Is All Knee Pain Created Equal?

As a massage therapist, it is outside our scope of practice to diagnose any condition we see. However, that does not prevent us from evaluating, assessing and working off this information. Often, we have patients who come in with a “google-osis”, meaning they just googled something like “knee pain” looked for whatever symptoms seemed to fit theirs or worse, looked up terms like ‘runners knee’ and low and behold, they think, “That’s’ what I have!”

I mention this, because recently, I had someone in for a taping prior to the marathon and they stated they had Osgood Schlatters Disease and wanted to be taped for the race. After doing an evaluation, I determined (to myself) that their condition was more likely what is known as “Chondromalacia”. When I mentioned to them that I think taping according to my findings vs. theirs, would be best. They of course acquiesced and trusted my suggestions for proper care.

Osgood Schlatter is a pretty common condition that is typically found in adolescents between ages 9-16 and primarily in boys. This patient was a woman in her late 40’s. It usually occurs after sudden growth spurts, when the bones grow faster than the muscles. This muscle tightness creates a lot of tension where the patella tendon attaches to the shin bone at the tibial tuberosity. This tension pulls on the underlying bone, damaging it, known as Traction Apophysitis, which results in inflammation and swelling. The pain that is felt is very similar to that of Chondromalacia, but the treatment approach is much different, as is the type of taping application that would be helpful for this individual. Patients with chondromalacia patella frequently have abnormal patellar “tracking” toward the lateral (outer) side of the femur. This typically occurs more in women due to what’s known as their “Q-angle” or angle from the hip to knee. This slightly off-kilter pathway allows the undersurface of the patella to grate along the femur, causing chronic inflammation and pain, typically in a similar area to several other types of “knee pain”.

If you suspect any injury, I strongly encourage you stay off the web and to be professionally evaluated by someone who commonly sees and treats musculoskeletal injuries. Using “Dr. Google” could not only be a waste of time, but may result in the exacerbation of the actual condition you have developed.

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