The WAITING ROOM => GENERAL KNEE QUESTIONS and comments (good for new threads) => Topic started by: MMatt_UK on October 22, 2013, 09:52:54 PM

Title: Plica
Post by: MMatt_UK on October 22, 2013, 09:52:54 PM

I am 15 Years old and a Rugby Player. Through out my life so far I have been suffering with all types of leg problems from walking on my tip toes when I was a little kid and having to go through all different departments of the Hospital for them to say "We don't know what to do anymore" and for my problem to still be here. My latest problem I have is that my knees are hurting, generally after I run for a long time going fast but also taking knocks since I play a "rough" sport as some people say.

I am quite tall but also quite heavy as well, I spoke to the Sport Person we have at my Rugby Club telling him a tiny bit about my past and how I gained a lot of other problems such as Lordosis etc..
He then went to look at me and told me to do a couple of things where he got the idea that I don't have much flexibility in my Legs(and guessing my back)

He then told me to sit down on the Bench/Table and he played around with my legs and touching my knees and moving them in all different types of angles and done different things. Within 2/3 Minutes he came up with the conclusion that I may have Plica in both Knees. Is there by any chance that this may be possible? If so how can I be 100% certain that I have is and also how can it be treated? By looking around on the internet I see Surgery is the main way for it to be treated and I don't really want to go through Surgery...

Any help? Thanks...

EDIT: I forgot to mention that I do also have pain in my ankles after a while of my Knees hurting could this be the same problem? I must also say I do think otherwise as well because I forgot to add before when I went for X-Rays on my Legs they did say I was "slightly" bow kneed so could it be Alignment instead or what?

I just want to run without being in pain any more...
Help D:
Title: Re: Plica
Post by: seant46 on October 23, 2013, 02:54:06 AM
Where exactly is the pain and can you describe the symptoms in detail?

It could be plica, it could be mal alignment or it could be both. I had my medial plica excised and it helped with the sharp-ish pain I would get while landing a jump or twisting but I still have some medial pain because my whole leg is not aligned properly.

A lot of people have plicas without pain, so even if you do have one it may not be the problem or the whole problem. Since there is pain in both knees and both ankles I would guess there is some alignment issues. If you have a painful plica you should be able to feel a painful band of tissue on the medial knee snapping over the side of the femur when you extend your leg while pointing your toes inward. It will feel like a rubber band moving under the skin snapping over the side of the femur causing pain(you can google this for a better explanation).

I would give a good hard physio and stretching routine a try first. You can get an MRI but it may show up saying that nothing is wrong, my MRI showed nothing was wrong but still had medial pain but apparently plicas dont always show up on MRIs because they are really thin I think. But again i also have alignment issue. If you want to find out more about alignment find a physi or chiropractor who has experience diagnosing this type of stuff and can tell you what muscles to work on. You can also get a series of X-rays with you knee extended, slightly bent, and fully bent to tell if your patella is tracking properly. They compare the position of the patella in each x ray to see if it is maltracking. Sometimes the patella is not the problem but it can be the femur/tibia that are rotating causing pain if maltracking is the cause of pain. I would start on the physio with professional guidance and maybe try to get MRI or a series of x rays if you think its needed.
Title: Re: Plica
Post by: seant46 on October 23, 2013, 03:03:37 AM
Oops i didnt see you already had x rays. Did they take it with the knee bent at different angles to check tracking?
Title: Re: Plica
Post by: MMatt_UK on October 23, 2013, 07:21:59 AM
Hello thanks for replying,

The pain is on the knee by saying that now it is kinda hard to say because it can sometimes change but it is most commonly above my knee and to both sides of my knee(in both legs). Also the pain in my ankles are just at each side of my ankle.

The X-Ray which was taken a few years ago was one taken just looking at my knees from front view and that is where they got bowed knees and I also think they took one on side view but I don't think they said anything about it since I only remember them saying bowed knees.

Looking up online it says that Plica is mainly when a Tissue is stuck inbetween two bones in the Knee when you bend your knee..(One of the Plicas, I haven't seen them all) is it possible that one of the Plicas only effect the person whilst running and applying heavy pressure to the area?(for example when jumping like you stated with yours) I always thought mine was when I applied pressure on to my leg when strength/heaviness. Also, if this is the case would it be able to happen for like a month but then stop pain for another month and may come back? because I have had this as a case for a long time now but I have never been pain free because I have loads of other pains all through my leg(Carves etc..)

I have already been told by a lot of people my legs are f**ked up, so please don't say anything I already know... :|
Title: Re: Plica
Post by: seant46 on October 23, 2013, 11:18:58 AM
Well its doesnt sound like anything or torn or anything, but some of us are just born with knee problems waiting to happen especially if we do sports. Could be some tendonitis or something but I would start by finding a good physio that has experience. Dont just call and make an appointment though, ask some questions about their experience with knees and people who specifically are into sports. Make sure they work with athletes.

Who knows if you do daily stretching and strengthening maybe you will be able to see some good improvement. One thing I have learned though is doing nothing about knee pain, does nothing to help knee pain. Dont just rest, it will only come back once you start sports again. Either way you will need to commit to doing physio/streching although it is boring- whether you fix it without or with surgery you have to try something to strengthen the muscles that may be weak causing pain. Right now you can start with just stretching and see if that helps, try 3 times a day doing the calfs, hamstrings, quads, psoas, and hip flexors. You can look these up on how to strech and hold for at least 30 seconds, ideally repeating them 3 times.

I wouldnt even be considering surgery yet, but you can get an appointment with a surgeon who only works on knees and see what he thinks just to get an opinion. Other than that you can try what I suggested before if you feel you need it- an MRI or x rays with knee bent at different angles to check patellar tracking. Definitely start with finding a physio who works with athletes though and lots of stretching.

Title: Re: Plica
Post by: MMatt_UK on October 23, 2013, 09:12:29 PM
One last question to you then: What do you think it is? Plica or are you unsure or puzzled about what it can be?

I will look in to trying to get a Good Physio and like you suggest to ask questions and not to just book, I guess that is the only thing I can do now to try and progress with fixing my knees. Although I guess when you add the word "Good" to Physio it means they will expect Money? Since the NHS here won't be much help with the "Good".

With the stretches, I am a typical teenage boy. Lazy... but seeing as this problem is starting to challenge me I think I will try and gain the effort to do this, most people will look at this and laugh and say "It isn't much he has to do" which it isn't but I am a teenager although I shouldn't use that as an excuse. But I will look in to exercises that you have suggested and also trying to find others which can help me.

I wouldn't like to consider surgery either so I will agree with you on that point. I wouldn't really want to go to the Hospital for an X-Ray or MRI because they would want to "Inspect" me before hand and find out on if I really need it and knowing them they will say "You have tight muscles" or "You just need to do stretches" like they have been saying all of my life yet if I do or don't do them I still progress, I wonder how that works.

Overall, I will convince my Mum to help me look for a Good Physio and then I will also look for stretches and to break the teenage habit.

Title: Re: Plica
Post by: seant46 on October 24, 2013, 09:22:15 AM
Well I have no training medically and even if I did It would be hard to say without seeing you in person. I would only be able to guess what is wrong. Either way a good stretching and physio routine should be able to improve the pain whether it is plica pain or mal alignment or a combo of both. I dont know if you will have to pay more but all Im saying is make sure they at least work with lots of athletes/runners, not just someone who mainly deals with old people or who doesnt have experience with knees.

I know how hard it can be to stick to do boring exercises and stretching everyday, but you have to ask yourself how much you value your knees and being able to do sports? You probably dont need to do strengthening everyday but stretching everyday would be wise, when you get up and before bed(quads, hamstrings, hip flexors, psoas are my main ones). Weak hips/butt muscles can also play a big part in knee pain if you google about it. Otherwise it may keep getting worse and you could end up like me not doing sports for a year and still trying to get my knees back in shape so I can run and stuff. Trust me you will thank yourself later in life if you put the work in to keep them healthy before they get worse. You dont know what you have until its gone! thats what im learning myself, i miss sports, dont become like me having to give them up for the last 10 months and counting trying to get them back in shape.

I would do physio for a few months, if there is now improvement then it may be time to consider an MRI and surgery to see if the plica is causing the pain. Some people are lucky and born with knees that last a long time naturally, and others need to put the work in so they will last. Just remember how much you want to keep playing rugby as motivation. By the sounds of it you have a great chance to be pain free or close to it one day.
Title: Re: Plica
Post by: MMatt_UK on October 24, 2013, 03:52:33 PM
Thanks for your help on this but you said how if I keep doing stretches on this then it will get stronger and eventually stop hurting(also with physio) which is obvious but like I said before how can it one minute be a pain and hurt me and the next minute be sort of fine?

Does Plica do that? Or could it be another issue?

Thanks! :P
Title: Re: Plica
Post by: seant46 on October 25, 2013, 05:25:49 AM
Well I said you have a good chance to not be in pain anymore. Im not really sure about hurting sometimes and not other times, youll have to ask a professional and I would get an MRI too if it causes lots of problems. We cant really diagnose on this site, just give info on where to look. Good luck
Title: Re: Plica
Post by: Clarkey on October 25, 2013, 05:34:15 PM
Hi There,

I had my medial pica removed & fat pad trimmed in my right knee nearly 4 years ago as I could no longer run anymore as I kept on getting pain & swelling & at times catching in my right knee. I did go down the conservative routes 1st and had PT & a cortisone injection & still did not improve. Even my MRI scan came back again normal. I opted to have an exploratory scope that was a risk as there may not find anything wrong so was a gamble that paid off.

It was not an easy road to recovery & took me 18 months to fully recoveryl from the surgery after having my medial plica removed & fat pad trimmed. The catching in the knee stopped that was caused the fat pat & plica being enlarged that caused pinching between the kneecap hence the sharp pain & catching I kept on feeling.

PT & stretching does really help ease the knee pain & maybe custom made orthotics could beneficial as you are then putting less strain on then knees. I am having problems again as I have a tight IT band & tight knotted quads that are strong just tight. Hope to run pain free once again as at the moment my right knee is too painful to run.

Doing daily stretching of quads & IT band does help reduce knee pain & further injury to the knees. Do stretches before a game & warm up by jogging around the pitch before a match. After the match stretch once again then have a nice cool shower that I am sure you do anyway, shower after a rugby match. This will relax your muscles & reduce your chances of getting an injury.

Tracking problems can also cause problems & have tracking problems in both my knees that is usually solved by strengthening your quads around the knee that in theory should reduce the tracking & looseness of the kneecap. PFS can also be a common problem for anyone taking part in sporting activities.

The above are all soft tissue problems that can be very painful & restrictive & can feel like a torn meniscus as symptoms are very similar that is just as restrictive.

Good luck & please keep the board posted with your progress.

[email protected]
Title: Re: Plica
Post by: MMatt_UK on October 29, 2013, 01:00:48 PM
Hey thanks for the replies, sorry I didn't reply sooner... Kinda forgot about this O_O

@seant46 Thanks for your help and advice, I will try push to go get it investigated so we can find the problem more faster. What doesn't help was I only got discharged a year ago from the hospital for another leg problem which they couldn't resolve. +1 to the NHS.

@Clarkey Thanks for your help. About the part about "stretches and jogging around the pitch before a match" we already do the jogging around the pitch and often do stretches together before the match. Although after the map I don't really stretch again I just generally go inside and get changed then go.
I will try start to do stretches after the match and also do daily stretches which seant46 also said I could do.
I will also like I said to seant46 push to get this investigated so that one year I can be pain free once we find the problem! :P

If you have any other advice please feel free to tell me! Thanks!
Title: Re: Plica
Post by: seant46 on October 29, 2013, 02:04:16 PM
Sounds like you have a good attitude! That will go along way. Just keep working till you find something that works, good luck!

Title: Re: Plica
Post by: Clarkey on October 30, 2013, 11:18:32 AM
If you determined to get back to full fitness again then you will achieve it and have youth on your side still. If it came to the worse case scenario and needed surgery you would recovery quickly and be back playing Rugby in no time. Hopefully it will not come to that stage and a good physio can sort your knees out.

Doing stretching after a rugby match is just as important as it is at the start of the match. One tends to forget about it after a match as you just want to shower and change and head home or to the Clubs Bar when you reach 18 unless you stick to just soft drink with your mates.

Good luck and keep the board posted with your progress.

[email protected]