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Knie blessure

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Description of problem

left knee, located on the inside posterior side.
My anatomy knowledge is pretty sparse, but as far as I can make out examing myself, there are two tendons running along the inside of the knee, from the hamstrings, to the gastroc? (or inserting into the tibia? It seems like one tendon is slipping over another one whenever I stretch the hamstring.
Example: Lying flat on back, bring straight leg up towards head as in a lying hamstring stretch. When I get to a certian distance a tendon just to the left of the outside one, slips to the right, over the outside one. It will remain locked like that until I unstretch the muscle, at which point it just slips back to normal. Originally it wasn't very painful, but it's been happening more recently lately, and has become more painful, and is starting to occur when I walk down stairs as well.
Another issue with that knee that has popped up, roughly at the same time, is a burning sensation underneath the top of the knee cap when kneeling on it in certain positions.
I went to see a Dr. about it, her prognosis, was:
Your knee might not be tracking properly, you have a strength imbalance between the two sides of the quad muscle that insert into the knee (I'm guessing the "tear drop" portion and the one on the opposite side.) She suggested swimming and cycling to strengthen the knee, saying they were the best exercises. And take pain killers. So obviously I was a little choked. Rehab? whats that? Well, anyways. My theory is that there is indeed an imbalance in the quad muscle, as well as a tightness in the hamstring muscle. Unfourtentely due to some nerve damage on the inside of that thigh left over from a muscle graft surgery, I feel that when doing exercises such as squats the inner portion of my quad, as well as the center and where it inserts into the knee; doesn't seem to contract as strongly as the other side. Just my observations.

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Welcome to my world!
Yes, it is your vastus medialis (VM) muscle, the teardrop. The doctor is right (there's a change).

This muscle atrophies very very quickly and the longer you leave it, the harder it is to make it work again. The problem is your body gets clever and uses all sorts of other muscles to do the same job. What you are feeling is the result of these muscles doing a job that they are not supposed to be doing. Even worse, this leads to a catch 22 because these muscles are learning a job that they aren't supposed to be doing and start to become good at it. Worse again, these muscles get tighter and further pull the knee out of alignment and so the vicious circle continues.

The standard ill informed bullshit resonse from doctors is to work the VM through the top range of motion only and do things like swimming and cycling. Sorry. This does not work.

The solution. You aren't going to like this. For now, stop doing any quad exercises as they are just making things worse. After a week or two, when the muscles have relaxed and the pain that you describe has gone, you can resume albeit with light weights.

BUT.. here's the big tip. Start the leg workout with the hack squat machine. Do not add any weights. Go as low as you can go, i.e. below parallel focussing only on both the eccentric and the concentric contractions in your VM. You will know you are doing it right because the atrophied VM will burn like crazy.

The correct body position to be in is much like sissy squats.

The first set, start in the low position (i.e. start from the bottom as it is easier to start with a concentric contraction than an eccentric contraction) and go upwards to just below 3/4. Go down to the low position again whilst keeping making sure that your VM is doing all the work and repeat for as many reps as you can stand, probably around 6-8 at first because it kills because your muscles are under constant tension.

The next set, go from low again to just about 3/4, again working on the constant tension.

The third set, do full range. If everything is right, you should feel no pain in your knee at all. However, you will feel a bit sick... sorry, can't win them all.

Anyway, once you have done three sets of these. Do some squats with just body weight and you will find that you are now tracking properly.

Now, try squatting with just the bar.

The hardest part is to resist the temptation to increase the weights too quickly. Each session you can increase the weights a little more.

You have to ensure that the muscles fire in the correct order. Once you have this happening reliably you are well on the way to recovery.

I hope this helps. I feel your pain (literally). My third knee operation went very wrong and I could not bend my leg for six weeks and I spent a couple of years taking advice from people without a damn clue.

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