Daily Mobility Exercises by Dr. Kelly Starrett Forums General Chronic IT band/quad TIGHTNESS and knee pain (chondromalacia patella?) for 6 years! Re: Chronic IT band/quad TIGHTNESS and knee pain (chondromalacia patella?) for 6 years!


Hey Kaitlin

Glancing over some of your other posts, you seem really passionate in helping
people heal. I have the same passion, but I feel like I have hit a roadblock
with myself that I can’t pass. I know that I am missing something in the puzzle
on healing myself. Glad you can offer some advice.

 Therapist have tried determining the
cause of my tightness. I was instructed it was a muscular imbalance, and that weakness
in my glute medius was the main culprit. Also was instructed, and read that
glute max, the deep core muscles, and VMO had a lesser role, although still
important to address. So I was first doing basic exercises such as clam shells,
bird dogs, X-band walks, hip thrusts, planks, lying side leg lifts against wall
etc.., then I added 90/90 split squat, single leg squats, single leg deadlifts,
wobble board balance. This was in order to activate the glute medius, glute
max, and then start getting VMO involvement as well as doing more functional

After doing  all that for years I still have knee pain, I
was doing it really religiously this past summer (it actually feels like my
knee pain is worse now), But the tightness I have in my IT band and quads may
have decreased roughly 30% in the last year, and the patella seems to be
tracking better, although it feels really compressed and tilted (i.e., the
lateral half of the patella is more compressed/tilted towards the femor, this
is also slightly shown on the x-ray where their is a slight decrease in joint
space were I feel the pain coming from, although the sports medicine physician
says everything is fine, and thats just a slight tilt in the patella and their
seems to be no cartilage damage). More recently (this past month) I am also
doing postural exercises as advised by a new physiotherapist I am seeing that
is highly regarded in my area. He has me focusing on keeping an aligned spine
while maintaining different positions, and also doing body weight squats with
an aligned posture. He says I have an anterior pelvic tilt, lordosis in my
lower back, and kyphosis in my upper back. He thinks the posterior excercises
will address those issues, and subsequently reduce my knee pain and help with
the entire kinetic chain, and result in less IT band tension. He says he is
really surprised tho that I have such knee pain given that my posture isn’t
that bad (he has seen people with worse posture and in no pain), and given that
I dont do extensive physical activities, he says hes seen cases similar to mine
but the difference being is that they are overdoing physical activities such as
running a lot (marathons etc..) But in their cases their symptoms subside
dramatically once they reduce physical activities, and through some corrective
excercises their issues are resolved within a few weeks-months. I asked him
about self-myofascial release and ART etc.. He says that will only bring
temporary relief as that is only addressing the symptoms, not the cause. 

I typically do physiotherapy exercises every 2-3 days now
(once upon a time I was really strict and was doing it every 2 days but noticed
I wasn’t really getting anything out of them, so I slowed down a little), The
exercises last over 1 hour, and I follow it with foam rolling, and stretching,
and suction cupping which also lasts over 1 hour. The whole session ends up
being between 2-3 hours. I also do postural exercises (in separate sessions
from the physiotherapy exercises) every day followed by foam rolling (if I dont
foam roll after the exercises my muscles will be very tight and be in pain).
The postural exercises are about 20 minutes followed by 20 minutes of foam
rolling. The physiotherapist told me to do it 4 times a day. But I dont see
that as realistic (were am I going to do them in school, and were am I going to
find the time since I am already doing so much rehab work. I have done them at least
once a day, and sometimes twice. These exercises I was doing at home, but
I was going to physiotherapy periodically to ask questions, and so they can
check my form.