Your armchair diagnosis: knee issue

[octopus]

@Asimovian

I’m not actually seeking medical advice. I’ve seen my doctor, and I have an MRI scheduled for next week. But since we have a little time before I get any MRI results, I wanted to see what other people think, particularly based on any experiences they’ve had.

A little more than a month ago, while playing tennis, I turned my body to hit a ball while my foot stayed planted, basically pivoting on my left knee. I felt a pretty sharp twinge toward the inside of that knee. I limped around for a couple of minutes, trying to walk it off, and ultimately resumed playing. Over the course of the following week, I played three more times, each time feeling that same tweak in that same spot of my knee more often. The area started to feel “weak” and a bit unstable in the sense that any kind of push off I wanted to do that would impact that part of my knee became harder to do, and by that third night of playing, I had to quit halfway through because I felt like I couldn’t push off at all.

I took about two and a half weeks off from playing. In the interim, I re-tweaked that same spot on my knee pretty badly while climbing down from a ladder. Same issue where I was trying to pivot my leg out to the left, but my shoe had a pretty good grip on the ladder step, so my foot didn’t turn with the rest of my leg. I spent the next two or three days hobbling any time I tried to walk stairs, particularly when going down the stairs. But that seemed to go away after a while.

When I resumed playing tennis a week and a half ago on a Sunday, it was mostly OK. I did feel a couple of twinges in that spot while playing, but was able to keep going. However, the next couple of days afterward were rough going. I played again on Thursday, and basically had the same experience. Finally I played again this last Saturday. I was able to play for just over three hours without experiencing significant pain. And the day after, I was largely pain-free. But on Monday, the pain in that same part of my knee flared up again, and with a vengeance. I don’t recall anything specific triggering it.

For this entire week, I’ve found myself experiencing varying level of pain even when just walking, though against most notable when using stairs. It feels sharpest as I’m straightening my leg when I’m walking, sometimes feeling like the knee is about to “lock” on me. And there’s also an occasional popping coming from the same area. Again, it comes and goes, so that sometimes I can walk almost normally, sometimes it’s moderate, and sometimes I’m limping pretty noticeably. And the level of pain can change dramatically, either direction, from one step to the next.

I finally gave in and called the doctor this morning, and was lucky to get an appointment this afternoon. Her reaction to the description above was that it sounded like a torn meniscus. However, when she did some movements with my leg and knee, I didn’t have any pain or difficulties. She mentioned it was also possible that I might have just sprained the MCL, or that maybe there was something else going on.

So, quarterbacks—what say you? What’s your best guess as to what’s actually going on? Mild meniscus tear? MCL sprain/tear? Other? Feel free to also:

[ul]
[li]place bets on physical therapy vs. surgery[/li][li]share your own experiences of figuring out and/or healing from knee trauma[/li][/ul]

Happy Friday!

My guess based on pain and exacerbation climbing downward is meniscus and ligament, perhaps acl, damage. Surgery.

[tavalla]

I did something fairly similar to my knee, except on the outside, and my progression of symptoms sounds pretty much the same.

Mine turned out to be where the hamstring joins onto the top of the fibula - it comes down the back of the leg and connects to the top of the fibula on the outside, and to two places at the top of the tibia (inside of the knee). So I’ve got one really tender spot, and the same feelings you do of the joint wanting to “lock” or feeling wobbly.

The good news is, if yours is anything like mine, that physiotherapy is doing the job nicely for me. Ultrasound, massage, ice: after three visits (add in dry needling at the third), I’m back to about 95 per cent and I think I’ll get the rest of the way on my own, no more visits needed.

Good luck. I hope it doesn’t come to surgery or anything.

[DSeid]

For the very little my guess is worth I’ll bet on physical therapy.

MRI read as normal makes an injury that would need to go directly to surgery for repair unlikely, whether it is a strained medial collateral ligament (MCL), a tendon injury, or some injury small enough that MRI did not see it internal of the knee (such as the meniscus or the ACL). A period of rehab and see how it goes. If failure to improve then consideration of arthroscopy for diagnostic purposes more than anything else.

Good luck.

[GrumpyBunny]

I’m betting on PT before surgery. They almost always do that first.

PT first. Surgery later. My meniscus – what was left of it after waiting six years to do anything – was removed. The ortho surgeon said it was shredded, and he didn’t think it was just from the original injury. I did dance for years and enjoyed running as teen.

I’ll likely need a knee replacement at some point, though I’m hoping that the technology they have to regrow cartilage improves over the decades and can be used for situations like mine.

Right now, between losing quite a bit of weight, PT/exercise, and occasional steroid injections, it’s doing ok. The ortho doc said that if pain is kept under control with conservative measures, it’s fine.

Best of luck with the MRI and I hope you only need PT, Asimovian.

[Asimovian]

OK, back from the orthopedist.

After going over the MRI with me, doing a number of manipulations with my leg and having me do some walking in various ways, he concluded the following:

[ul]
[li]There is no meniscus tear that he could see.[/li][li]I have a mild strain of the ACL (he noted that the MRI report said that the ACL was “intact” but commented, “Yeah, but it’s not normal, either.”).[/li][li]That I have marrow swelling in the spot where I’m feeling the sharp pain (which he showed me on the MRI image).[/li][/ul]

His theory is that at the point of injury, I slammed my femur into my shinbone and simultaneously twisted, causing both injuries (he disagreed with the technician’s report that the swelling was a result of an older injury).

He gave me a hinged knee brace for walking and told me that I couldn’t do any weight-bearing type exercising for 6-8 weeks (including no tennis, of course). I’m allowed to swim, walk in water or use an exercise bike with low tension on the fly wheel. He wants me back in four weeks to see about progress and to have x-rays taken. There was no mention of surgery, of course, since there wouldn’t be anything to operate on based on his diagnosis.

In reference to the cartilage loss, he agreed with that part of the report, but thinks it’s unrelated to what I’m feeling now, and more associated with age and playing tennis.

That’s all the news that’s fit to print!

[IvoryTowerDenizen]

Bummer on being out of commission for a bit, but yay for no surgery.

[Buttercup_Smith]

Knee injuries suck. I have arthritis in both knees with one being worse. Like you, going down stairs is the absolute worst pain wise. I have been getting lubricant injections which have worked in the past but not so much this go around. No mention of PT but I know I could stand to lose some weight. Motrin works best for me. Steroid injections give temporary relief and certain weather conditions exacerbate the flares. I forsee a knee replacement in the future.

Here’s hoping you can get back to your beloved tennis after the four weeks.