Persistent knee issue

Sounds almost like a knee-cap tracking issue: strength imbalance between the quad muscles. Try doing some straight leg raises with the foot turned out and pulled up (dorsiflexed). Hold for a 10-count, then relax. Repeat. Do this several times throughout the day.

Other question to accompany this would be: How has the bike riding been going?

No bike riding in ages. But the only time I've had a knee pain when riding my bike was when my foot was slightly turned out (there was a little play in the cleat). Turned my foot straight and knee pain went away.

The point of turning your foot out with the straight leg raise is to put the load on the vastus medialis -- the only one of the quad muscles that pulls the kneecap medially. All the other three pull it outward... The VM needs to be comparatively stronger.

And biking tends to do a lot towards balancing out the quads.

New discovery:

When I raise both my legs to a horizontal position, I can feel play in my right knee cap. I can wiggle it around. No wiggle in the left knee cap.

I wonder if I should get a different kind of knee sleeve. I ordered the Zensah knee sleeve to deal with the swelling/to speed recovery. But now I'm wondering if I should get something specfically to hold the patella in place while walking.

I'll try those leg raises, too. Thanks.

The compression sleeve is to take down swelling, speeding recovery - therapeutic. I'm not going to use it to keep the patella in place (now that I've talked to the person mentioned below - I was beginning to freak out). I want to find the source of the problem, not just manage the symptom.

To that end ...

My office is directly across the street from my favorite store - my LRS. The store manager was a sports trainer for a collegiate team for many years. The snapping and newly discovered patella wiggle had me a bit freaked out, so I just ran across the street to have her look at my knee. She looked at my knee and my hips. My hips are off; the right hip is pulled forward a bit.

She said the ITB can pull the patella to the side, if the ITB is tightened at the hip (I had an ITB issue/flare up 6 years ago, same leg, after running 26.2 miles). As the ITB slips around at the knee, it can create the snapping sound (which she heard while I was there). I can feel a little popping at this spot when I flex the knee while putting my finger on the spot.

She said whether it's walking or running, just stepping off a curve or walking on uneven surface can tweak something, leading to a spasm or tightening, then eventually the whole thing goes off the rails.

Foam roller on the ITB, lower back, glute and hamstring; more piriformis massage; ice the knee.

Hope that's the end of it.

I worked my ITB last night and this morning. Ow. Ow. Ow ow ow. The hip flexor area was very tight, as was the knee.

The knee was irritated last night, less so this morning. Hips seem to be better aligned. Heat coming off the knee and, curiously, the veins running across the patella and patella ligament are bulging. I should have brought a cold pack to keep on the knee; oops.

The wiggle in the patella is gone. Just like that. Wow.

Looking forward to the arrival of the compression knee sleeve.

Because I don't have faith that they will solve my problem.

My experience is that doctors favor RICE and pills to treat the symptom; they don't determine the cause of the problem. I know how to treat the symptom.

I had a great experience with my PT 6 years ago (requires a referral from my doc). At this point, I don't think it's necessary. My PT taught me a lot, but the actual therapy was merely learning to strengthen balancing muscles. Planks, bridges, wall sits, lunges, leg press. I got that covered, no need to return to be told to do more stability work.

A better source of outside help would be an LMT, but I think the foam roller was a good substitute for that. Put my hips back in alignment and all the stressed connectivity is relieved. I can feel tightness at the piriformis, so I'll have to do some work with the massage ball again, and stay on top of the ITB to make sure it remains relaxed.

I think the shoes are not the problem. I didn't take care of my lower back and hamstring problem when I should have and I allowed the hip to remain aggravated. Was sloppy/lazy with my own maintenance.