Knee Pain for no reason

I have an individual that has insidious onset of tibial tuberosity tenderness (not patellar tenderness at all). Unable to kneel on the spot. Pain with knee flexion. Looks and smells like OSD but I would not think that it will be there at age 20. He also has no history of OSD through out his adolescence. No redness like with a cyst. Has been suffering for 3 weeks. He has rested for 3 weeks (no running but other activites). No improvement.
Any ideas?

Please go through prone hip extension, Janda Hip Extension, Janda Side Lying, and palpation through rectus femoris.

Still shot from Craig Liebenson's companion DVD to Rehabilitation of the Spine.

In this case, my first thought would be to use IASTM through the anterior quad and retest. Other aggressive manual therapy would work as well.
Also is there a difference in pain when when he squats with angled tibia vs a vertical tibia?

The unstoppable GUA SHA!!!!!!!!!

What I believe is happening or can happen is that the lower-crossed’s tone of the rectus femoris is so powerful that during bouts of knee flexion, it crushes the patella and/or changes the angle of the patella tendon. It can change every movement into something severely quad-dominant and doesn’t yield until there is anterior knee pain like this. Try beating up the rectus femoris, quads, and popliteus and half kneeling hip extension stretch.

  • December 30, 2010

Leave a Reply 6 comments

marto Reply

I am 40 and have the same problem, tibial tuberosity pain. No pain when doing box squats or convential sqauts. Pain to kneel on it. it was suggested i may be going through puberty again. No history of previous osd. Broad diagnosis of tissue failure at the patella tendon insertion onto the tibial tuberosity. Anatomy may be different and not everything is text book.
It is peculiar my hip abd is stronger on the right but when the weight gets heavy during the squat the knee has habit to cave in.
Also didn’t help doing bands early on with start of training. Eccentric load too much. I use foam roller on quads, would love some strong masage.

drcbdc Reply

Charlie I see you did a gig with Liebensen out west, any chance you can bring something east? bought your DVD’s and digesting….had to pop the brain plug to ease the pressure. Great stuff!! I would love to witness a couple of assessments, i’m more visual and hands on. I began to watch the videos and within 10 minutes I’m drooling on myself…….blame it on adult ADD. do the math of how many hours of video, spare me the embarassment of my children witnessing this and set up a seminar, please…pretty please! keep on posting, I’m a believer! sorry for being off topic I was just on your site and could not find email.

drcbdc Reply

now I see your email. : }

Amanda Campbell Reply

I have RA and Fibro for some years now.I was put on all the reg Rx’s at first Pacquenil, Methotrexade, steroids. These didn’t work so Enbrel was added. I felt terrific from day one. It lasted three years and then it was like I was never on it. I had to be taken off methotrexade because of all the UTI I had. They tried me on Remicade and was sick for six weeks. We have tried Simponi, Cimzia with no luck. I have been off Enbrel for about a year and a half, so they wondered if it would work again. I’m in my second week and I feel awful. Has anyone gone back on it and had it work? Sorry about all the misspelled RX’s.

Charlie Reply

Amanda – These medical interventions are not my expertise. I’m sorry I can’t be of more help.

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