Quinkin’s Blog: a place of running dreams come true

Patella femoral pain, knee physio, writing, photography, learning to swim.

About

This blog documents the battles of a runner who fought against the dark forces of patella femoral pain for three years and won.

A blog that shows that sometimes hard work, patience and courage shown in the face of pain can result in never believed possible inspiring dreams coming true.   

Three years ago I struggled to walk a hundred metres, my knee was in pain with every step. Now I run 50 to 60kms a week and have run in races for the first time in twenty two years.

Quinkin is a giant Yowie who writes speculative fiction, takes landscape photos, is a field botanist running on one good leg. He follows the Cronulla Sharks Rugby League team in their forty year quest to win the NRL premiership.

14 Comments »

  1. if you are still looking for a good soft tissue therapist and that your condition is manageable conservatively then don’t hesitate to contact me.

    Comment by Arnaud Domange | February 9, 2007 | Reply

  2. Thanks Aranud, but I already have massgae therpaist

    Comment by quinkin | February 10, 2007 | Reply

  3. Ever considered a chiro-practor, or a Chinese Sports Injury doctor? Have you done your MRI?

    Comment by Anonymous | April 14, 2008 | Reply

  4. Hey,
    I am also suffering from the same condition you are and would like it if you could tell me what things you are doing that are helping you to activate your vmo. It is INCREDIBLY frustrating as you know dealing with this. I know that there is info from your postings, but it would nice if you were to list for me the exact program your on so I may implement a similar one. If you email me that would be great!

    Thanks for the help,
    Nick D

    Comment by Nick | August 16, 2008 | Reply

  5. My email is nick61323@hotmail.com. Again thanks for any help you can provide.

    Comment by Nick | August 17, 2008 | Reply

  6. Hi Nick,

    The things I do to activate my VMO are:

    1)McConnell taping, reduces inflammation and improves the VMO:VL ratio.

    2) VMO visualisations. Sit in chair and pratice squeezing your VMO whilst holding the VLAT still. This should be done with knee taped.

    3) Some physios have biofeedback gear. They hook up electrodes to the VMO and VL, which records the ratio between muscles. To build the VMO it should fire at a better than 1:1 ratio. Seeing the read on the biofeedback gear can help the patient retrain their VMO to fire first.

    4) Walking cylcing and running can activate the VMO. The trick is to reduce inflammation and that is were I swear by McConnell taping.

    5) Hard work, patience and courage. This injury is bit like climbing a mountain you need to chip away at it by hard work.

    There is information on how I tape my knee in other posts on this blog, the things I have found useful in my battle against knee pain, and also the exercises I do.

    I strongly recommend that anyone wanting to give knee taping a go that they must see a physio expert in knee taping to show them how to do it. It is likely that anyone trying this without expert advice could get it wrong and make the knee worse.

    On the exercises (all done with knee taped):

    1 Standing quad and glute contractions. standing upright with a ball or pillow between your inner thighs, first squeeze your but cheeks (imagine there is a 100 hundred dollar bill there and you want to hold it there. Then squeeze inner thigh muscle with pillow.)

    2. Wall squats. Stand against wall with back straight, feet extended in front of you. Slide down the wall as if sitting in a chair, whilst doing this squeeze the pillow between your inner thigh. I only squat to about 30 degrees or whatever is pain free.

    3. Balancing. Put a loop of theraband around your ankles. Stand with feet toghether. Stand on one leg, bringing the other leg at an angle of 45 degree behind you.

    4. Walk throughs. Pratice a normal walking motion, with knee over second toe. As you do this try to activate the vastus medialis obliqus muscle.

    5. VMO activations. This is the most challenging excercise. Contract the inner thigh muscle (VMO), whilst keeping the outer muscle (VLAT) still. In patella femoral injury the VMO becomes inhibited by pain. The goal is turn this around, so that the VMO fires first and more strongly than the VLAT if the VMO will get stronger.

    http://quinkin.wordpress.com/2007/06/06/mcconell-taping/

    http://quinkin.wordpress.com/2007/06/29/useful-products-for-patella-femoral-pain/

    http://quinkin.wordpress.com/2007/07/06/battle-of-the-maltracking-patella/

    Comment by quinkin | August 17, 2008 | Reply

  7. I would try doing super deep tissue massages. I use the stuff at Trigger Point Therapy to help. Everyone is different but all this muscle imbalance I think is oeverblown. I did PT for a year and made no headway. My muscles were all knotted up and I think it will take a good month to get them back to normal.

    The guy on the video at:http://tpmassageball.com/products.php
    was teh first person to explain what causes most of these pains. I wish I did this a long time ago.

    I was doign teh foam toller before but after awhile it was too soft. Also I was never massaging my VMO. I did it once with this roller and realized how tight it was. It was crazy painful which show how tight ot was. Hope its not too late for me. know some damage it already done but for me if I did this from teh begining I know I would not have gotten injured.

    I thnk its reckless how the orthos and PT people never talk about the muscle elasticity since that is what actually pulls your tendons.

    Comment by Chris | September 14, 2008 | Reply

  8. Hi Chris,

    Yes, I have found deep tissue massage and trigger point massage helpful, particularly to realease tightness in my pain quad, patella and VLAT tendons.

    I use a rolling pin to self massage, it doesn’t go soft.

    I disagree with you on the question of the muscle imbalance. There in no myth about isolated VMO strengthening in my experience. A stronger VMO has been the key to my recovery.

    I was going backward with PT for a long time, but that was because the PT I was doing was ineffective.

    Comment by quinkin | September 16, 2008 | Reply

  9. HI there,

    I have been in the same situation as you were regarding knee pain for the last 14 months.I was 22 and in the best shape of my life… on my way to becoming a police officer, but my knees decided to “FREAK OUT” on me. I had to change my immediate career plans due to my inability to run. I am glad I found your blog, because it is encouraging to see that it is possible to get better. I hope I will be able to be successful like you have been with your rehabilitation. I hope you do not mind if I contact you in the future to get some pointers regarding rehab.

    Thank you for taking the time to write this blog… I am reading through it week by week.

    Thanks again
    -Kyle

    Comment by Kyle | June 12, 2009 | Reply

    • Hello Kyle,

      Sorry to hear that knee pain has affected your life and career.

      There is plenty of information about how I treated my injury on some of the older posts on this blog.

      If I had to mention one thing it would be that the best move I ever made was seeing a good sports doctor, who knew knees. He gave me a referral to top physiotherapist who showed me McConnell knee taping and quad and glute exercises. Until then, I was getting nowhere, and like you knee pain was diminishing my life in so many ways.

      However, there was no quick fix for me, it took me two years of hard work, but the rehab eventually paid off. You’ve really got to set you mind to never giving up, and working hard to beat knee pain, even if there is no guarantee of success.

      If you decide to tape your knee I’d suggest you see a physio show is proficient in its application.

      Comment by quinkin | June 13, 2009 | Reply

  10. Hi Quinkin,

    Can you explain what “walk throughs” are in your exercises? This PF pain is debilitating, with me its more inflammation, rubbing, friction feeling, really bad “chondromalacia” as the doctor puts it. Had MRI which only showed Joint effusion, but everything else is normal. Its been almost a year and surgery is my next step as I’ve made no progress. I’m not trying to run pain-free, just walk, get through my day not being miserable. A lot of the PT, (squats) etc.. are even painful to do. Been doing a lot of SLR stuff. Also for the life of me..I can’t differentiate activating just VMO as opposed to all the quads.. I’ve tried so hard.. I think my tracking problem comes from my laterally rotated tibias which makes the tibial tubercle (where the patella tendon attaches) lateral, thereby pulling the patella laterally. I’ve tried taping which seems to help short term for a few hours..then it feels like its “compressing” the kneecap so I need to take it off. Any help would be appreciated, Your story is beyond encouraging and inspiring. Thanks.

    Comment by larry | June 23, 2009 | Reply

    • Hi Larry,

      From February 2006, to June 2008, like you, I was trying to walk pain free and to avoid knee surgery. I know how knee pain can diminish your life in so many ways, I have been in the same place as you are now. I kept fighting because there was no alternative, patella femoral never leaves you alone to let you have a moments peace! Eventually, although I never expected it to, the pain started to diminish, it was gradual, no chance to celebrate.

      I NEVER dreamed I would run again, I only wanted to walk pain free.

      A massage therapist said to me “one day you’ll wake up and it’ll be better.”

      That day is almost there for me now.

      Walk throughs were a simple exercise that mimics a walking motion. My physio explained to me that my gait was dysfunctional when I walked (My feet were flat and my thigh rolled inwards). In a walk through I imagined I was about to take a walking step, I would imagine landing heel first, then moving forward, concentrating on the knee moving over the second toe, so my thigh didn’t roll inward. I tried to isolate my VMO as well while doing the walk through.

      Like you I’m not sure if I ever got the VMO activations completely right. But the knee tape got the VMO to work better than without. And slowly like chipping away at a mountain, the VMO got stronger, this took from November 2006 until now, I still haven’t completely rebuilt it. However, the stronger it gets, the less pain there is, and the better my knee functions.

      There was also a stage where the tape didn’t seem to help me. I used to get this thing I called the ‘nerve pain’. My physio explained it was the lateral branch of the nerve stretching. It was was either suffer the nerve pain or feel a strangling vice of tightness in my inner quad and sensation of my knee cap about to sublux. I chose to keep using the tape. At other times I had to throw the tape off because the nerve pain drove me to distraction.

      At the worst of my pain in March 2007, I went to see a sports physician, and discussed options for surgery: lateral release, chrondoplasty or patella femoral reconstruction. He ruled me out as a candidate for a lateral release, and explained that chrondolplasty was a bit hit or miss. I decided to stick with the physio. Other than a very weak VMO and a mobile patella there wasn’t anything needing reconstructive work. You could discuss these options with a good sports doctor, get the appropriate referrals.

      All I can say is keep fighting Larry, I wish you all the very best in beating this. The more strength you can get out of your VMO the better your knee should become. I also found custom made orthotics and the right shoes (Brook Addiction 8) to be really helpful. Sometimes, doing swimming or pool jogging was an alternative exercise.

      Comment by quinkin | June 23, 2009 | Reply

  11. Hi, please don’t stop blogging I have only just found you!
    I’ve run for about 7 years and my knees have always caused me problems on and off. I’ve done several 10Ks and loved it but I can never train as much as I want to because of my knees. Have seen physios & been told not to run again ever, then been given exercises by others who say it’s ok…but it’s always come back. It’s beyond frustrating as I’m sure you understand. Thing is, it sounds like what you have! Am travelling atm, so haven’t run in more than 6 months, but am arriving in Coffs to live at end of next month and planning to get back into it asap – I had almost given up hope of getting where I want to be with my running, on account of my knees, but the little I have read of your blog so far, I see a little glimmer of possibility. Am not onine much atm as on the road but will bookmark your blog and read properly as soon as I can. Thanks for sharing your experience and enjoy your next run :)

    Comment by Pam | October 8, 2009 | Reply

    • Hi Pam, I’ll keep blogging. Although the posts will be more about my running than knee pain, I hope. Plenty of old posts about the bad old days of knee pain on here.

      Enjoy the rest of your travels.

      Cheers Quinkin

      Comment by quinkin | October 9, 2009 | Reply


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