Knee Pain and Inability to Straighten After Squatting: Causes and Solutions - Orthopedics

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Knee pain and the inability to fully straighten the knee after squatting can be quite concerning, especially given your history of a marathon injury. Based on the information you've provided, it sounds like you may be experiencing a combination of issues related to your knee joint, possibly involving the ligaments, cartilage, or surrounding soft tissues.


Potential Causes
1. Patellar Tendinopathy: Given your history of running, it's possible that you may have developed patellar tendinopathy, commonly known as "jumper's knee." This condition occurs due to overuse and can lead to pain around the kneecap, especially when squatting or jumping.

2. Meniscus Injury: If you have a history of knee injuries, there is a chance that you may have sustained a meniscus tear. This type of injury can lead to pain, swelling, and a feeling of instability in the knee. The inability to fully straighten the knee could be due to a "locking" sensation caused by a torn meniscus.

3. Patellofemoral Pain Syndrome: This condition is characterized by pain around the kneecap and is often exacerbated by activities that put stress on the knee joint, such as squatting. It can be due to muscle imbalances, overuse, or improper tracking of the patella.

4. Ligament Strain: Injuries to the ligaments, such as the anterior cruciate ligament (ACL) or the medial collateral ligament (MCL), can also cause pain and instability in the knee. If you experienced a significant injury during your marathon, it’s worth considering whether a ligament strain could be contributing to your symptoms.

5. Osteoarthritis: If you are experiencing chronic pain, it could also be a sign of early osteoarthritis, especially if there is a history of joint injury. This condition can lead to joint stiffness and pain, particularly after activities like squatting.


Recommended Solutions
1. Rest and Ice: Initially, it’s important to rest the knee and apply ice to reduce inflammation and pain. Avoid activities that exacerbate the pain, such as deep squatting or running.

2. Physical Therapy: Engaging in a structured physical therapy program can be beneficial. A physical therapist can assess your knee mechanics, strengthen the muscles around the knee (especially the quadriceps and hamstrings), and improve flexibility. They can also provide specific exercises to address any muscle imbalances.

3. Strengthening Exercises: Focus on strengthening the quadriceps, hamstrings, and hip muscles. Exercises like straight leg raises, wall sits, and step-ups can help improve muscle strength without putting excessive strain on the knee.

4. Modify Activities: While you may enjoy running and cycling, consider modifying your activities to include low-impact exercises that do not aggravate your knee pain. Swimming or using an elliptical machine can provide cardiovascular benefits without stressing the knee.

5. Consult a Specialist: If your symptoms persist or worsen, it may be beneficial to consult an orthopedic specialist. They may recommend imaging studies, such as an MRI, to assess for any structural damage to the knee, including meniscus tears or ligament injuries.

6. Pain Management: Over-the-counter pain relievers, such as NSAIDs (e.g., ibuprofen), can help manage pain and inflammation. However, consult with a healthcare provider before starting any medication, especially if you have other health conditions or are taking other medications.

7. Gradual Return to Activity: Once your pain has decreased and you have regained strength and flexibility, gradually return to your running routine. Start with shorter distances and lower intensity, and listen to your body to avoid re-injury.

In summary, your knee pain and inability to fully straighten it after squatting could be due to various factors, including tendinopathy, meniscus injury, or ligament strain. A comprehensive approach involving rest, physical therapy, and possibly further evaluation by a specialist will be essential in addressing your symptoms and facilitating recovery.