Teenager with knee pain when sitting indian style


Q: Okay...well I'm sixteen years old I've had this knee problem for about three years now. It happens when I sit on my knees, "indian style sit", stretching, kneeling. Things of that sort. Something inside my left knee gets caught. I've went to several doctors and all of them tell me something different. One said that it might be my meniscious getting caught on something. That's exactly what it feels like. When it happens I can't straighten my leg. I can't put any weight on it at all. I'm stuck on crutches. It feels tight. The pain is almost unbarable. It's getting worse and worse. Last monday is happened. I was out for about three days. That's usually the amount of days it takes to get where I can walk on it finally. It loosens up on it's own and eventually will get to were I can put weight on it. I use to say "my knee would pop out" cause that's the only thing that would make since. My knee doesn't really pop out, it's something inside getting pinches of hooked. But it's not a pinches nerve, I've felt that before and the pain it's different. It's really putting a strain on my life. I'm looking for an answer.


A:   The symptoms that you described in your question may be due to one of the most common causes of knee pain in persons of your age group: Patellofemoral syndrome or Chondromalacia patella. The pain typically is located behind/under the kneecap and often shows during activities that require knee flexion and forceful contraction of the quadriceps (e.g, during squats, bicycle, ascending/descending stairs or pendants). Pain may be worsen by sitting with the knee flexed (“indian style”) for a long period of time, such as while watching a movie, hence leading to the terms "theatre sign" and "movie-goer's knee." The causes are diverse: Overuse (repetitive use or activity), overloading, and misuse of the patellofemoral joint. The suggested strategy for conservative treatment should be as follows: Physical therapy program (exercises and pain control with TENS, ultrasound, ice packs after exercises), anti-inflammatory medication (i.e.: “Aleve”, “Advil”), education  so  you understand which activities avoid because those can aggravate patellofemoral syndrome. Also, and very important, remark the need for extended adherence to the exercise regimen. The physical therapist should educate you about a home exercise program Allow time for these conservative measures (e.g.: exercise program) to have an effect , usually 4-6 weeks is adequate for some resolution of symptoms.

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