Author Topic: muscle/tendon "snap" or "catching" sensation inside knee (Read 8729 times)

casual runner · « **on:** January 21, 2012, 05:26:43 PM »

I've been doing conservative treatment for meniscus tears in my left knee for 10 months now. Still not sure if I can avoid surgery or not. But recently an even more annoying problem arose. I started feeling a "snapping" or "catching" sensation inside the left knee. After seeing two orthopedists and a physical therapist, nobody can say 100% sure exactly what is happening, but it appears that the muscles or tendons such as the gracilis or sartorius or semitendinosus muscles or their associated tendons are irritated or hardened and catching on each other instead of slipping by smoothly. The MCL was mentioned, but I'm not sure it is involved. The "catching" or "snapping" occurs just above the joint line on the inside of the knee. It doesn't hurt much, the general area is not swollen (I have some slight swelling that I cant eliminate entirely due to the meniscus), but the sensation is unbearably annoying. Just wondering if anyone else has experienced this, i can't find much information on it on the web. I'm icing it and stretching it, but it's not going away, and no better solutions have been offered. I feel that horrible snapping whenever I bend or straighten my knee, and its driving me nuts!! I thought it was the meniscus catching but I've been told by everyone who examined it that its above the meniscus.

casual runner · « **Reply #1 on:** January 21, 2012, 05:28:40 PM »

Oh yeah, one more little thing.

HEEEEELLLLPPPPPPPPP!!!!

knee2no · « **Reply #2 on:** January 22, 2012, 08:09:25 PM »

How do you know its a meniscus tear? Is your meniscus tear in the medial or lateral meniscus and is the catching on the same side?

casual runner · « **Reply #3 on:** January 23, 2012, 12:08:05 AM »

I was told by several doctors I have a tear or tears in one or both compartments-lateral and medial. My knee swelled up last March, and I showed the classic symptoms of a tear according to them. I also had an MRI.

I'm told the worse tear is on the medial side, the same side where this catching/snapping is. But the snapping is pretty obviously not coming from the meniscus, though that was my initial fear 2 doctors and one PT say its not and I'm started to agree with them. It feels exterior to the joint itself, and you can feel the tendon "snap" with your fingers when I flex or extend the leg.

Runner1993 · « **Reply #4 on:** January 23, 2012, 12:15:24 AM »

Maybe plica syndrome? Just an idea to look into...

casual runner · « **Reply #5 on:** January 23, 2012, 05:03:37 AM »

Quote from: Runner1993 on January 23, 2012, 12:15:24 AM

Maybe plica syndrome? Just an idea to look into...

Thanks for that idea. I read up on that and while there are some similarities, I don't think its my problem. I will keep it in mind though.
I don't think they can make a definite diagnosis of tendon snapping without doing an ultrasound. So far nobody has suggested it but I may have to ask for it. I keep hoping it just goes away as quickly as it came.

allyd · « **Reply #6 on:** January 23, 2012, 05:25:52 AM »

I think I have something similar going on with my knee. Like you say it snaps on the medial side a bit whenever I extend my knee, no pain or anything, just more annoying. This happened presurgery and postsurgery for me - so ongoing for 1.5 yrs now. Lately, I've notice it seems to dissapear when my knee is warmed from activity, biking, running, etc. Originally I thought it was something with my meniscus, or loose cartilage that needed to be cleaned out.

Well, after my scope came back clean, I asked my OS about it at one of my post op appointments. When I showed her where it was and she felt what was happening (because you can feel it catch) she quickly said "that's not on the 'inside' of your knee, but more superficial, and likely the hamstring tendons catching/snapping across the femur as you extend" I asked if it was going to cause problems, and she deferred a bit by simply saying "we'll see" I probed a little more but still got the "we'll see". I kind of got the impression it's not something they worry about to much as long as it's not causing pain? Actually, not sure I've ever seen or heard of a fix?

casual runner · « **Reply #7 on:** January 23, 2012, 02:48:19 PM »

"well see", good non-answer hehe. I dont think is something they encounter very often. When I asked my orthopedist what can be done about it he changed the subject.

If you google "snapping semitendinosus" and "snapping pes syndrome" you'll find a few references on this problem. It can be cured
with tendon surgery if all else fails, but I'm not too keen on that idea just yet. My PT has me doing some exercises to try to increase involvement of the other side of the hamstrings to reduce possible overuse on the snapping side. Too soon to tell if it helps.

This site talks about "snapping knee syndrome" which appears to be the same as "snapping pes syndrome"

http://www.ajronline.org/content/188/1/W63.long

This one shows surgical photographs (take that as a warning-I'm pretty squeamish but the pics are B&W so they dont bother me) of the procedure. That one appears to be one of the first reports on this issue in the medical literature. There are a couple more recent ones I've posted below it. I haven't read those yet.

http://www.joint.idv.tw/04/pub/snapping%20syndrome%20caused%20by%20the%20semitendinosus%20tendon.1989.pdf

Bollen SR, Arvinte D. Snapping pes syndrome: a report of four cases. J Bone Joint Surg Br. 2008; 90:334-5.

Karataglis D, Papadopoulos P, Fotiadou A, et al. Snapping knee syndrome in an athlete caused by the semitendinosus and gracilis tendons. A case report. Knee. 2008;15:151-4.

allyd · « **Reply #8 on:** January 23, 2012, 03:27:16 PM »

Thanks for the info… I’ll read up on it. It was completely a non-answer by my OS. The non-answer of “I know exactly what’s wrong, but I’m not going to tell you, because it’s not something I want to deal with unless it becomes a major issue”

AND, to be honest… I kind of see it as a non-issue as well. It doesn’t cause me pain and I’m hoping as I continue to rehab it will disappear. Given all the other problems I’ve worked through, this is relatively minor to me at this point – not something I’d let them cut me open for again. But it sounds like yours may be causing you more pain/problems and definitely worth the probe with your OS.

casual runner · « **Reply #9 on:** January 23, 2012, 04:35:08 PM »

Mine doesn't hurt too much, per se...It is just unbelievably annoying, and I take pains to avoid having it happen. Going up stairs for example, I will either go stiff legged on that knee or I will do a quick "high step" to get past the snap quickly rather than go through the slow process of feeling it catch, tighten (like drawing a bowstring back!) as I bend, then SNAP! It seems worse when I'm tiring, at the end of a walk or at the end of the day.

Fortunately it only happens when I bend the knee past a certain point, about 25-30 degrees. It doesn't do it when I'm walking on flat level surfaces.

aaa · « **Reply #10 on:** January 23, 2012, 04:52:53 PM »

just a word of advise ... i would try to get direction if it is safe to work through the snapping / catching while trying to progress with PT ... even if the snapping is annoying

modifying movement pattern to get around the snapping can lead to new problems ... muscles can get retrained to work differently, and end up being inhibited ... and believe me, that is not a fun problem to deal with

casual runner · « **Reply #11 on:** January 23, 2012, 05:56:07 PM »

Quote from: yb on January 23, 2012, 04:52:53 PM

just a word of advise ... i would try to get direction if it is safe to work through the snapping / catching while trying to progress with PT ... even if the snapping is annoying

modifying movement pattern to get around the snapping can lead to new problems ... muscles can get retrained to work differently, and end up being inhibited ... and believe me, that is not a fun problem to deal with

Absolutely excellent advice, that's part of why this is bothering me so much because I don't want to retrain myself to do things the wrong way. That may be part of the reason this started in the first place. I'm waiting to see what they have me do in PT this week. The PT I saw last Friday sounded like he might want to back off the knee strengthening exercises (which seem to be working for the mesniscus pain, at least a little bit) in favor of resting that medial hamstring and working the other one more...

allyd · « **Reply #12 on:** January 23, 2012, 06:21:59 PM »

Definitely sounds like it is more bothersome for you. It sounds exactly the same as me, I will feel it catch at about 20 degrees when extending my knee – but not when I flex. Nothing about it causes me to modify my activity – which for me would be the first sign it needs to be addressed in some form, whether it’s a different PT program, rest, or something else.

I remember my PT also noted I seemingly have some chronic swelling in the area/fat pad which could be contributing to the tendon catching… Just wondering if the swelling from your meniscus maybe is causing some of it? Just a thought, nothing to base it on in terms of fact…

casual runner · « **Reply #13 on:** January 26, 2012, 07:51:24 PM »

I do think there is meniscus involvement, whether it be swelling from the meniscus area or more direct contact with the tendons. The epicenter of the snapping tendon (if thats what it is) seems to be right at the joint line. Maybe the tendons are catching the edge of the meniscus somehow. Or maybe it is the meniscus snapping, and it's just transmitting that to the tendons by contact. I'm very discouraged today. I think I have to get arthroscopy.

casual runner · « **Reply #14 on:** April 07, 2012, 07:58:13 PM »

I'm very happy to say that the snapping has improved/decreased considerably. I only feel it occasionally when tired or when the knee swells a bit (which may be when I'm tired). I never feel it when going up stairs anymore.

I wish everything else was going as well, but that was the most annoying part of my knee condition and I'm glad it is almost gone.
I believe the meniscus issue is also improving though and that probably has resulted in less swelling and less snapping.

ALRunner · « **Reply #15 on:** June 06, 2012, 06:22:49 PM »

Glad to hear it. BTW, stop running. I know, your name is similar to mine. The single best advice I could ever give myself if possible would be to go back in time and stop running the second I got knee pain. I truly hope you've given it up at this point (seriously).

pzero7 · « **Reply #16 on:** July 06, 2012, 09:16:35 AM »

Hi,
I am experiencing the same snapping sensation on the inside of my right knee. I had acl reconstruction surgery back in January and everything was going well until I slipped twice in the bathroom and I think ever since then I felt this unbearably annoying snapping of the tendon it feels like when I bend my knee past the 90 degree point. It doesn't hurt but it's just so darn annoying. Just wondering what did you do to decrease it? Been researching online and have found quite a number of possible causes.

Thanks.

ALRunner · « **Reply #17 on:** July 06, 2012, 09:29:05 AM »

Quote from: pzero7 on July 06, 2012, 09:16:35 AM

Hi,
I am experiencing the same snapping sensation on the inside of my right knee. I had acl reconstruction surgery back in January and everything was going well until I slipped twice in the bathroom and I think ever since then I felt this unbearably annoying snapping of the tendon it feels like when I bend my knee past the 90 degree point. It doesn't hurt but it's just so darn annoying. Just wondering what did you do to decrease it? Been researching online and have found quite a number of possible causes.

Thanks.

For what it's worth, the clicking/snapping in my knee is also if I am bent at least 90 degrees and then extend it. This snapping happened after a few months straight of tendon pain. I had assumed some kind of a calcific growth or something similar responsible for it. I've found nothing online indicating an obvious way to resolve it.

Snapping without symptoms is no problem--I bet many of your joints do it, most people's do. But in the case of my tendon it correlated to symptoms.

I had a 3T MRI last month on my knee again. Other than a couple of cysts that I think are totally unrelated to my knee issue (but haven't yet seen the doctor), I had a "thickening" of the tendon and some signal consistent with "mild tendinosis". My snapping/clicking has gotten worse over recent months despite me taking as good care of this tendon as I can.

I guess what I'm trying to say is if that doesn't resolve itself there is likely nothing you can do about it. You may have read about things like graston technique breaking up scar tissue but frankly I've not read much or anything indicating it really can do this in a tendon. Certainly for a deep one, like the AC ligament it would not do anything.

Clarkey · « **Reply #18 on:** March 27, 2013, 12:48:53 AM »

Hi All,

What you have all been describing sounds similar to what I went through before a scope on my right knee back in November 2009 I had a catching sensation and pain and had my medial plica removed and fat pad trimmed and did stop the catching.

Again re injured my right knee and have similar problems again and my OS did suggest try PT 1st as my muscle are very tensed up and if that fails will have a cortisone injection as I have some fluid in my right knee and the injection may reduce the swelling and break down the fluid and hopefully does the trick and can get back to competitive running once again that I am unable to do since a 3rd heavy fall onto my right knee in January 2013 on black ice.

I hope the above works for me as the last thing I want is a 2nd exploratory scope as my 1st scope took 18 months to recover from and did not really help when my former Manager made me come back to work after 2 weeks post op working manually as a Greenkeeper on the Golf Course even though I had a sick note to cover me from my GP. I was bullied out of my job in the end due to bullying from the Course Manager due to having Asperger syndrome a high functioning form of Autism and glad I left the job now and can nurse my new knee injury and no longer have to worry about work and my former Course Manager.

nickwclarke2013@BhamUK.

ALRunner · « **Reply #19 on:** March 27, 2013, 08:14:54 PM »

Quote from: Clarkey on March 27, 2013, 12:48:53 AM

Hi All,

What you have all been describing sounds similar to what I went through before a scope on my right knee back in November 2009 I had a catching sensation and pain and had my medial plica removed and fat pad trimmed and did stop the catching.

Again re injured my right knee and have similar problems again and my OS did suggest try PT 1st as my muscle are very tensed up and if that fails will have a cortisone injection as I have some fluid in my right knee and the injection may reduce the swelling and break down the fluid and hopefully does the trick and can get back to competitive running once again that I am unable to do since a 3rd heavy fall onto my right knee in January 2013 on black ice.

I hope the above works for me as the last thing I want is a 2nd exploratory scope as my 1st scope took 18 months to recover from and did not really help when my former Manager made me come back to work after 2 weeks post op working manually as a Greenkeeper on the Golf Course even though I had a sick note to cover me from my GP. I was bullied out of my job in the end due to bullying from the Course Manager due to having Asperger syndrome a high functioning form of Autism and glad I left the job now and can nurse my new knee injury and no longer have to worry about work and my former Course Manager.

nickwclarke2013@BhamUK.

Good luck. I'll give you the same advice I wish I could have given myself years ago: stop running. It confounds everything here. In my case I don't even need a knee to do my job; I could do it from a wheel chair or couch. Particularly if you job requires good joints, just stop running entirely. It took me years to finally give up on running entirely and I now no longer get that sense of yearning when I see a running. Amazing how long it took to kick that.

It seems highly unlikely a cortisone injection will solve your issue and I suspect you know that.

Now that I'm no longer part of the running community I feel I have an objectivity that I didn't when I was part of it. I also parroted the massively incorrect view that running isn't bad for one's knees. The long term studies about arthritis are hugely self selective; the long term runners have good joints because those with bad were already forced out, but the injury rate of running is huge (we all know that, too). And yet despite this we pretend it's fine.

I am sure that running is fine for some people. They can get to the age of 80 and it will have caused no duress anymore than if they had never run, but there are literally millions of people who have hurt themselves running, so we really need to stop pretending that it is a net zero impact on the joints. For many of us it is clearly a very injurious activity. It's a damn hard habit to kick, though.

Clarkey · « **Reply #20 on:** March 27, 2013, 11:42:12 PM »

Hi ALRunner,

I know that running is not good for the knees and if it something you enjoy doing then are prepared to take a few risks in order to get to a competitive level and at the peak before my fall on black ice my average running pace was under 7 minutes a mile and was running 9 miles 4 times a week and did get a bit of pain and swelling at the bottom of my right knee that expected with all the running I had been doing up until the fall.

I do have PFS in both knees that's no big deal what is concerning right now is not be able to run at a good pace as soon as I try to increase my running pace get pain and discomfort at the bottom of my right knee. I am no longer work as a Greenkeeper and will do some gardening jobs while out of work looking for jobs supporting Autistic Children that looks a long way of right now but a possibility in the future.

Since my scope I no longer get the catching sensation just pain and swelling towards the bottom of kneecap that can increase while kneeling squatting at times. I have had two cortisone injections so far pre op and then pre op and not sure why my right knee seems to never become right again and suppose falling 3 times on it won’t help it improve.

I could not give up running altogether & my PT suggested a good pair of running shoes and custom made orthotics and have a gait analysis done and can train yourself to run in a way that will put less impact on the joints. I was also warned in advance by my PT that a car engine needs oil and once it runs dry the car engine stops and ceases up. Knee’s will also one day suddenly cease up and then need a TKR and always think positive that I will not be on of those statistics with wearing out my knees as I am only 34 and hope to have many years more of running long distance as I see people twice my age running still. I can however see where you are coming from and its good to warn me in advance.

nickwclarke2013@BhamUK

ALRunner · « **Reply #21 on:** March 28, 2013, 01:54:01 PM »

Quote from: Clarkey on March 27, 2013, 11:42:12 PM

Hi ALRunner,

I know that running is not good for the knees and if it something you enjoy doing then are prepared to take a few risks in order to get to a competitive level and at the peak before my fall on black ice my average running pace was under 7 minutes a mile and was running 9 miles 4 times a week and did get a bit of pain and swelling at the bottom of my right knee that expected with all the running I had been doing up until the fall.

I do have PFS in both knees that's no big deal what is concerning right now is not be able to run at a good pace as soon as I try to increase my running pace get pain and discomfort at the bottom of my right knee. I am no longer work as a Greenkeeper and will do some gardening jobs while out of work looking for jobs supporting Autistic Children that looks a long way of right now but a possibility in the future.

Since my scope I no longer get the catching sensation just pain and swelling towards the bottom of kneecap that can increase while kneeling squatting at times. I have had two cortisone injections so far pre op and then pre op and not sure why my right knee seems to never become right again and suppose falling 3 times on it won’t help it improve.

I could not give up running altogether & my PT suggested a good pair of running shoes and custom made orthotics and have a gait analysis done and can train yourself to run in a way that will put less impact on the joints. I was also warned in advance by my PT that a car engine needs oil and once it runs dry the car engine stops and ceases up. Knee’s will also one day suddenly cease up and then need a TKR and always think positive that I will not be on of those statistics with wearing out my knees as I am only 34 and hope to have many years more of running long distance as I see people twice my age running still. I can however see where you are coming from and its good to warn me in advance.

nickwclarke2013@BhamUK

I'm your age almost exactly. I know there are some people twice our age running, but there are many more twice our age who sure as heck can't. Even many people our age can't! I think to a large degree it is just pure luck whether a person's physique and running style and life style combine to allow them such an activity for long periods of time. Ultimately we play the hand we're dealt. We can modify it to a degree, but you can't take a bad hand and make it a pair of aces no matter what you try.

I won't try and force my experience into yours, but back in the day I threw money at shoes, spent huge amounts of time trying to change my gait, tried forefooting, barefooted, everything.

I eventually found that barefoot-type running in very light shoes was fairly doable--it was much better on my knee (but not perfect). However, it introduced new issues--ones that I never had when heavy heel-striking in the past, including arch pain, top of foot bone pain, and now I have spent the last 18 months very, very slowly healing some achilles tendinosis. So, although I partially protected my knee I moved the stress to other joints.

It took so long to get over running, but I did it. I just wish I had done it back in the past. Several years ago I had no joint pain of any kind, I was fit, I could run a few miles at a time, no problems with anything. It's when I started doing long distance that my body couldn't keep up and I've spent now 7-8 years with knee pain. I'm glad I stopped when I did (the last MRI I had showed nothing significant other than tendinosis, so at least I didn't keep going until I blasted away cartilage), I just wish I had stopped much earlier. My life post-running is as meaningful as it was pre-running. I don't need to run to exist or love life. The major difference is now I have this pain with me, and I know it could be hear for the rest of my life. This isn't a pity party, but a warning to others.

Clarkey · « **Reply #22 on:** March 28, 2013, 05:28:11 PM »

Hi ALRunner,

When I had my right knee checked out by my OS last week he said my ligaments seem to be all in tact and have no signs or a torn meniscus and only found some fluid in the knee that he could feel during the examination and not too convinced that PT will solve my knee pain as it is immediate pain at the bottom of my right knee as soon as I try to run.

I will see how it goes before deciding if running long distance is a good or bad idea when I see my OS again in a few weeks time and will see if PT helps or not. Must have been hard for you to give up running and will also find this difficult to stop all together.

nickwclarke2013@BhamUK

ALRunner · « **Reply #23 on:** March 28, 2013, 08:19:16 PM »

Quote from: Clarkey on March 28, 2013, 05:28:11 PM

Must have been hard for you to give up running and will also find this difficult to stop all together.

I think it's hard for a lot of people. I've come upon people on forums who have already had a couple of operations and yet still run, even though it was the direct cause of the need to operate. It's not like they are pro athletes, so risking future capabilities and long term pain isn't their livelihood; they just can't quit.

I don't have to tell you how awesome running is when everything goes well. Hard to stop!