I write this from the love seat, as I sit down for a mandatory icing session for my knee.
As you may or may not know, I have been having an issue with my left knee since November 2010. I’ve been to two sessions of physical therapy (with two different providers), and had 3 sets of x-rays. I can be doing ok for weeks and then have debilitating pain.
The first ortho told me I had osteo-arthritis in my knees. I was give a cortisone shot in each knee, and then I went through my first course of PT. It seemed to be doing better. When it flared up again, my PCP did a second set of x-rays and said she absolutely did NOT see any arthritis, and she felt my issue was patellar-femoral syndrome. A fancy way to say my knee cap doesn’t track properly in the groove at the bottom of my femur. I went to a 2nd course of PT, which was focused on strengthening my quad so that it could help to pull my knee cap back inward. I finished PT and was doing better, but now it’s back again.
This time the pain seems more intense. I hurt pretty much every day, some days more intense than others. The simple act of getting up from my desk and walking to the break room at work takes effort and causes pain. The other day I stepped out of the car and put my weight on my foot to get out, and felt the sharpest pain yet. I really thought I was going to fall on my face (which would’ve been über embarrassing because several neighbors were outside at the time, lol). I can be in bed and bend my knee slightly and the pain will shoot out.
So, I called the doctor.
She saw me today and during the physical exam she was moving my knee and leg in different directions and it was very stable. She did note that it is swollen, and when she pressed on the outer edge of my knee cap I felt immediate pain. After she moved my knee around and she went to straighten it back out, I felt that familiar sharp pain.
Dr G told me that the stability of my knee tells her it’s not a ligament related issue. The pain I felt when she straightened my knee out, along with some of the issues I’ve described, made her think there could be a meniscal tear, but she still wanted to do another set of x-rays. Set #3! Yay! Not. LOL
We reviewed the x-rays, and I noticed she kept zooming in on one spot on my knee cap. I don’t know if I mentioned it before, but I have patella alta. Reach down and feel your knee caps. See where they sit? Lower down on the femur. Well, mine sit about half an inch higher than the average knee cap. Not a problem in and of itself, but combined with the angle of my knee cap, it is likely contributing.
I also have a bone spur on the outer edge of my femur, and because of where my knee cap sits, it is rubbing/catching on that spur. Definitely not helping the situation.
She still thinks the majority of the issue is the patellar-femoral syndrome. I basically was near tears when I asked her, “so basically, this is my life because I was born with high knee caps?!?”
She said no, that it was absolutely treatable, but she is concerned that in addition to that there may be a tear. She’s about the same age as me, so she said that at our age, there doesn’t need to be some catastrophic event to cause a slight tear in a meniscus. It could be a simple as squatting down wrong.
Right now I am awaiting my referral for an MRI, and a PT referral with a 3rd provider. I feel my wallet shrinking by the minute, but I need to get better. I feel great about this MRI referral, because I have felt for a while that something of a soft tissue nature was going on…but it seemed like nobody believed me. At the end of the day, I could be wrong, but I’d rather have the test to rule it out. Definitely tired of going in circles with this.
As far as activity level, she told me to do the things I can tolerate. I asked her about biking since we have a Tri It For Life meet up for a bike session. Dr. G said I’m fine to bike as long as I focus on keeping an even cadence with my pedaling and not setting the gears so hard that I’m pushing down with a lot of force.
Once she sent me on my way, I did meet up with TIFL for a run. We basically did Week 3/Day 1 of C25K twice (out and back) and I wore the brace I got from the first ortho (lol). I was able to complete the workout with minimal pain. I will take some anti-inflammatories tonight and we’ll see how I feel tomorrow.
I am hoping this MRI will tell us what we need to know. Keep your fingers crossed.