Question
QUESTION: Hey there,

Several years ago I partially tore my MCL in my knee playing soccer. I went through physical therapy and everything healed and went back to normal.

About a year ago I re-injured my knee playing basketball. I went and had an orthopedic doctor look at it and he thought I had a partial tear in my PCL. I went through physical therapy again and had an MRI done. Come to find out due to the first injury, I have what he said were a loose PCL and ACL. He basically told me that surgery, if I wanted it, was up to me. My knee has never given out. My problem is that I constantly have a dull ache in my knee. I've been working on making my quad and surrounding muscles stronger, but am completely exhausted with my situation. Please help!

Thanks

ANSWER: Hey David. According to your MRI findings it sounds like you may suffer from knee instability. Instability of the knee may be due to chronic injury of the anterior cruciate ligament, posterior cruciate ligament and/or the medial collateral ligament. Instability results in the knee subluxing or opening abnormally with various activities including pivoting, turning, or twisting. This usually causes pain, similar to the dull ache that you are experiencing. Although, strengthening the muscles which surround the joint is important, you need to also focus on proprioceptive training. Proprioception is your body抯 ability to react properly to external forces. It is the ability to sense where your body is in space and ultimately controls your body抯 movements. Balance is also a key element to proprioception. Proprioceptive training involves exercises that use wobble boards and stability balls. To get started you can practice standing on your injured with your non-injured leg bend at 90 degrees (similar to a stork stance). Note any wobbling. You want to work up to standing for 60 seconds without wobbling. Once that is achieved try the same thing with your eyes closed.  I would focus on conservative treatment before another consult with your orthopedic surgeon. I hope this helps.

---------- FOLLOW-UP ----------

QUESTION: Very interesting! The problem is, I have no idea what I'm doing wrong to make my knee hurt. Some days I wake up and go through an entire day pain free. Other days I wake up and my knee hurts on and off throughout the day. I've thought before that I may have some form of patella tendonitis since my knee is so loose. I am a teacher so I'm on my feet most of the day, so I am directly impacted by this. I belong to a gym, so, do you have an ideas as to what exercises I can do at the gym in reference to proprioceptive training. Thanks a bunch. I too, am a huge believer in conservative treatments first!

Answer
Unfortunately, without performing a physical examination it is difficulty to diagnose you with patellar tendonitis. If this is the case, you would feel pain along the patellar tendon which is located directly under the knee cap. Due to copyright restrictions I cant send any pictures but you should check out websites by searching specifically for proprioceptive exercises. If your gym has personal trainers you may want to consult with them for l exercises and ensure that you are performing each exercise properly.