Knee joint ???

JWW · Aug 19, 2002

This has been a on going issue with me for a few years now. I go to the doc's and he tells me athritis without even touching my knees.

The pain will sometimes come from nowhere but they usually confine me to the couch after hiking or a hard ride. It make it especially brutal going up the stairs at home. I have even slept on the couch to avod the stairs. The one thing that will sometimes help is a tight neoprene wrap.

So im sitting here at my desk today with my hands on my knees. When I bend them its not really smooth and fluid. The right knee has what feels like a bump that pops up and out the right side when I elevate my lower leg. The left just sort of creaks and rattles. Makes for a heck of a time getting out of my chair.

On a healthys knee is this usually a smooth motion? Does this sound like a arthrites type issue?

Im 27 and aside from smoking I consider myself to be in decent shape. I have been riding for a total of 7 years. 5 years on a quad, took a break for 5 years and have been on 2 wheels for the last 2 years.

Thanks
Jeff

DougMXer · Aug 19, 2002

If I were you I would start taking glucosamine/Chondroiton joint food daily, and go and see an orthopedic surgeon soonish.
Cheers
D

skmcbride · Aug 20, 2002

Jeff,
From your description I would be inclined to say that your problem is not in the knee joint proper, but the patello-femoral joint or simply put your kneecap. Your difficulty with stairs and getting out of chairs or low sofas after some time (called "theatre sign") are classic symptoms of chrondromalacia patellae or patello femoral tracking problems. These are fancy names for compressive or arthritic problems under the kneecap causing anterior (front) knee pain especially in deep knee bending. It is often concurrent with "catching" or "creaking" termed crepitis. The causes are often multifactorial ranging from overuse, poor joint alignment (biomechanics), muscle weakness or imbalance, trauma, extensibity issues, and arthritic changes from all of the above. Often mild and sometimes moderate cases can be effectively treated with rehabilitation without surgical intervention. This will depend greatly on the severity and time frame of the problem as well as your biomechanics. There are many surgical options with varying degrees of success, most of which are done orthroscopically as an outpatient. It sounds to me that a MRI may be in order or a diagnostic scope to see what is going on, or at the very least, a physical exam by a competent orthopedic doc. I am partial to sport medicine specialists as they will be very familiar with your presentation. I could give you more advice with greater detail.
Good Luck, Keith

JWW · Aug 20, 2002

Thanks for all the info. It looks like I have some more homework to do.

I did get with the doctor again. He put my on a drug called naproxyn or something like that. I dont have the bottle in front of me. Within about 5 hours I was able to go up and down the stairs with very little pain. I'm supposed to take them twice a day for 1 month then go back and see him. At this point Im feeling pretty good but the real test will be Monday after I have gone riding.

Thanks again for the info.

MikeT · Aug 21, 2002

Naproxen is the generic for Alleve. Really good stuff, however that just masks the problem I believe. I'd go with skmcbrides advice on this. It sounds like he's either a Doctor or has had his knees rebuilt! :)

JWW · Aug 21, 2002

Mike- Yeah I started thinking about that last night. If im only hiding the problem I wonder is I am doing anymore damage while I wait.

Rooster · Aug 21, 2002

I'm no doctor, but I do know that the use of painkillers and continued routine may lead to more damage. (i.e. if you can't feel the pain, you push harder). I did this with my back last year. I was gobbling down Alleve like they were PEZ and the next thing I know, I'm in thereapy for six weeks.

mingy · Aug 21, 2002

Jeff,
Sorry to hear about the knees. From your description and age this may be something you are going to have to deal with for a while. Keith was right on about seeking a better opinion from a sports medicine guy. Old time orthopedic guys don't consider anything a problem unless they can read it on an x-ray.
As far as the Naproxen/Aleve, this is a standard first line treatment for your condition. It is an analgesic (pain reliever), however this is probably not the reason your doc prescribed it for you. It is also an anti-inflamatory, and this is no dought part of your problem.
You would be smart to take the riding easy while you are on the treatment, but it is not simply to "mask the pain." If taken as presribed it will help to eliminate any inflamatory processes you have going on in those knees. Just be sure to take it with food or at least a lot of water as it can be a strong irritant to the stomach.

JWW · Aug 21, 2002

Mingy- You are correct. He said it was for the anti inflamatory reasons that he gave it to me.

mark_england · Aug 27, 2002

i agree with skmcbride
it sound like you have a patella femoral tracking issue, though this isnt always an arthritic condition,
do a search on a lady called Kate Grace,, she is based in San Diago and probably the world expert in this condition,, she has developed a brace (neoprene) which works very very well.
wearing this and doing the recomemnded excercises works wonders,
i see people who have had surgical proceedures for this condition,,,, most seem un successful , ofcourse i probably dont get to see the successful ones.

but id say the last thing u want is surgury for this condition.

if ur struggling to get Kates contact details let me know and ill sort them out for u

JWW · Aug 27, 2002

Mark- Thanks I will check it out. I use a EVS brace/support right now that seems to help.

I had x-rays this morning and made a appt. for the ortho on the 4th. I've been searching the net looking for info. It pretty much sounds like full recovery is a lost cause.

Will have more info next week.

KDX'r in IN · Sep 1, 2002

This is almost excactly the same problem I have. SKM has right on the docs diagnosis. I am taking relafin and robaxin and going to threapy. Chrondormaltia is softening of the underside of the kneecap. My kneecap would not move, it should move up and down. I also have pain in the hollow area right below the kneecap. Diagnosis...tendinitis. The main thing they do in therapy is to stretch your hamstrings and calves. Then you have to build up muscle. Things they have me doing include wall squats, just slide up and down along a wall, stair step-ups, and leg presses with low weight. One of the biggest things is ICE it. Take an icecube and massage the knee when it hurts the most. If the pain is not severe I use a bag of frozen peas.

JWW · Sep 20, 2002

Turns out to be torn cartlidge in the joint. Gave me the option of surgery or just deal with the pain. I go back in 4 weeks.

dirty~d~ · Sep 20, 2002

Compare the options -

Surgery - Laid up for 4-6 weeks minimum and a slight chance it'll fix the problem, plus it could cause more problems down the road

or

Deal with the pain - uh, that's about it.

As long as you keep your knee and the surrounding tissues in a healthy, working order (strength and flexibility) you should be alright. Taking the glucosamine/Chondroiton formula daily will help minimize some of the problem. Try not to rely on the naproxyn (I hate that stuff) unless you are really uncomfortable and the option of ice/stretching does no good. Knees and ankles are the worst joints to have chronic problems with. Good luck.

JWW · Sep 20, 2002

Yeah I quit taking the Naproxen. It didnt do a thing for the pain. They actually gave me a few different things and nothing seemed to help. Best relief I have found is a EVS neoprene wrap.

I have read a few things on the net and unless it gets alot worse Im going to leave it alone. Spending a couple weekends on the couch is alot better than a month or two.

Chili · Sep 21, 2002

I would be of the same opinion to leave it alone until it is unmanageable. I had Arthroscopic surgery on my knee to remove some bone chips and to shave down a deforming bone, there was also a small tear in the meniscus that was repaired. My assessment after all that my knee still aches like it did before and about the only positive I've noticed from the surgery is I'm somewhat less tender after playing hockey. If you can deal with the pain I would try to stick it out as long as possible.

JWW · Nov 16, 2002

I finally had to do something about my issues. After riding the last few times my knee doubled in size and I could barely make it up the stairs to go to bed. I had arthroscopic surgery yesterday to remove all the bad cartlidge. It turns out I had a problem with the plica in my knee. I was pretty out of it when we left the surgery center so Im not exactly sure what the problem was. Had something to do with too much in there almost double the size or amount. He thinks it could have been there from birth and it finally started to give me problems. I will find out exactly what the problem was when I go in for the follow up. Until then I get to hop around with a immobilizer for 12 days. If you guys have any info please pass it along.

A funny little thing I noticed is my dog seems to know something is wrong. She usually jumps on my because she is so excited. Instead she has been laying by my side the entire time. Its kinda cool..

JWW · Nov 16, 2002

Some photo from the arthroscope

photo 1

photo 2

Knee joint ???

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