Hey guys! I was asked to post this here for further review, and I greatly appreciate any guidance on where to go from here. Here’s the breakdown, from a 30 year-old female:
Knee Symptoms:
- Pain is centralized in inner side of right knee. Feels like something engorges and rolls around there after I’m more active.
- Lots of catching, locking & sensation of giving out, especially when stepping/lowering down
- Very notable increase in crepitus
- When I bend & straighten my knee, it feels like it jumps the train track–not moving smoothly at all.
- Swelling (decreased over the past 2 weeks with reduced activity, but was very swollen initially)
- Inability to bend knee fully (which is improving as swelling decreases)
- No trouble/pain when knee is fully straightened
- Still able to walk, even hike, with very little pain–bigger annoyance is inability to move freely
- History of issues/surgery with this knee: dislocation, osteochondritis, and chunk of femur removed from behind patella in 2000; OATS Surgery in 2010 after 2nd dislocation (meniscus was torn then, but not repaired). Happened after doing relatively heavy squats and weighted box step ups 2 weeks ago, after several weeks of working out more than I used to. Coach said my squat form was great, but right after I finished I felt unstable doing weighted lunges and switched to box step ups. No notable “pop” but by next day, knee was very swollen, painful, and motion was very limited (including difficulty even walking).
Hello, I have a few questions before giving a longer response.
How is the swelling now? Typically I revert to the classification of “barely noticeable”, “ping pong ball”, “orange” if that makes it easier to respond.
What have you been doing for training in the interim?
Derek
Hi Derek,
Swelling is much improved, “barely noticeable” sounds about right. Other symptoms are improving as well.
Regarding activity, no strength training for the past 10 days or so (was on vacation, and didn’t want to make the situation worse without knowing more). Have done a few hikes in the interim though, generally felt ok apart from the trouble descending/going downhill as described above.
Thanks again for your guidance.
That is awesome to hear. If your flexion is coming back fully you are likely over the hump. It is not uncommon to have some occasional swelling with acute increases in activity or introduction of new exercises if you have had any surgery to the patellofemoral joint. They typically resolve on their own with some slight modification, and then reintroduction of the activities. Any time you have increased swelling in the joint it is common to have increased crepitus or feelings of “giving out.” This too resolves as the swelling goes down. It is highly unlikely that you did anything “wrong” with a movement, but more likely the increase in volume or addition of some new exercises. You will be perfectly fine to resume training when you get back from your vacation. If you have any additional problems as you are resuming training let me know.
Derek
Thank you Derek, that’s much appreciated (and reassuring). Will keep you posted!