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Author Topic: Mysterious shin pain  (Read 3932 times)

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Offline vickster

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Mysterious shin pain
« on: October 01, 2014, 03:54:21 PM »
I don't know if anyone might have experienced something similar, but I am having pain in my 'good' right leg about 5cm below my knee, lateral side.  It aches while sitting (desk job), while lying and is especially bad in the morning.  It is also a little twingy while cycling (more so on hills and when I start to tire), and using the rower and recumbent in the gym.  There isn't a specific 'sore' spot, and no swelling or pain in the knee. 

A bit of background, a couple of scopes on the other (left) knee in 2010 following injury, since then I've had a couple of rounds of hyaluronic acid (most recently Dec 2013).  I had an MRI then as was getting pain, the highlights of the report are small horizontal lateral meniscus tear, a medial flap tear, the fibrocartilage in my femoral defect is breaking down, got some grade 2 (ish) arthritis around the knee (you know the usual stuff at 42 years of age :( )  There's also a small exotosis on the fibula head apparently

To make matters worse on the left leg, I got knocked off my bike in Feb this year, developed a massive haematoma over my tibia which got infected and had to have IV antibiotics and surgery to clean it all out.  Slowly getting better, waiting for all the scar tissue in the void left by the cleaning out to go. I lost a lot of calf muscle, and I developed some lumbar back pain / sacro-iliac joint pain as consequence of the weakness in the leg and probably cycling too much too soon with the weak leg!

The left is sore to kneel on, twist etc, but right now less of a bother than the 'good' right

I'm back cycling and in the gym, but the physio doesn't think it's down to over training, no issues with strength now

My physio has had a good look at it, moved the joint, prodded around the patella, done all the various tests for ligament and meniscus, looked at my hip etc and is stumped as the pain doesn't seem to be coming from the knee!  She wondered if it might be shin splints, but I can't run, don't walk terribly much, all of my exercise is non weight bearing

She is contacting my OS (who looks after the knee and did the shin surgery) and is thinking an appointment with a rheumatologist might be in order just to rule out possible causes - I just have general soft tissue aches and pains that are nagging and annoying, but not usually bad enough to need medication.  I feel broadly fit and well otherwise (not even an autumn cold yet)!  Could probably eat better (am overweight) and sleep more (I don't smoke or drink a lot)

Anybody had anything similar and found a solution?  Thanks for reading :)
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline LAS

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Re: Mysterious shin pain
« Reply #1 on: October 04, 2014, 01:49:09 PM »
Hi Vickster:  Sorry to hear your having a problem with your good knee.   When I had first started with knee pain in my left bad knee, I had some medial pain along with  pain radiating down the front of my lower leg which I thought was shin splints.  My primary care physician thought so to.   Long story short it was meniscal tearing.   1 year later the other knee started the same way with medial pain but to the back of the knee.   The end result was MRI and surgery on both knees.   I always have been told by Drs. that once one knee starts failing it's common for the other to follow.   If you think it's shin splints, rest your body for a few days and see if that helps.  As you know, shin splints are from overuse.  Cycling hills puts a lot of stress on muscles and tendons and RICER is pretty much  the cure.  I get twinges all the time from arthritic pain.   Also I had no visible swelling in the bad knee with all that damage in there but it did show up on MRI.   If you can I would try to cut to the chase and get an x-ray and or MRI to rule out degenerative issues.     

Best of Luck:   LAS   

Offline vickster

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Re: Mysterious shin pain
« Reply #2 on: October 04, 2014, 07:07:29 PM »
Thanks LAS  :)

My physio has asked the OS to see me, should be in the next week or two.  I'm sure he'll order any imaging, blood work etc that he thinks is needed.  Physio also mentioned the possibility of a rheumatology consult, the OS can refer me if required

I've not really cycled for a week, and not been near much in the way of what a real cyclist would call a hill  ;D  I have been in the gym, mainly rowing and recumbent bike, bit of walking. Got to travel overseas for the day on Monday so we'll see how I cope with airports etc

The aching is starting to disturb my sleep so certainly need it looked at.
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline vickster

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Re: Mysterious shin pain
« Reply #3 on: October 19, 2014, 11:12:13 PM »
I saw the OS yesterday, thorough review of my right leg and sent me for an X-ray.  The head of fibula is certainly the culprit.  There's a shadow there on the X Ray, he wants more information so Im having an MRI, probably this week if there's a slot.  Could be plain old wear and tear, seems quite an unusual place for arthritis from googling. I need to cut back on the cycling, he says that the power through big leg muscles could be an issue, placing stress on the bones.  Most likely courses of action depending on the MRI could be rest or possibly a steroid injection.

Guess I'll have more info in a week or so.  Sigh, was kind of hoping it was just inflammation from overuse, not more bone damage in the good leg!
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline LAS

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Re: Mysterious shin pain
« Reply #4 on: October 20, 2014, 12:01:44 AM »
 Interesting.  too much Cycling bothers my knees, and causes them to ache,  although the OS recommends it.   Sometimes shadows represent a stress fracture.  Do you have any redness or inflammation lateral to the knee?    Let us know the results of the MRI and good luck.   LAS

Offline vickster

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Re: Mysterious shin pain
« Reply #5 on: October 20, 2014, 11:04:03 AM »
No swelling and no obvious inflammation - more pain which can be either pinchy (more when doing something like walking or cycling) or achy (at rest, sat in car, foot at a specific angle).  I don't have much flexibility in my ankles which may not be helping

Until about 2-3 months ago I rarely had any discomfort in my right leg while cycling.  I assumed overuse was the issue as I was trying to train for a 100 mile event after the injury to my left leg (I did pull out, never did it).  Not had a lot of luck this year!  Need to get fit again as I am entered for the event again in August 2015!

MRI scheduled for Thursday, a day when the OS's requested radiologist is available to review so hopefully I'll get some response fairly swiftly
« Last Edit: October 20, 2014, 12:26:43 PM by Vickster »
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline LAS

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Re: Mysterious shin pain
« Reply #6 on: October 21, 2014, 04:30:44 AM »
Hi Vickster:   To train for a 100 mile event is a lot of stress on the knees especially if you already  have a bad left knee.   Your probably over compensating for the left knee as it is.  Working out that much is probably not a good idea.   It's one thing if you work out and do 25 miles 4 days a week.  It's another to ride 100 miles all at once.  Because you have the injured knee my guess would be that even if you didn't have a problem training you would develop one by the end of the event.      If I push my knees too much by doing 5 extra  miles just on a stationery bike, it  I'm  down for a few days.   I guess you could say it's taking a chance you won't do damage.   It's was a good idea to cancel yourself from the event at least for now and try to heal.  Hopefully the problem is minor and the steroid injection will help.    Best of Luck with your MRI.   LAS     

Offline vickster

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Re: Mysterious shin pain
« Reply #7 on: October 21, 2014, 06:59:44 AM »
Thanks, LAS.  The ride's not until August 2015, so even if I have to rest up for 3 months I'll have enough time to train in th new year (I'm not much of a winter cyclist anyhow).  I've done 100 miles before since damaging the left knee (5 years ago) and also several 100km+ rides.  Until recently, I'd had minimal discomfort in the knees even after the long rides (other bits tend to hurt more after that length of time in the saddle :o )  Most weeks I've been doing around 70-100 miles but across 3 or 4 rides
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline LAS

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Re: Mysterious shin pain
« Reply #8 on: October 23, 2014, 05:43:09 PM »
You seem determined to make the ride and I think you will.  Promise in 2015 your will let us know how your knees make out.  In the meantime, I think it's today your having an MRI, Let us know your results.
Of note; I entered a charity event 7 mile RR and my knees we OK, not great but OK.  That was walking which was huge for me!  I did enjoy the buzz when I finished.    LAS

Offline vickster

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Re: Mysterious shin pain
« Reply #9 on: October 23, 2014, 06:00:35 PM »
Thanks LAS.  This is a big ride, on closed roads around the London Olympics road race route, it's hard to get a place (100k applicants for 20k places or similar) and is a once in a lifetime opportunity realistically

Yes, I had my scan this afternoon.  Have looked at the disc, but no clue what I'm looking for!  I guess I'll hear the results next week

Leg was very sore by the end of the scan, not helped by driving earlier.  I did go to the gym last night, will probably give it a miss tonight :)  Another day in the office tomorrow, will see how that goes!
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline vickster

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Re: Mysterious shin pain
« Reply #10 on: October 29, 2014, 09:31:21 PM »
OS reviewed the scan on Monday apparently but had no time to dictate anything to his secretary.  Hopefully, he will be able to do so tomorrow

I still can't see anything on the images!  :P

I did get the findings of the X Ray, spikes and osteophytes in posterior tibio-fibular joint which doesn't sound too promising and were the reason for the scan
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline LAS

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Re: Mysterious shin pain
« Reply #11 on: October 30, 2014, 01:26:36 AM »
I'm pretty sure that if you have developed osteophytes it is from other cartilage in the knee that is damaged.  Well you know you have degeneration (?osteoarthritis).  It will be interesting to see if the remaining cartilage has joint damage.   Good Luck  LAS

Offline vickster

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Re: Mysterious shin pain
« Reply #12 on: October 31, 2014, 04:33:01 PM »
Hi LAS,
I am still waiting to hear from the OS but I did speak to my physio who looked at the MRI report.  Apparently I have chondromalacia grade 2 on the lateral apex of the patella (no biggie, same as the other knee) but the cause of the pain would appear to be some ulceration behind the fibula.  I'll have a better idea of why and what to do when I hear from the OS.  Whether it's somehow being rubbed by these pesky spikes, don't know.  Steroid jab or a full dose of NSAID for a while might calm it down
Vicks
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline LAS

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Re: Mysterious shin pain
« Reply #13 on: November 01, 2014, 03:17:38 AM »
Have you found what shadow represented on the x-ray?  LAS

Offline vickster

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Re: Mysterious shin pain
« Reply #14 on: November 01, 2014, 06:47:55 AM »
No, because I've not seen the OS nor the mri report. Off on holiday today so I guess it'll be another week, in,ess the secretary emails me
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up















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