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Author Topic: Pain under knee, lateral side above fibula?  (Read 3634 times)

Offline Puffy the Knee Slayer

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Re: Pain under knee, lateral side above fibula?
« Reply #45 on: August 17, 2017, 12:00:14 PM »
My physio seems to be mystified by what is causing my problems. He did a fat pad test which he says is negative, yet I can still see a bulge compared to my left knee and still getting anterior knee pain. Also think doing leg press, which he recommended at very low weight, has aggravated the old FPI anterior knee pain.

As I can squat over 90 degrees he doesn't think my lateral pain is ITB, it also comes on when I'm sitting down which to me sounds like PFPS except it is solely on lateral side and is sharp twisting pain not the ache of PFPS.

Was reading somewhere that PFPS is meant to resolve within 6 weeks of physio treatment - HAH.

I think that current physio has helped somewhat with the lateral pain, in that it is not flaring up as much as before, and he's got me back to doing 7 mins on the cross trainer, pain free, whereas before I could not do over 3-4 mins without the twisting pain.

I see podiatry in September for biomechanical assessment, and then OS in October.

I still haven't made a decision about having the botox treatment but I best do it soon as if I go back in October and haven't had it they will probably discharge me.

My hunch is that my lateral pain is the meniscus rather than ITB, based on the feelings of getting stuck, twisting etc

I can ask for another MRI but I very much doubt I will get it.

Was hearing now you only get 3 NHS physio sessions and if you need more you have to go back to the GP, am grateful I can afford private physio for now but this whole knee problem has cost me so much and still isn't resolved.

@Clarkey - sorry to hear of your ongoing hip problems in addition to the knee, this is the problem,we end up with multiple issues as a knock on effect. I hope the PT helps so that you do not need surgery on your hip as well as your knee.
06/07 ankle sprain - collapsed arch
01/08 fall doing physio
06/09 MRI fat pad impingement
01/13 MRI medial meniscal tear
03/15 - decent orthotics
01/15 MRI - pes anseurine bursitis, SPL fat pad impingement, PFMaltracking
Cortisone 04/15; 03/16; 06/16; 08/15 Cortisone+Duralane; 10/16 Cortisone+Botox

Offline Vickster

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Re: Pain under knee, lateral side above fibula?
« Reply #46 on: August 17, 2017, 02:18:28 PM »
Could you perhaps get a consult with Clare Robertson at Parkside? I realise she is quite expensive but is a recognised PF expert. Fresh pair of eyes is always good :)
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
LK New MRI shows lat & medial meniscus tear & other stuff
RK MRI lat meniscus tear
8/1/15 RK Steroid jab,
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation

Offline Puffy the Knee Slayer

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Re: Pain under knee, lateral side above fibula?
« Reply #47 on: September 02, 2017, 04:43:02 PM »
Have now seen the Podiatrist. My xrays show that my toes are only 12 degrees of deviation - the threshold for a bunion is 15 degrees - therefore surgery is not an option at this stage and may even make things worse.

The podiatrist feels that with all the goings on with my knee, my biomechanics have probably changed and therefore the best way forward is to address the issue with physio. Therefore he has recommended a sports physio. I have no idea how much this is going to cost as their website has no info on fees for self-paying clients - so I suspect it will cost the earth. Have emailed them to find out.

Podiatrist has also recommended Hoka trainers, which should take the pressure off my toe. Will have a trip down to Run and Become to try them out.

He's said my xrays show that my left toe is actually worse, even though I'm getting more pain in the right toe, thus he thinks the issue is more biomechanical than to do with the level of deviation.

He has given me an open appointment with the option of having an MRI scan on my toes if the physio doesn't help, but says even if the MRI shows inflammation my only options at this stage will be injections. He's told me there really isn't a way to stop bunions getting worse, but they can be fixed when they do get worse. He checked my orthotics and doesn't think I need a new prescription.

He's also said he'd wait and see the physio before making a decision about having another botox treatment into the TFL for my knee, so will have to postpone my OS appointment again.

In terms of the lateral pain, am now able to do 10 minutes on the cross trainer, credit to the other sports physio I was seeing (who has now left), he has helped. Can also feel my glutes are much stronger and working more effectively. But still having anterior knee pain and lateral pain has not gone altogether, though it is not as bad.

@Vickster, I would consider Clare Robertson if all else fails but really she is pretty unaffordable atm. I'll probably try this new person the podiatrist has recommended, they do gait analysis so should be able to see where my function is failing. If it doesn't work I will probably need injections for my toe as it is very painful and I'm unable to take anti-inflammatories.
06/07 ankle sprain - collapsed arch
01/08 fall doing physio
06/09 MRI fat pad impingement
01/13 MRI medial meniscal tear
03/15 - decent orthotics
01/15 MRI - pes anseurine bursitis, SPL fat pad impingement, PFMaltracking
Cortisone 04/15; 03/16; 06/16; 08/15 Cortisone+Duralane; 10/16 Cortisone+Botox

Offline Clarkey

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Re: Pain under knee, lateral side above fibula?
« Reply #48 on: September 03, 2017, 09:18:37 PM »
Hi Puffy,

Shame you are not based in the Midlands region of the UK, The Birmingham Royal Orthopaedic Hospital has an excellent team of physiotherapists and extended scope practitioner that each have special areas of interest. There must be some good PFPS physiotherapists on the NHS at your nearest orthopaedic hospital or unit that do both NHS and private.

Might be a silly suggestion have you ever tried reflexology that will not cure the pain just ease it slightly and at the same time make you feel more relaxed. Also beneficial for other heath related injuries and problems.

https://tennenttechnique.blogspot.co.uk/p/foot-pain-and-reflexology.html

Still waiting for a date for scope#3 like to know soon so I can plan ahead, the Saturday Autism Club that starts again next week Saturday be nice to tell my leader a date, should be next month but might now be November or December with the NHS under budget and overworked.


[email protected]
RK: PFPS, Arthrofibrosis & Tendinopathy
16/01/18
18/07/14 Anterior interval release  
16/11/09 Medial plica excision & fat pad trim
Cortisone injections: R-Hip - FAI 04/04/17  RK 23/12/15, 22/10/15, 13/05/15, 30/03/10, 23/04/09

Offline Jose831avalos

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Re: Pain under knee, lateral side above fibula?
« Reply #49 on: September 05, 2017, 06:08:24 PM »
Work on hamstring

Offline Puffy the Knee Slayer

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Re: Pain under knee, lateral side above fibula?
« Reply #50 on: September 17, 2017, 12:45:49 PM »
I've now seen the new physio, he is very stern and a bit scary tbh in direct contrast to the last physio but seems to know his stuff. Also the new place is quite posh and has a personal training gym attached to it where lots of very fit people are. It's quite intimidating.

He says I have classic PFS and that no surgery will help, he has seen 2 people who had the ITB lengthening op and were not any better. He does not think botox will help me either as he says I am too flexible rather than too tight. He said the NHS does not give as thorough assessment as he does (not strictly accurate in my case but anyway) and are just offering the op as they have not got the time. I don't think so as they are trying to avoid giving me a scope.

Anyway he has given me some new exercises to do, which have to be done in order, at the gym (which may be a pain given how busy it gets, getting hold of the equipment to do them in order etc). He says recovery from PFS is a long hard road. I expect that means it will be costly.

I tried the Hoka trainers and could not find one pair that fit properly, they are too narrow for my wide feet, one pair made my right toe feel better but my left toe worse, another pair was lovely cushioning for my feet but made the lateral knee pain worse etc. Even men's sizes were too narrow. I need to find something that has stability but also decent cushioning for my painful big toes.

@Jose, yes I have been working on hamstrings, along with everything else.

@Clarkey, have not tried reflexology but with having to pay for physio shouldn't think I could afford both. Hope you get a date soon for your scope.

I am due to see the OS in October, I would rather postpone the botox and have it there as an option if this new rehab programme with the sports physio does not work out, but I don't know if they will agree to that, they may discharge me instead.
06/07 ankle sprain - collapsed arch
01/08 fall doing physio
06/09 MRI fat pad impingement
01/13 MRI medial meniscal tear
03/15 - decent orthotics
01/15 MRI - pes anseurine bursitis, SPL fat pad impingement, PFMaltracking
Cortisone 04/15; 03/16; 06/16; 08/15 Cortisone+Duralane; 10/16 Cortisone+Botox

Offline Puffy the Knee Slayer

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Re: Pain under knee, lateral side above fibula?
« Reply #51 on: January 11, 2018, 01:22:44 PM »
I saw the OS this week, actually saw the consultant. It did not go very well. He rushed me, did not really listen, talked over me etc and I felt so flummoxed I did not present my case very well. I normally have someone go with me but they were ill so I had to go alone.

The upshot of it is that I have been discharged from the OS clinic as they feel there is nothing that can be done for me surgically, but I have been referred back to the NHS physio who runs the botox clinic, to be assessed for further botox if I want it, and that I can discuss with the physio if I want to put it on hold.

The OS refused to comment on the lateral pain I've had since the steroid injection into the lateral femoral condyle in 2016, saying that he can't comment as he did not give me the injection.

He examined me but it was short and perfunctory and I got the impression he just wanted to shut me up and discharge me. I'd already told him the pain is not replicated on examination and only hurts with activity. He asked me what the pain felt like and when I told him it seemed to me he did not believe me.

He seemed overjoyed I'm seeing a private sports physio and agreed with his opinion even before he had examined me  - just think he was thrilled to discharge me.

After my consultation I had to fill in a survey on how he did, but I had seen the receptionist reading previous patient's surveys after they handed them in, so didn't feel I could be honest that I was not happy at all with the consultation.

My current sports physio does not feel surgery will help though he is neutral about the botox. He feels my problems stem from hypermobility rather than tightness so all the usual treatments like ITB lengthening and botox will not really help. I am carrying on with him for now though had a setback after he got me to do split squats which just aggravated the anterior knee pain, so he has taken me back to goblet squats.

I am really upset that no one at the NHS clinic will take responsibility for what their injection caused or do anything about it. But I know from experience it is totally pointless complaining, they all just back each other up and obfuscate.

Some weeks ago the private sports podiatrist suggested the lateral pain has been caused by them catching my popliteus when they injected the LFC. He did some manipulation which has helped a bit but it has not got rid of it.

I don't know, I am so fed up of the whole thing, I don't really know what to do.

It is January 2018 - 10 years of fat pad impingement. And now over a year of lateral pain too.

Happy *%&@~#!* new year  :'(
06/07 ankle sprain - collapsed arch
01/08 fall doing physio
06/09 MRI fat pad impingement
01/13 MRI medial meniscal tear
03/15 - decent orthotics
01/15 MRI - pes anseurine bursitis, SPL fat pad impingement, PFMaltracking
Cortisone 04/15; 03/16; 06/16; 08/15 Cortisone+Duralane; 10/16 Cortisone+Botox

Offline Clarkey

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Re: Pain under knee, lateral side above fibula?
« Reply #52 on: January 11, 2018, 07:08:44 PM »
Hi Puffy,

Sorry, you are not making any progress with your ongoing knee saga! I suggest that you get a GP referral to Birmingham Royal Orthopaedic Hospital that takes on patients nationwide do not have to live in the city of Birmingham or surrounding counties. Dr Bhogal I highly recommend a Consultant in Sport and Exercise Medicine at the sports injury clinic. He has a great portfolio as a team doctor for the England Cricket Team that have just lost the ashes badly.

http://www.roh.nhs.uk/about-us/our-team/item/dr-b

The staff at the hospital are fantastic and would see Dr Bhogal 1st before seeing an OS, he will know what to do and which procedures to try out first before considering surgery. I had ESWT and x-ray guided cortisone injection for my patella tendonitis and now having patella decompression surgery this coming Tuesday 16th January. He also found I had a labral tear in my right hip by doing a full gait assessment.

Good luck, don't give up hope, I thought Tuesday would never arrive a year ago after all the setbacks finally making progress. I am sure you will once you find someone that sympathetic and understanding towards you ongoing knee problems.

[email protected]
RK: PFPS, Arthrofibrosis & Tendinopathy
16/01/18
18/07/14 Anterior interval release  
16/11/09 Medial plica excision & fat pad trim
Cortisone injections: R-Hip - FAI 04/04/17  RK 23/12/15, 22/10/15, 13/05/15, 30/03/10, 23/04/09