Superficial Knee Pain for years

cmbear · 04-27-2009, 12:22 PM

Hi guys,

Any help/information would be appreciated.

I should preface this by saying I used to run a fair amount and over the last few months I've been strength training successfully (SS). I perform mobility drills, dynamic warm-ups, and foam rolling regularly. My pain has neither increased or decreased over the last few months.

1. When did the pain begin?

3-4 years ago.

2. What were you doing at the time? Or did the pain come on gradually over time?

Gradually. I used to run a fair amount.

3. Where, anatomically, is the pain?

What’s unusual is that the pain is not under the patella, as in runner’s knee, or distal to the patella on the patellar tendon, as in patellar tendonitis, or proximal to the patella on the quadriceps tendon, as in quadriceps tendonitis. It’s on TOP of the patella, about a centimeter down from the proximal edge of the patella. It’s unclear whether the pain is actually on the patella, or on the part of the quadriceps tendon that passes over (connects to?) the patella. In any case, it’s VERY tender if I press on that part of the patella. The pain is localized to an area about a centimeter square and is only there if I press on it with my fingers or articulate my knee

4. What does the pain feel like? Sharp? Dull? Aching? Stabbing? Shooting?

Dull normally. Sharp upon touch.

5. Is the pain constant, or intermittent, or only on certain motions?
It's in the background always, but more palpable during certain movements.

6. What motions make your pain worse?

Running, jumping, squatting, and walking up stairs all allow me to feel it…I’m guessing because pressure is generated between the quadriceps tendon and the patella.

7. What, if anything, makes your pain better?

Not much. Rest, temporarily.

8. Does your pain radiate to any other part of your body?
No.

9. What things could you do before, that you cannot do now because of your injury?

While motion isn't inhibited much, pain is triggered during the above-mentioned activities.

10. What is your main concern regarding the pain and its consequences?

It's annoying, distracting and has lasted for years.

11. Have you ever injured that part of your body before? If so, how?
Nothing major.

Thanks again. Would appreciate any feedback.

Cloud9Fitness · 04-29-2009, 01:42 PM

I suspect superficial pre-patellar bursitis. The differential diagnosis includes the tendinopathies you mentioned, ligamentous injury, and pes anserinus bursitis. Due to the amount of time you have had the symptoms, I doubt you have a septic version. I would suggest seeing a sports medicine physician. If they agree, then you may have the bursa drained or receive a corticosteroid shot.