Patellofemoral Dysfunction: This condition is characterized by abnormal tracking on the knee cap (patella) during movements of the knee joint. The contraction of the vastus lateralis and vastus medialis muscles must be coordinated properly for the patella to track normally. Trigger points in either of these muscles can compromise this coordination, causing the knee cap to be displaced laterally.
Phantom Limb Pain: Because the pain from trigger points is typically experienced in a another region of the body, it is often responsible for phantom limb pain in people that have had a limb amputated. These people may be told that their pain is “not real” and is fabricated in their mind, but in reality their pain is as real as anyone else’s pain and has its origin in trigger points in the remaining part of the limb or trunk. Referred pain doesn’t require the body part targeted by the pain to actually exist, as it’s just a neurological reflex designed to tell the brain to modify one’s physical activity so the muscle harboring the trigger point can rest and recover.
Nerve Entrapment: Pain on the lateral aspect of the knee may be caused by entrapment of the lateral femoral cutaneous nerves.
Knee Joint Injury: Strains or tears of the ligaments and menisci are quite common in professional and recreational sports. As with any joint, the knee joint structures are susceptible to abnormal stress from chronic tension in the muscles that move the joint (i.e. the quadricep, hamstring, and gastrocnemius muscles). It is my opinion that many of these injuries could be avoided with some regular (maintenance) trigger point treatment to the vastus lateralis, vastus medialis, and hamstring muscles. I think this is especially true for the athletes at both ends of the conditioning spectrum (the poorly conditioned and highly conditioned athletes). Of course, many of these injuries occur from physical trauma to the leg and knee, and are thus unavoidable in the traditional sense.
Knee Tendonitis: This condition can take place in two locations in the knee joint. Quadriceps tendonitis involves inflammation at the attachment of the vastus lateralis muscle to the patella. It entails pain along the superior and lateral border of the knee cap and is thought to be caused by chronic trigger point activity in the vastus lateralis muscle. Patellar tendonitis or “jumper’s knee” is inflammation of the patellar tendon as it runs from the bottom of the patella to its attachment on the tibia bone in the lower leg. It is not thought to have a myofascial origin or cause.
I.T. Band Syndrome: This condition is typically seen in runners and produces pain and tenderness around the outside of the knee and lower thigh. It may be caused by trigger point activity in the tensor fascia latae, vastus lateralis (pain) and/or gluteus maximus muscles that produces excessive tension in the iliotobial tract, causing it to rub back and forth. It is typically seen in bowlegged runners or runners that have excessive wear on the lateral sole of their running shoes.
Growing Pains: Unexplained knee and thigh pain in children is often attributed to “growing pains” when trigger point activity in the quadriceps (and other muscles) is the real cause. Children are constantly pushing their bodies to new limits and can easily overload the leg muscles while playing.