Knee Pain

Patient

Q: I am a tall (6'4" tall and 225 pounds) male. Early 30's. I work in a factory that requires climbing stairs, ladders, and stepping up on top of high platforms (2-3 feet above my feet). I have recently felt knee pain. Mostly on the inside of my knees. Mostly on my right knee, which is the side I most frequently use. I am fairly certain that it is due to my height, and may be related to the fact that on ladders and such, my knees will often hit the next step up if I take them straight on. So I often turn my feet to the inside, so that my knee tracks out from my center-line, and won't bump the steel of the next step. I suspect that I have weakened myself on a crucial muscle, and it has injured me because of this. When I take the larger steps, where bumping myself is not an issue, I still revert to a weird angle on my foot, because I'm not strong enough to just take the step straight on. The other thing that I have done recently and might have aggravated or caused an injury, is working at a low height, I often squat down and rest my body weight on my bent knees, instead of bending at the waste. Doing this now hurts, and it is next to impossible to stand up without extreme discomfort. I was under the impression that bending at the waist is bad for the back, and I already have back pain because nothing in this world is built for a tall person (cars, chairs, tables, etc), so I have been squatting. What can I do to get better? This is my job, and I can't just stop doing these things. What can I do to prevent this from happening again? I suspect doing strengthening exercises for a certain muscle, or muscle group?

Doctor

A:   Thank you for your question,
Knee pain can be very troubling - especially when it interferes with your job.  The first thing I recommend is to eliminate factors that may make your knee pain worse. Smoking and excess weight are the leading contributors of knee problems that one can control.
I also recommend you wear the most comfortable shoes you can afford.  A good pair of shoes can go a long way in reducing joint stress. Custom orthotic inserts also help to relieve joint pain.
When pain tends to occur in very specific positions as you described, it is usually attributed to a muscle imbalance. An appointment with your local physical therapist can isolate the muscle imbalance and he or she can suggest the appropriate exercises for your situation
I hope this helps

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