Pain on inside of my knee

[miketheskier]

I'm due to get an appointment this Thursday but am due to go skiing next Thursday for a month so am starting to worry..

I dislocated me right patella (third time on that knee) about seven weeks ago. I saw the doctor after a few weeks and he said skiing in January would be fine and passed me on to physio. I decided to use my insurance and went private. The physio told me that everything is fine (there is no patella maltracking), and that I just need to go to the gym and I should be fine.

I've been going to the gym since then, slowly building up and everything was fine until last Thursday. Thursday was the first time I decided to go on the treadmill again since the incident (mainly to get some confidence in really). I managed a couple miles and went to do my usual leg press exercises but stopped short cause something didn't feel right. Two hours later in home, sat on sofa and get a sharp pain on inside of my knee, it starts in the middle and goes just to the top, near the vmo.

Since then I've been popping ibuprofen and doing RICE twice daily. I only get pain intermittently at the moment and it tends to go away if I carry on walking. But the amount of pain isn't subsiding. There hasn't been any noticeable swelling or bruising either.

My gym routine up to that point was:

10-15 minutes Bike and/or step up machine
3x8 reps of single leg presses started from (left: 50 right: 30) and been doing (left: 60 right: 60) since a week before pain
3x20 reps of balancing on bosu ball (round facing up), on one leg and moving foot from tip toes to heel
3x15 reps of single leg step downs
3x15 reps of single leg squats (1 week before pain)
3x15 reps of squats with 6kg weight on bosu ball (flat side facing up)
3 reps of 1 minute wall squat, 5 second squeeze small exercise ball, 5 second just hold it (few days before pain)

Every third visit I would add:
3x10 reps of squats with 30kg weight

Anyone experienced something similar before? Physio said it might be cartilage damage when I spoke to him but the lack of swelling is making me think I could ski through it?

[chewymix]

not sure but my medial meniscus tear never produced any swelling at all - until it was scoped that is...

[flyman683]

Different knee pain location for me (more related to meniscus issues, so lower on the inside of knee) but I had a recent visit with a orthopedic up here who has a lot of experience on the non-surgical, rehab, and cartilage repair approaches. I'm coming off ACL repair and menisectomy about 1.5 years ago. I haven't had swelling, but I've had pretty constant dull pain plus some sharp pain "under load" in recent months.

Some of the interesting things we discussed, that might help longer term:
1) Vitamin D, according to several recent studies, apparently plays a much bigger part in allowing healing on some of these injuries. I'm in AK so I can almost guarantee I'm deficient. Might be same for you too...
2) Ibuprofen/Naproxen use also has shown some major effects on bone density/muscle density in areas of injury/repair. I've tried to cut back majorly from a near daily use.
3) Added in the cartilage helping supplements, even though I think they are probably snake oil... but I'm willing to try it, so who knows.

These things aren't cures but I'm hoping they keep arthritis away for as long as possible. Insurance here won't cover any of the "more interesting" cartilage repair techniques like injections unless you can "prove" arthritis, and I don't want to waste money on an MRI so I'm following those recommendations for now.

It's obviously anecdotal, but I have noticed a bit of the pain has at least reduced over the last month or so... without really changing much else. I'm hoping its the Vitamin D (which has other good effects, and is hard to "hurt yourself" with...)

[miketheskier]

So after an MRI it turns out I have grade II cartilage damage. Can't get a hold of my doctor to see what the issue with skiing is and I'm out in Niseko for another 3 half weeks... Anyone skied with cartilage tears before? Or should I just do damage limitation and head back home?

[jma233]

http://en.m.wikipedia.org/wiki/Artic...rtilage_damage

Its also possible the cartilage damage isn't the cause of your pain. There is poor correlation between those who have MRI findings and knee pain.

[justr]

Scan the healthy population... and you'll find cartilage damage in a lot of symptom free knees, bulging discs in a lot of pain free backs, and findinds in a lot of hips.

Find a great physio.

[WMD]

Yes, many people have meniscus tears without symptoms. There is a new study out (http://www.m.webmd.com/pain-manageme...n-knee-surgery) showing that meniscus surgery may not do any good. I am not a doctor but wish I had not had the surgery as they removed most of my meniscus and now I have arthritis. I have a tear in my other knee and am choosing not to have surgery on it. Strengthening the knees seems to help.

[chewymix]

I could be mistaken without further info but it sounds like you have an articular defect rather than a torn meniscus. That's a rather different outlook in terms of treatment and prognosis.