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Getting pain in knee joint while doing quadriceps exercise. What could be causing this?

DOCTOR OF THE MONTH - Feb 2014
Feb 2014
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Answered by

Orthopaedic Surgeon, Joint Replacement
Practicing since : 2004
Answered : 5930 Questions
Question
I am having pain when I try to straighten my knee fully. I was doing an exercise where you have your leg on the floor, then contract the quad, then lift the leg. When I contracted the quad, my knee locked up and there was pain around the knee joint, and I could not lift my leg off the floor. Also, one morning I was "stretching" my legs when lying down and contracted the quads, and had pain in that same knee. What might be the problem?
Posted Thu, 28 Feb 2013 in Bones, Muscles and Joints
 
 
Answered by Dr. Saurabh Gupta 1 hour later
Hi,
Thanks for posting your query.

From description it seems the problem might be the patellar tendonitis or jumpers knee.Patellar tendonitis is the condition that arises when the tendon and the tissues that surround it, become inflamed and irritated. This is usually due to overuse , repetitive or prolonged activities placing strain on the patellar tendon.

The quadriceps muscle is primarily responsible for straightening the knee during activity and is particularly active during running, jumping and kicking. During contraction of the quadriceps tension is placed on the patellar tendon via the patella.So when you do quadriceps exercise , during quadriceps contraction some tension is placed on patellar tendon and pain occurs.

You can do the hamstring stretch right away. When the pain in your knee has decreased, you can do the quadriceps stretch and start strengthening the thigh muscles using the rest of the exercises as advised by your physical therapist.
For this condition should undergo a graduated flexibility and strengthening program. So I advice you to discuss this with your physical therapist.

I hope this is helpful to you.Please do write back if you have any additional concerns.

Wishing you good health...
Regards.
Dr Saurabh Gupta.
Orthopaedic Surgeon.
Above answer was peer-reviewed by
 
Follow-up: Getting pain in knee joint while doing quadriceps exercise. What could be causing this? 1 hour later
Thank you very much! A couple of questions:

It seemed like the pain upon contracting the quad muscles was located along the sides of the knee, although it may have also included the patellar tendon (it's hard to remember but it felt like it was mainly on the sides of the knee). Could this possibly be due to another issue besides the patellar tendonitis, like some kind of patellar tracking problem or an issue with how the quad muscles contract? Or is it most likely due to the patellar tendonitis itself alone?

Do you think this means that it is too early in my rehab to be doing that exercise where the quad is contracted before raising the leg?

Could this difficulty contracting the quads be caused by wearing new arch supports in the shoes? Perhaps this irritated the muscles surrounding the knee?

Can patellar tendonitis be caused by a fallen arch, and wearing shoes that don't provide enough arch support?

How can I know if I need arch supports in my shoes? I have no foot pain.

Thank you for your help!

 
 
Answered by Dr. Saurabh Gupta 9 hours later
Hello,
Thanks for writing again

It could be possible to having pain along the side of your knees due to patellar tracking problem.

As I had already said do the hamstring stretch right away. When the pain in your knee has decreased, you can do the quadriceps stretch.

Patellar tendinitis can be caused by problems with the way your hips, legs, knees or feet are aligned. Having wide hips, being knock-kneed, or having flat feet(fallen arch), can predispose you to patellar tendinitis because certain body mechanics will place more stress on this area with activity.

You need arch support specially during the activities like running, jumping,long walk.

I hope that clears your doubts.
If you do not have any clarifications, you can close the discussion and rate the answer.

Wishing you speedy recovery...

Regards.
Dr Saurabh Gupta.
Orthopaedic Surgeon.
Above answer was peer-reviewed by
 
Follow-up: Getting pain in knee joint while doing quadriceps exercise. What could be causing this? 14 hours later
Thank you very much! Can you tell me how I might know if I have a patellar tracking problem? That knee has always made crunching sounds when I go up or down stairs. Might that be a symptom?

If I wear arch supports, should I get used to them gradually over time? Like wear them for a couple of hours a day to start with and then wear them more often? If I wear arch supports, will it make it painful for me to sometimes wear shoes with no supports or to walk barefoot?

I appreciate your help, thank you!
 
 
Answered by Dr. Saurabh Gupta 8 hours later
Hi,
Thanks for posting your query.

If you have knee pain when you are squatting, standing up from a sitting position, going down stairs, or sitting, you may have patellar tracking disorder.A popping, grinding, slipping, or catching of the kneecap as the knee bends or extends or crunching sound when you go up or down might be a symptom of pattelar tracking problem.

It's not necessary but you can start using arch support gradully over time.It will not make you painful if sometime you wear shoes with no supports or to walk barefoot.

I hope this is helpful to you.

Best wishes.

Regards.
Dr Saurabh Gupta.
Orthopaedic Surgeon.
Above answer was peer-reviewed by
 
Follow-up: Getting pain in knee joint while doing quadriceps exercise. What could be causing this? 17 hours later
Thank you! I was wondering: The doctor and physical therapist both say I have a fallen arch. It does appear to be fallen when you look at both feet when I am standing. But I did the "wet foot test" where you put your foot in water and stand on a piece of paper, and it showed that the foot has a "normal" arch. It did not show a flat arch. So it seems the weight distribution on that foot is normal. Is it possible to have an arch that looks fallen, or partly fallen, but to still have a normal weight distribution on the foot (the arch is still up off the floor and does not touch the floor)? And would I still need arch support in my shoes?
 
 
Answered by Dr. Saurabh Gupta 5 hours later
Hi,
Thanks for posting your query again

If a youth or adult appears flatfooted while standing in a full weight bearing position, but an arch appears when the person dorsiflexes (stands on heel or pulls the toes back with the rest of the foot flat on the floor), this condition is called flexible flatfoot. This is not a true collapsed arch, as the medial longitudinal arch is still present and the Windlass mechanism still operates; this presentation is actually due to excessive pronation of the foot (rolling inwards), although the term 'flat foot' is still applicable as it is a somewhat generic term.
Most flexible flat feet are asymptomatic, and do not cause pain. In these cases, there is usually no cause for concern, and the condition may be considered a normal human variant.

I hope this explanation clears your doubts. Please do write back if you have any additional concerns.

Wishing you good health...

Regards.
Dr Saurabh Gupta.
Orthopaedic Surgeon.
Above answer was peer-reviewed by
 
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