Pop in knee followed by tightness and slight swelling

Pain & Rehab Forum [Moderated]
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Hello BBM,

A few days ago I was rolling at BJJ and posted my left foot out and felt and heard a pop in my left knee.  I immediately stopped and my training partner did not hear it so it couldn't have been that loud.  It was slightly painful at the time but I was able to walk around and bear weight on it.  The pain went away in about 5 minutes.  This was at 6:00am and I rode the stationary bike for 30 minutes that afternoon and only noticed a little tightness.

The next day, I didn't train at all and my knee was a little swollen but felt fine.  I walked stairs several times that day and noticed a slight tightness but that could have just been in my mind. 

I rode the stationary bike the next day and it felt pretty good.  While I was sleeping that night, I woke up to a dull achy/pain in my knee.  Took some NSAIDS and went back to sleep and was fine.  

I did RDL's the next day and trained as usual and even added in some rowing.  

Overall, it seems okay but occasionally, I'll move laterally and feel a quick pain in my knee that is not severe but makes me think something is going on.  I noticed it the most in the pool with my kids.

Prior to this injury, I had adjusted training to incorporate some Bulgarian Split Squats and that felt terrible on my knees and that same left knee felt quite tight for several weeks.  I did not alter training other than just reducing the activity alightly.  This was roughly 2 months ago and it has mostly vanished until this injury.  As of today, I can feel that my knee is "Off", but I can still bear weight and I am being careful to walk straight and not change directions too quickly.  

I'm trying to get some additional running into my training as I have a Hyrox in December.  Not going to be doing any running until this is figured out and wanted to get some thoughts from BBM about what might have happened and how to proceed with training and activities.  Please let me know your thoughts and recommendations.  

Sorry for the long post.  I thought more info would be better than less.  

Rory
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Thanks for the post. Good to see you again, though I wish it were under better circumstances.

To be honest, I’m not sure anything here is injured at all. A knee can pop for all sorts of harmless reasons, and a pop on its own tells you little. Yours was briefly sore, settled in five minutes, and let you bear weight, bike, RDL, and row within a few days. That’s not how a knee with a real structural problem usually behaves. So I wouldn’t assume there’s an injury to diagnose here.

The occasional lateral twinge and the “off” feeling may be related to a knee that has been exposed to a stress it wasn’t ready for, or it could be nothing. I’d bet you’ve also experienced knee pain (and in other joints) randomly when moving at other times. I’d be curious about any recent changes in training load and or life stress, to see if the unrestricted training we’re working back towards needs adjustment.

As far the plan goes, I don’t know that you really need to modify anything, pending more declarative symptoms (e.g. pain, swelling, etc.). If symptoms have increased, then adjusting training is a good idea. For the Hyrox, you don’t need to swear off running until it’s “figured out,” especially if you don’t have any symptoms. This week will be telling.

For the “just do what doesn’t hurt” idea, I think that’s mostly right, but most people still need to modify something rather than assume everything’s fine as-is. Knee pain is often load-sensitive, velocity-sensitive, or both. The entry point is to take the weight down and slow things down until it’s comfortable: slower tempo, higher reps, +/- a shorter range of motion, +/- a different variation of the movement, whatever lets you train the area without stirring it up.

From there you build back to full training by peeling those constraints off in reverse, gradually.

If you want structure for the rehab part, the Knee Rehab Template lays it out, though you may not need it here. And if it doesn’t sort itself out or you’d rather have someone look at it directly, we do pain and rehab consultations and can build the plan around you.

Further reading

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Thanks, Jordan. This is super helpful and made me much more optimistic. I did take yesterday off completely as a rest day as I’ve been going very hard. Today things feel much better. I’ll see how the week goes with training and keep you guys posted. Thanks for all that you do.

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