Lateral release

[Trek420]

I start PT in a week or so, then I'm going to meet with a trainer and see if she's willing to work with me to strengthen my legs (and the rest of me). My goal is to finish a half marathon in November - most likely my last.

Sounds like a good plan. I think you're right about the expiration date on joint replacement. I considered toe joint replacement (no kidding). After multiple consults considering what my options would be in 10 years when that fails (pick a sport or shoes and fuse the joint to match that) decided to work on the joint ... and the rest of the bod instead.

With the right PT and training here's a toast to you conquering your half marathon and many more.

[ef2204]

Snapdragen, From what I know about the lateral release, there are two things that are accomplished with the surgery. First, releasing the tendon on the outside of the knee cap keeps it from pulling out of place and therefore gets rid of the grinding feeling inside of your knee when you bend it and causes the irritation. Second, it gives the docs a chance to clean out the inside of the knee socket and remove/repair the shredded tissues caused by the knee cap pulling up and out. The pictures from the inside of my knee before and after show a dramatic change.

I did learn in the process that "over-strengthening" the muscles on the inner-thigh side of your quads (I'm forgetting the correct muscle name) immediately above your knee can counter act the tight tendon on the outside of your knee (which is what pulls the knee cap up and out of track). Women are particularly prone to problems with this injury because the width of our hips emphasize the strength of the major quad muscles and we don't focus on strengthening the other supporting/balancing muscles. By super strengthening the inner quad muscle, you can help bring the balance back - perhaps without surgery. Running builds the muscles on your outer quad, so find an activity or exercise that will balance that strength if you can. I would recommend that you try everything you can to work that inner-quad muscle to avoid having surgery. I have found Pilates classes (on the reformers) to be a huge help with building strength in the underlying/supporting muscle groups.

During PT to recover from the surgery, they also teach you to completely relax your leg and put your fingers on the outside of the kneecap (almost under it where the tendon connects) and push the knee cap towards the inside of your leg - flat across the top of the knee socket. In the recovery stage, it keeps tight scar tissue from forming where they released the tendon, but might also help you now with lengthening the tendon (and perhaps helping to avoid having to release the tendon). After having the lateral release, I can pick my knee caps up and move them side to side.

If your PT is worth their credentials, he or she should be VERY supportive of your desire to try strengthening before surgery - it might take months to a year to see improvement. At the very least, it will put you at a better fitness level going into the surgery, if needed, which makes recovery easier. Best of luck to you!

[KnottedYet]

VMO - vastus medialis obliquus
It's the tear-drop shaped critter you see bulging out on the inner side of the thigh above the kneecap. It shows up very nicely in sprinters, they have honkin' VMOs.

Lots of VMO-specific exercises out there. When you find one that looks good to you, rest your fingers on the belly of the VMO to be sure you can feel it kicking in.

And ask someone to check your body mechanics to figure out what made you tight laterally in the first place. (anterior pelvic tilt, internally rotated hips, knee locking, over pronated feet, etc.) Wide hips allow women to get away with some sloppy mechanics, but we pay for it later.