Chronic Knee Pain

[emilyinVA]

I need some help to figure out what is going on... I am a 22 yr old female who has been experiencing pain in my patellar tendon region for as long as I can remember.  It began as early as maybe age 7 or 8 and my pediatrician attributed it to "growing pains" saying I would outgrow them.  The pain is not constant; it comes and goes, regardless of activity level.  Sometimes it hurts after a hard workout, sometimes it hurts when I'm just sitting around.  I have looked for patterns to try to self-diagnose, such as hydration levels, with no success.  The pain often begins in my knee as a dull ache that can be temporarily alleviated by putting pressure on the patellar tendon, but then will radiate into either my hip or ankle.  NSAID's seem to help sometimes.  However, today I woke up with excruciating pain in my quad.  It is not a cramp because there are no knots on palpation and stretching does not help.  If I sit and flex my hip, the pain moves into my patellar tendon, similar to the pain I have experienced for years, but much much worse.  I have no idea what is going on... any help would be appreciated.  Also, I was a gymnast for 13 years so I have had my share of orthopaedic problems, but never in my knees.  I am also extremely flexible so muscle tightness is not a cause...  Thanks!

[emilyinVA]

Thank your for your advice.  However, the pain I experience is not really "deep knee pain" and never hurts during activity.  Most often I notice it during the night (it is enough to wake me) or when I am just out and about doing errands.  There is never any swelling so I have not used ice.  And I don't think strengthening my quads is the solution... I weigh 135lbs. but can leg press a 630lbs. 1 RM max.   I have never heard of anyone with this problem so if anyone has a solution, I value your advice.  Thanks!

[Dr_Veena]

Hi,
     How are you? Knee pain is a very common symptom which can occur due to a variety of causes like arthritis, fractures, ligament tears, meniscal tears, chondromalacia, sciatica etc.
Proper evaluation will help in making diagnosis. An X-ray would help in revealing any fractures or ligament tears. With the symptoms that you have mentioned, I feel it is a case of damage to the knee joint due to over use. There could be damage to the joint surfaces or due to overuse reduction in the amount of synovial fluid present in the joint causing friction during movement and damage to the cartilage.
Also with the history of pains since childhood there is a chance of chondromalacia. Chondromalacia refers to a softening of the cartilage under the kneecap (patella). It is a common cause of deep knee pain and stiffness in younger women and can be associated with pain and stiffness after prolonged sitting and climbing stairs or hills. While treatment with antiinflammatory medications, ice packs, and rest can help, long-term relief is best achieved by strengthening exercises for the quadriceps muscles of the front of the thigh.
I would suggest to get a workup done for the knee joint by an orthopaedician with X-ray and MRI.
All the best