  Skateboarding shoes are amongst the worst in the world.  The flatness and unsupported nature of the soles in these shoes will ultimately cause collapse of the arch resulting in flat feet, which puts a twist in the ankle and continues to the knee.  The body will try to compensate by building muscle on the inside of the knee.  This build up of additional muscle (and the loss of muscle on the outside of the knee) will cause the patella to be dragged out of position.

There are exercises one can perform to correct this:

Lie flat on your back with a towel rolled underneath the knee.  Rotate the ankle away from the body, then push down on the towel with your knee.  Hold for 10 secs.  Release.  Repeat 3 times, 3 times a day.

The same exercise can be performed sitting:

Straighten (raise up) the lower half of your leg til it is at approximately 80% extension.  Rotate the ankle outwards, then straighten the leg to it's fullest extent.  This will ultimately re-distribute muscle mass evenly on the knee and drag the patella back into position.

Never underestimate the importance of rest - and junk the Etnies.  They look cool, but will make you a crip'.

[wannaclimb8a]

deffinately agree with your point gruff that the worse thing is not knowing whats actually causing the pain although the pain itself can be quite bad.i have intermittent problems with both knees now which maibly only happens after a long descent off the hills when i try and get down too quick and repeatedly jar my knees.half the time you go too the docs or a&e and they just tell you to rest it anyway which is well annoying.


rich