First off, I am not a doctor, but I do have experience with writing scientific papers and research, so I have based all my discoveries on papers I have read in respected journals. I didn't however, keep the papers and articles where I read this information. These are all solutions to the problems I had.
I had knee pain from around January of 2015 to March of 2016 and more recently a month or so ago. In my opinion the source of this knee pain is sitting too much.
I only started to address the problem around autumn of 2015 as it wasn't that severe but around this time it started to always bug me whenever I bent my knees. I started doing hip exercises around this time, gluteus medius exercises, hip flexor stretches, abduction and adduction, VMO activation etc. They all gave temporary relief from this pain. I'm not saying they don't work, but they definitely prevented further damage and are great exercises as well. Among them I tried stretching and foam rolling the rectus femoris, the IT band, hamstring, TFL, and other muscles. None of these exercises helped in the long term.
Around January this year, I discovered an exercise which could allow me to do a lunge without pain and it is called the "Physio Lunge", involving putting around 80% of your body weight on the affected leg, which sounds bad, but it works. You can google this exercise or find it on youtube. It is great for building the quads and glutes without pain. This gave me around a week or so of painless tennis and it felt great. The pain then came back. I was getting pretty frustrated after trying so many exercises without success.
Then @Chas Tennis mentioned a figure of 4 stretch for the piriformis. I stretched this group for a few days and somehow to my disbelief I was pain free and my knee was 90%. I then played loads of tennis without any troubles at all, I even worried I was playing too much but after around a month, I was fine and very content. Problem solved, everybody laugh, roll on snare drum, curtains.
NOPE. I had assignments for my course and spent a lot of time sitting again, and a few weeks ago the pain was back. I then intensely did all those exercises again and the figure of 4 stretch only offered temporary relief, as soon as I hit the courts, the pain was back.
I started reading again, I read about the effects of sitting and picked up somewhere that the hips can start to internally rotate. I put this in the back of my brain. I then started reading about the VMO and how it is impossible to isolate and some paper indicated that the commonly prescribed exercises for building the VMO, did not work. I then read that the "Knee Valgus" is caused by internal rotation, again I was not sure how this helped me. Chas Tennis mentioned the importance of posture and alignment, once again this issues was too complicated for me to solve without the help of a physio/doctor.
Why was the piriformis stretch so successful? What does it do? It rotates the hip externally. So why don't I try external hip rotation exercises? Ok, so I did. I attached a resistance band to my ankle, bended my leg so that the shin was parallel to the floor, and then started rotation the hip externally so the ankle finishes at right angles behind my other leg. I then stretched the piriformis after. I did some bending exercises after, and my leg felt very light and the knee was not being stressed in anyway. I hit the court a few hours later, and there was 0 pain. A few weeks later and my knee is better than ever. I can perform single leg squats with no pain. I also measured the distance my knee was moving laterally, a month ago it was around 7 mm, now it is around 4mm. So I hope this is acceptable, but I will keep looking to improve it.
I know this is a long rant, but I searched hundreds of online forums, hundreds of scientific papers and dozens of online articles. Would only the external hip rotation exercise have fixed my problems a year ago? I can't say. But kneecap tracking issues are very complex and I hope anyone who can't find a solution can try this or even critique it and tell me if I am doing some damage or creating other issues.
I had knee pain from around January of 2015 to March of 2016 and more recently a month or so ago. In my opinion the source of this knee pain is sitting too much.
I only started to address the problem around autumn of 2015 as it wasn't that severe but around this time it started to always bug me whenever I bent my knees. I started doing hip exercises around this time, gluteus medius exercises, hip flexor stretches, abduction and adduction, VMO activation etc. They all gave temporary relief from this pain. I'm not saying they don't work, but they definitely prevented further damage and are great exercises as well. Among them I tried stretching and foam rolling the rectus femoris, the IT band, hamstring, TFL, and other muscles. None of these exercises helped in the long term.
Around January this year, I discovered an exercise which could allow me to do a lunge without pain and it is called the "Physio Lunge", involving putting around 80% of your body weight on the affected leg, which sounds bad, but it works. You can google this exercise or find it on youtube. It is great for building the quads and glutes without pain. This gave me around a week or so of painless tennis and it felt great. The pain then came back. I was getting pretty frustrated after trying so many exercises without success.
Then @Chas Tennis mentioned a figure of 4 stretch for the piriformis. I stretched this group for a few days and somehow to my disbelief I was pain free and my knee was 90%. I then played loads of tennis without any troubles at all, I even worried I was playing too much but after around a month, I was fine and very content. Problem solved, everybody laugh, roll on snare drum, curtains.
NOPE. I had assignments for my course and spent a lot of time sitting again, and a few weeks ago the pain was back. I then intensely did all those exercises again and the figure of 4 stretch only offered temporary relief, as soon as I hit the courts, the pain was back.
I started reading again, I read about the effects of sitting and picked up somewhere that the hips can start to internally rotate. I put this in the back of my brain. I then started reading about the VMO and how it is impossible to isolate and some paper indicated that the commonly prescribed exercises for building the VMO, did not work. I then read that the "Knee Valgus" is caused by internal rotation, again I was not sure how this helped me. Chas Tennis mentioned the importance of posture and alignment, once again this issues was too complicated for me to solve without the help of a physio/doctor.
Why was the piriformis stretch so successful? What does it do? It rotates the hip externally. So why don't I try external hip rotation exercises? Ok, so I did. I attached a resistance band to my ankle, bended my leg so that the shin was parallel to the floor, and then started rotation the hip externally so the ankle finishes at right angles behind my other leg. I then stretched the piriformis after. I did some bending exercises after, and my leg felt very light and the knee was not being stressed in anyway. I hit the court a few hours later, and there was 0 pain. A few weeks later and my knee is better than ever. I can perform single leg squats with no pain. I also measured the distance my knee was moving laterally, a month ago it was around 7 mm, now it is around 4mm. So I hope this is acceptable, but I will keep looking to improve it.
I know this is a long rant, but I searched hundreds of online forums, hundreds of scientific papers and dozens of online articles. Would only the external hip rotation exercise have fixed my problems a year ago? I can't say. But kneecap tracking issues are very complex and I hope anyone who can't find a solution can try this or even critique it and tell me if I am doing some damage or creating other issues.
