Thread: Knee question...

Early February I hurt my MCL in my left knee....when I fell, heard the pop and knew that something was not right. Went to an ortho (didn't get an MRI done, only X-rays) and a PT and the conclusion was a second degree MCL sprain...nothing too big. I mentioned at the time that I was having some very slight pain towards the top and underneath the kneecap and the doc said that it was probably nothing major....but.....
With the weather turning nice, I got out onto the bike to do some riding here and that has kind of exascerbated some things. Went out for about 3 hours each day this past weekend and I have had some pain in the kneecap area for the past two days...specifically the upper portion. Recently, I have noticed a consistent popping in my knee. It's not audible, but if I place my hand over my knee cap and flex, I get to a point where the weight on the leg causes a small pop in the kneecap. Also, if I am down in the catcher position (as in baseball), putting weight on the leg to lift myself up makes the kneecap area sound like velcro being pulled apart.
My Question is then, did I do more damage to my knee than originally thought? It seems to me that there is perhaps meniscus or cartilage damage in the knee and it is concerning me. Did I perhaps screw up my ACL as well? I realize I need to go to a doctor...which I will, however, I do not have health insurance now and am looking for some sort of idea as to what may be wrong...an MRI is definitely in the relatively near future. Thanks for any help or info provided.

First, get health insurance, this could get pricey. MRIs are pretty expensive.
Second, get your ortho to give you a script for an MRI, thats the only way to confirm anything. Sounds like it may be meniscus damage(pain near the kneecap) and a torn lig(the popping, catching sound).

JMHO

B)

Dark Star: what you are describing is most likely patello-femoral syndrome. the criunching/popping sensation you describe is a bit of roughness on the back side of the knee cap as it rubs against the surface of the femur. This is usually an overuse and or degenerative type of problem that is most likely either related to a biomechanical isssue or a muscle imbalance/tightness issue you might have. So what this means is it is probably not related to your MCL injury. Very likely it was there before the MCL since this type of problem does not come on over night. It takes quite some time for the sympotms to appear, once you realize something is wrong it has already been there for a while. BUT, your MCL injury "may" have caused you to notice this more, especially if you were limping around on it, your quad got atrophied, muscles got tight etc...

A good anaolgy of patello-femoral syndrome is driving your car with the front end out of alignment, it begins to wear at the surface of the tire. In this case that suface that is getting worn is the surface of the patella or the surface of the femur.

A few common causes of this type of injury:

1. tight hamstrings: this one is one of the most common, causes the patella to be compressed into the femur
2. fallen arch: I know its along way from your knee but a fallen arch can cause misalignment of the patella
3. weak medial quads: allows the patella to ride to the outside of the froove that it sits in
4. tight IT band: pulls the patella to the outside of the groove:

Now this is not an exhaustive list, there are many more causes and sometimes there may be more than one that is causeing your injury.

For starters try stretching the hamstrings 3-4x/day everyday and see what happens. Give this maybe 3 weeks of this. If there is no improvement than go see your ortho doc and tell him you think you have patello-femoral syndrome and want to get rid of it.

MRI is not necessarily needed for this injury. A good doc can make this diagnosis without any imaging at all. Figuring out the cause is most of the battle. After that correcting it is easy.

Vinman....

Thank you very much for your in-depth reply. It sounds like this is a distinct possibility...I was hobbling around for a couple of months after the injury itself and I did what rehab I could (which admittedly was little...) Quad muscle definitely atrophied some so this could certain be an effect of that. It's not painful, really. At times I notice a slight discomfort when walking up a steep grade, but aside from that I don't really notice it. Sometimes the knee itself still feels a little bit weak, but nothing major. Thanks again for the reply.

DS

First get to someone in your area who does tons of knees & does them well.

Second: sounds like there are 2 more posibilities. Patellar tracking issue vs./&/or Plica formation.

Lateral Patellar Tracking : the muscles on the outside of your leg are much stronger than the muscles on the inside & they pull the knee cap outward instead of upward

Plica : the tissues in the knee become inflammed & tiny folds become irratated & cuase the patella to "jump" or "stutter" when you extend your knee

Both are more of an overuse issue & could be brought out by "fall down go boom" on the snow or hoppping on the bike for a 3 hr ride in the early season. anything that would cause swelling & inflamation & increase the float of the patella....thus the soft tissue in the knees to become sensative to the floating of the patella

Best to get a correct diagnosis & start from there; best of luck for a speedy recovery