Knee damage

Having ran for 5 years on all surfaces and terrain, I was talked into taking part in a five aside football match.

The upshot is That I have injured my left knee. have been to the doctors then physio, but was told The ligaments and muscles around the knee were fine.
I have been referred to a specialist for possibly an MRI scan as they can not help.
I would assume surgery may be on the cards, the question is have any of you out there been able resume full strength and mobility post op?
I was advised that swimmimg or cycling may help however the last thing I need right now is to make matters worse.
I appreciate I am looking at a worst case scenario, but as my legs in agony and can do nowt else but wait for the appointment.
Anyone?

Post opperation rehab is much better with good fitness going in to the opp. If the pain is on impact only then cycling and swimming may be just the thing. My partner was out of running for 4mths due to a foot injury that was slow to respond to treatment and it's only the swimming and cycling that kept him sane, not a miserable sod and me from killing him!!! Is the problem front, inside, outside, back of knee? I really do hope that it can be fixed without the need for surgery. This is a great little link that I often use for research purposes http://www.runninginjuryoracle.com/.

Um... if the ligaments and the muscles around the knee are "fine", why would you need an operation?
Definitely get the MRI to see if there is anything crazy knocking around in there, but please don't go jumping into an op, once you take something out of the knee, you generally can't replace it...

is it in agony as you sit still, as you move it a bit, as someone else moves it, or what? if the doctor and physio can't help, find someone who can.

My daughter really crocked her knee the year before last and could barely walk on it for a couple of weeks. She had an MRI but it came out all clear. The surgeon was really disappointed about it too :) and she was back playing rugby in no time

I had knee problems about 7/8 years ago, I had a very good Physio at the time she give me exercises to do, but she advised me that if I saw a Doctor and was referred to a surgeon he would want to operate and I was to avoid this at all costs, because in her view they can do more damage than good.

I ended up taking 7 months out of running and did my exercises in the gym 3 times a week, the result was the knee is now fine and I descend better than I climb with no knee problems. If you haven’t already done so, see a good physio I am sure there must be some on here who can recommend one. Sorry if I am telling you how to suck eggs.
:o

ATB

Tahr

Thanks for all the replies,

race the sweeper,
its my left knee & if you place your left hand over it, the pain would be under your thumb & little finger, usually in the muscle, also there is a lot of pain if I bend my foot to my buttocks there is a great deal of pain behind the knee. Usually twice a day the joint seems to give way causing me to stumble with intense pain under the kneecap.

Zephr,
Sitting down it just aches, and its what wakes me up every morning,it seems to really swell up in the evening. it is very painfull when the joint ,locks out straight, all of this does,nt seem to be easing.

I have an appointment tomorrow with the specialist, fingers crossed he may be able to shed some light. I am just guessing surgery may be onthe cards

I allways look on the black side, that way your never dissapointed with the outcome.

Tomsdad

Quote:

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Originally Posted by tomsdad

Thanks for all the replies,

race the sweeper,
its my left knee & if you place your left hand over it, the pain would be under your thumb & little finger, usually in the muscle, also there is a lot of pain if I bend my foot to my buttocks there is a great deal of pain behind the knee. Usually twice a day the joint seems to give way causing me to stumble with intense pain under the kneecap.

Zephr,
Sitting down it just aches, and its what wakes me up every morning,it seems to really swell up in the evening. it is very painfull when the joint ,locks out straight, all of this does,nt seem to be easing.

I have an appointment tomorrow with the specialist, fingers crossed he may be able to shed some light. I am just guessing surgery may be onthe cards

I allways look on the black side, that way your never dissapointed with the outcome.

Tomsdad

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Pain along the joint line on the inner half with some swelling most likely due to a medial meniscal tear, pain behind the knee cap in extremes of flexion and a grinding sensation could be caused by damage to knee cap (patella) joint surface cartilage (chondromalacia patellae). Pain below the knee cap is usually patellar tendonitis.

You can look these all up.

Pain behid the knee in the muscle is usually just that, a muscle strain.

Your 'giving way' sounds like it is due to the pain and not likely to be because of an ACL tear if someone has already examined it correctly and found the ligament to be competent.

An MRI is the way to go as things are not resolving. Keep an open mind, see what it shows, may not be as bad as you think.

Yup- I'd go with silent runner on that one.
Get an MRI if you can.

It may take a while to get one, but its better waiting x months for an MRI, and the results in order to find that its something that can be rehabbed, rather than going the whole hog, getting something taken out of your knee that can't be put back and stops you running as well as you could for the rest of your life.

I know a couple of people who have had meniscus tears in the past, and haven't gone for surgery- they are now running better than ever. (that being said, every situation, and every body is different) Get several opinions before committing to anything.

Cheers for the replies,
I had a couple of x-rays, these showed (from the front view), the two nuckles meeting with the usuall gap but thinner on the inside of the joint (towards the other leg)
I was advised that it was one of two things - arthritis I,m only 43! or cartillage damage but, I dont think the sudden onset can be down to arthritis as I can jog but its most painfull to walk on.
I m on the waiting list for an MRI, if It is cartillage, would excercise help the healing process or would I have to visit a sports injury specialist for guidance

Td

completely agree with zephyr and silentrunner re taking a conservative approach

But do as much exercise as you can - change your exercise, don't stop it.

See a decent physio; do whatever doesn't hurt too much: swim, walk(in good shoes, on the flat) or cycle(low resistance and a long way, not stomping up hills)
Same principles if you use machines to exercise; knees need good muscles, and your head and heart need the exercise

google / sportsinjuryclinic.net or youtube 'static quads exercises', and if you can(pain permitting) try 'lunges' or 'dips' on one knee to strength your medial(inner) quads muscle and re-balance the patella(kneecap) tracking around the femur(thighbone) - caution - this may hurt - if so - physio first

'joint space narrowing' implies that the x-ray-invisible cartilage is worn; this is technically the first stage of 'arthitis' but it is inevitable in all of us and NOT necessarily likely to lead to destructive joint problems.
If your leg and thigh muscles are sound, your technique reasonable, and your training sensible you can be optimistic in the longer term.

a word of caution re MRI - you may end up a VOMIT - 'Victim Of Medical Imaging Technology" - just because you can see something on the picture doesn't mean it is the cause of the problem, or that cutting it out would be a solution...

CoI I'm a slightly cynical GP , and 'carry on regardless' runner

VOMIT.
I like that.

A question we have not asked; what was the mechanism of injury? I am curious because some bloke headbutted my left
knee this morning as he fell to the ground and, obviously, my knee hurts a lot/swollen etc but I am confident of the injury because I understand how it happened.

I was diagnosed as having arthritis in my knee at 40, it was no real surprise to me as my father, Grandfather and brother all suffer from the same problem, the exercise I did to strengthen the knee was almost exactly the same as Drmorris described, see my previous post. My Physio told me whatever you do don’t stop running,:) it works for me, if I do have to take some time off though other injuries or personal reasons the knee can start to niggle a bit after a couple of months without running.

ATB

Tahr

Go onto YouTube and watch the excerpt from Naylor's run, and listen carefully about the damage he sustained to his knee and how he has managed to carry on after that.... sounds familiar? He is describing what we now refer to Pose or Chi running, funny that a fell runner in the 70s and 80s knew how to adapt himself without the shoe companies telling him what was needed.

NEVER STOP RUNNING! ;)

Silentrunner,
thanks for the reply, I have the DVD & will look into it
justbeen told by the consultant that I have arthritis under my kneecap and on the inner side of the joint.
Basically he told me never to run again and focus on cycling, as any further running will just increase the pain ang ultimatly degenerate the knee.
I have the option of keyhole surgery to trim the cartilage but he emphasised that there would be no guarantee this would help matters.

I,m absolutly gutted to say the least

Td

What a load of tosh. What did your orthopaedic surgeon look like? Did he look like he enjoyed sport or was he just giving you a safe answer. If he truly listenend to you, then he would have helped you run, not put you off it and scared the bejesus out of you.

I don't want to knock anyone but you have to keep running, just look after your knees.

Quote:

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Originally Posted by tomsdad

Silentrunner,
thanks for the reply, I have the DVD & will look into it
justbeen told by the consultant that I have arthritis under my kneecap and on the inner side of the joint.
Basically he told me never to run again and focus on cycling, as any further running will just increase the pain ang ultimatly degenerate the knee.
I have the option of keyhole surgery to trim the cartilage but he emphasised that there would be no guarantee this would help matters.
I,m absolutly gutted to say the least
Td

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Tom's Dad, I have exactly the same problem as you (at least I have the arthritis under my kneecap) and I had arthroscopy about 11 years ago to trim some bits off. Some of the doctors and consultants that I've seen over the years told me not to run (to non-runners that must seem like the bleeding obvious) but I have found I can manage it by still running and, when there's a painful phase, not running but just for a while. In the past 3 or 4 years I've done loads of fell running including (and I'm proud of this) the Three Peaks Race last week.

In my experience: arthroscopy was useful because it showed me the extent of the damage BUT it took some months to recover from this operation. However, if you are having a painful phase, you've a few weeks without running anyway. Glucosamine supplements didn't make any difference to my arthritis (but other people have told me it made a big difference to them). Don't run when it is painful (some painful phases last for months but I've recently had a relatively non-painful phase lasting a few years); use extra cushioned road shoes for road running and add under arch / heel supports to all your shoes (not just running shoes). Don't carry heavy bags (I made the mistake of a long trekking trip to the Himalaya with a heavy rucksack and took months for the pain to subside afterwards). When you do start running again, limit how much distance you do in training - I do the bare minimum to be able to cope with races that I'm planning. Don't run the downhills in training - steep downhills generate the most knee pain for me - so I just 'slow jog' desents except in racing. Avoid fell races with long steep descents - takes ages to recover the knees afterwards. Short fast races and trail races suit me best because they are testing in terms of fitness but limit 'time on feet'. Obviously Three Peaks was an exception and now, 10 days on, I'm still suffering with knee pain and taking very very short runs only (25 mins on the road) and stopping to walk when I feel the knees. I knew this would happen and went ahead anyway - my choice!

Some people are properly unlucky with serious cartilege damage from arthritis that means they definitely can't go running - everyone is different but only you will know how your knees are feeling. Don't be in denial if they hurt, but with a long rest, you might be surprised. Doctors who are also runners have always encouraged me to 'self-manage', including when I fractured my kneecap (the other one). And I understand that you're gutted. I get p*ssed off with mine but I have learned to be pleased with the running that I can do. And in the 11 years since arthroscopy, it hasn't got worse overall - except some phases / bad patches. Maybe my knees will turn out very bad in my 50s or 60s but I've deliberately taken this choice - I'd rather run now and take the risk. Each to their own, but saving my knees for later, and resting through my 40s, didn't seem right.

Good mental attitude Eleanor.

I don't agree with the extra cushioning and arch/heel supports without correct indications, but I agree with your sentiment.

Gus shows a nice (or not!) photo of his knee cap here during keyhole surgery to clean up the knee and he is back running again now
http://penninefellrunners.co.uk/wordpress/?p=554

Quote:

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Originally Posted by tomsdad

Silentrunner,
thanks for the reply, I have the DVD & will look into it
justbeen told by the consultant that I have arthritis under my kneecap and on the inner side of the joint.
Basically he told me never to run again and focus on cycling, as any further running will just increase the pain ang ultimatly degenerate the knee.
I have the option of keyhole surgery to trim the cartilage but he emphasised that there would be no guarantee this would help matters.

I,m absolutly gutted to say the least

Td

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Surely the sudden onset of your pain tells us it is not due to the arthritis seen on your X-ray - these changes will have come on over years/decades, not overnight. You will need to decide for yourself whether you follow your Consultant's advice or not - if it was me I think I would be following the gist of Eleanor's advice.

I am reminded of Denise Park's article in The Fellrunner (Spring 2008) about Maureen Laney's knee - X-rays showed early OA but in fact she had a torn meniscus which was the cause of her pain - and at surgery no sign of arthritis was found.

Quote:

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Originally Posted by silentrunner

I don't agree with the extra cushioning and arch/heel supports without correct indications, but I agree with your sentiment.

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Yes good point silentrunner - I had my insoles sorted via my physio and the surgeon who sorted out my fractured kneecap - so corrent indications on these are very important.