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Knee/patella Pain.

June 1 2017 summer basketball starts. He  got a sharp knee pain one day.  He tried but Couldn’t run.  Hurt right on patella.  Found out he had Bipartite patella.  It Hurt to walk.  He rested it For 3 months.  It got better.  He Played his jv basketball season.  He Started aau in the spring.  In May he got the sharp pain again.  Rested it for a month and then tried to start playing on it again when summer basketball started in June of 2018.  First day of practice he tried to run up and down the court.  He couldn’t.  It Hurt to much to where he limped.  It hurt on the patella.  It also hurt when he would push down (not in) on the upper part of patella and also would ache alittle where Bipartite was.    He Rested  it for a few more weeks but it continued to hurt. So we went to his Dr and then decided to have surgery.  The Dr Took a small fragment out.  He said it  had started to pull away from rest of patella. We Could see it visually too, as it was sticking out more on his right upper outer part of his knee cap.
Surgery was on June 18 2018.  He did all the recommended exercises and everything he was supposed to. He had
Therapy 3x a week.  Plus stretching exercises that he does religiously on non PT days.  

At around the 2 month mark he got sharp pain on left side of patella and inner/middle part of patella (this is when he first got these symptoms, but he hadn’t tried to do much up until this point.  So we aren’t sure if it was there since surgery because he hadn’t tried to do to much up until this point since surgery).
He also has a popping noise when bending the knee.   But that doesn’t seem to hurt.  He says He feels like he needs to pop it though. That is off and on.

He continued to do therapy, etc but the sharp pain would still be there.  He would stop when it got to much.  

At 4 months he still continued therapy. He Could bike without pain.  Aqua therapy without pain.  But sometimes running in pool would cause pain in the patella.  Strength exercises would cause some pain in patella. But not as bad as running.  Running would always make it hurt.  In that inner/middle part of patella.

On Dec 1 ( 5 1/2 months post surgery) He  Started doing more intense strength training on his legs to improve the quad muscles.  His quads are getting much stronger.  His right leg is almost the size of his left. And has improved in strength ( but still not as strong as his left leg). With the improvement of the quads he still has the pain in the inner/middle part of patella.  He hasn’t seen any improvement in the pain.  

Jan 2 (6 1/2 months post surgery) conner begins doing some stuff at basketball practice .  He tries to do some half speed dribbles, defensive slides , karaoke, shooting drills.  Light defensive drills, Until it hurts to much, Then he stops for the day.

Jan 8. He did about half of b-ball practice at about half speed.  He got real sore on that inner/middle patella area. The Inner/middle part of Patella was even sore the next day.  It hurt when he would walk. (Usually it isn’t sore the next day, but he hadn’t pushed it like this before).  

The quad that was reattached has been improving.  It will ache sometimes  during isolation strength exercises.  But no pain like he gets from the patella.  

He does feel and hear a popping type noise when doing certain things, but isn’t painful.

He Doesn’t get any Pain when he pushes w his thumbs down on the patella.  

It’s been almost 7 months and he still can’t jog/run with out pain.
Pain gets worse the further into running he goes.  Usually very quickly.  

**Things that always cause pain in conners knee:
Any type of Jogging,  running, jumping. Pain Usually comes right away.  

**Things that sometimes cause pain:
Dynamics stretching.
Defensive slides
Karaoke
Jump rope
Lunges
Squats
Leg press

**Things that don’t cause pain :
Static stretches
Straight leg strength exercises
Stationary Biking.
Elliptical
Swimming
Walking (unless sore from a work out PT).
Resting, lying down


***Questions about the pain and his knee:

Is it the quads still needing to get stronger?

Is it the permanent sutures that were sewed through the patella causing issues?

Is the patella not tracking right?

Patella femoral?

Meniscus?

Tendon or ligament?


**Safety concerns:
Can He  make his knee worse by trying to play through the pain?

What (pain level) should He stop at(push it to and then stop what he is doing)?  




1 Responses
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15695260 tn?1549593113
Hello and welcome to MedHelp forums.  

Your son has had a long history of knee pain and I'm sorry to hear the surgery wasn't successful at resolving the issue.  Certainly he should be followed by his physician.  What is their perception of this ongoing issue?  Does your son's school have an athletic trainer that can give insight or input?  It would be helpful to know what their thoughts are and if they recommend that he continue with the sport that is giving him pain.  Exercise is essential and I do not underestimate the importance of a teen's high school preferred sport but is it feasible that he get back to playing it with the ongoing pain he suffers from doing it?  That is a question that is hard to discuss probably without great emotion but important to work with your medical team on.  Here is information on the subject https://www.mayoclinic.org/diseases-conditions/patellofemoral-pain-syndrome/symptoms-causes/syc-20350792
Most likely it would be best for your son to discontinue his practices until he has been evaluated again by an orthopedic specialists.  We wish you the best.
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