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Author Topic: confused - medial meniscus? *Update* Patella Femoral SS  (Read 1800 times)

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Offline kba

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confused - medial meniscus? *Update* Patella Femoral SS
« on: October 14, 2014, 05:25:34 PM »
A little about myself, I am 38 years old, female. I used to somewhat crossfit, but for the past 4 and a half years, only do Olympic weightlifting workouts.

A few weeks ago, I felt some tightness over my left knee, more so in a squat with the knee bent. It was something that went away after warm up. I brought this up with my chiropractor and he did some knee checks and adjustment.. I squatted twice the week after that, and did not feel any of that tight rubber band feeling on the knee. 3rd workout I did snatch and pulls... felt it somewhat on the snatch but it went away. Next workout, power snatch OK, then squat cleans, I felt the tightness. Due to thinking about that feeling of like a tight band from the bottom of the knee cap, over it and to the inside, i did not go heavy as planned and did not drop under. I felt knee soreness the next day.

I decided to do no workouts. I went to the chiro again he did the checks an orthopedic does for the knee, like bend, twisting etc... It is narrowed down to the medial meniscus. twisting I dont feel any of that tightness/soreness, but it is when the leg is bent all the way with no twist. He said hopefully it is something that will heal over time, and/or it could be ligament tendon stuff. We dont know for sure without an MRI. Worse case is physical therapy, and surgery?, if nothing changes after 6 weeks or gets worse. I am hopeful its not that bad, I haven't felt pain. I either or feel the tightness in the full bent or its just some soreness on the side of my knee. I can fully straighten and extend my leg. That left ankle tends to turn out also, which could slightly contribute, he says. he thinks over the two weeks I have been "idle" (no gym), there is some healing, so there is that hope.

He told me just to go ahead back to working out. Since I don't feel pain during a workout, use how I feel after as a guide, do I feel more sore, tight, or any slight pain? Then what I did in the workout irritated it. I do want to avoid making backwards progress in healing so I will be conservative.

I might go ahead get knee sleeves, they will probably just keep them warm only, so I will still be careful. I never wore them before because I am always warm, and when I have worn knee sleeves, I sweat even more. anyhow, if you have any you recommend, let me know. I am thinking about Rehband. And I will try to be diligent with icing afterwards.

I am thinking squats, or anything where I bend my knee all the way (which pretty much only squats is what I can think of) is what I can be most conservative with for now, since that is when I feel the tightness or soreness (and during the chiro knee test). Start with light weights and over time go up, but really watch my form, and if I feel any knee tightness at all, I will stop right away. Step ups would be OK with a not very high step so 90 degree knee bend but not less than that. I can go by feel for the other stuff, deadlift, pulls, overhead movements etc.

My mobility/flexiblity has been very good, and my form. I have no recollection of anything acute happening or hearing a pop or a click. Maybe this is overuse? Or I had squatted and my knee went slightly in without realizing?

If anyone has advice or feedback, please let me know. I have high deductible insurance, and that is why I have not sought an MRI, that and I don't have any pain or symptoms others have mentioned related to meniscus.

After 2 weeks of no gym, this past Sunday, I did deadlift, step ups (to a box about 13 or 15 inches), and then upper body, shoulder press, lat pull down.

As for how I feel afterwards, I was OK during the workout, I did not feel any knee tightness.  Yesterday, I did have some soreness due to the time off.  My left side lower back has been tighter than the other side (though for chiro adjustments, I am off on the right side), so that came up, but left leg more sore than the right.  I have no idea what this means, I know its not pain or very tight soreness.

I guess Wednesday, if my soreness is gone, I will try squats, but light, and maybe not all the way to the bottom to see how those are, and how I am the next day.   Then I guess this weekend I could try the lifts, pending how the squats were...

I see the chiro again Thursday.  I have been doing research on the internet but there is an overload of information about meniscus.  I don't know if I really need to do an MRI and all of that, but I want err on the side of caution and not cause further damage.  I would much prefer to pause my training and do whatever modifications I have to do..

Thanks for the help
« Last Edit: October 25, 2014, 02:02:13 AM by kba, Reason: got a diagnosis »

Offline Vickster

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Re: confused - possible medial meniscus?
« Reply #1 on: October 14, 2014, 05:39:59 PM »
Usually RICE is the protocol for knee injury (rest-ice (including after activity)-compression-elevation), plus stopping the activities that aggravate.  Can you stop all the leg-based weights, maybe stick to upper body, maybe cardio the exercise bike, elliptical, walking (no running) on the treadmill, swimming (but not frog kick), minimal resistance, gentle stretching type stuff?  I am surprised the chiro has said carry on regardless given your level of concern

With a meniscus tear, surgery is usually the last resort when there are clear symptoms of pain, swelling, biomechanical issues (locking, buckling)

The meniscus tissue starts to degenerate (harden) as you get older (30 onwards typically) and so you wouldn't necessarily need any sort of trauma to tear it

Have a look at the meniscus primer in the information hub which is good.  It could be nothing to do with the meniscus, knees are extremely complex and weird pains can come from anywhere and everywhere!

Can you see an orthopedic knee specialist?  For a thorough examination first off - MRIs are actually quite hit and miss for meniscus tears

In the UK, at least chiropractors don't go through many years of medical training nor have formal medical qualifications (guessing you are in the US).  I'd certainly want a specialist doctor's opinion

Good luck :)
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 kba

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Re: confused - possible medial meniscus?
« Reply #2 on: October 15, 2014, 01:26:51 AM »
Vickster,
Thank you for your reply.

Yes I can stop lower body, if need be, for the sake of the knee.  The disadvantage is losing leg strength, as it is the primary mover for the Olympic lifts :(

It is possible I could be overly concerned, but because of hearing and reading about knee issues and worst cases, it has made me paranoid.  So far no pain, mainly soreness (or tightness), swelling (as far as I know) or the locking.

I went over the primer.. and see what you mean as maybe there could be other issues with my knee.  Unfortunately I am in the USA (haha at least for the medical insurance reasons).  Yes, the Chiro does not have the same medical training, the one I see has spent time in the Netherlands and worked in a practice with orthos, neurologists etc.. so I think that is how he knew how to do the knee tests on me and mention it could be possible medial meniscus.

I should go to an orthopedic.  I am hoping the exam won't be too costly out of pocket, but I see it is important to at least know what to I need do and I hope rule anything out.

I dont know if it will help but I have recently gotten two products
http://www.vitacost.com/source-naturals-hyaluronic-joint-complex-120-tablets-2
http://www.vitacost.com/jarrow-formulas-glucosamine-plus-chondroitin-plus-msm-120-capsules

I figure if it doesnt hurt, I will give these a try, as I read about glucosamine sulfate and hyaluronic acid helping people.

If you or anyone out there has suggested dose, please let me know. I read about 1500mg of glucosamine sulfate, and 100 of hyaluronic is good, and need a few weeks to know if it helps or not.


Offline kba

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Re: confused - medial meniscus? *Update* Patella Femoral SS
« Reply #3 on: October 25, 2014, 03:43:08 AM »
I went today to the orthopedic.  I had x-rays (the results were fine from that).

My diagnosis is PFSS Patella Femoral Stress Syndrome, patella femoral lesion of patella femoral joint - or basically that I have some wearing of the cartilage, which happens over time.  He said one does not feel it till it wears down to the nerves.  there is cartilage replacement surgery, but that is used for extreme cases.

I could wait for an MRI he said.  usually athletes do it right away to rule things out but 1) I don't make money from my sport and I would have to pay for it myself 2) it is not crucial if I take care of this and do not compete.  He does not think it is the meniscus, and for cartilage, the MRI is not necessary, at least in my case, but something I can consider if I do not improve in 1-2 months.

I can over time, strengthen in particular the inner side of the quad muscle, and the movement pattern of the patella (which goes off to the left when straightened), and eventually squat like I used to again, the full range of motion, slowly building back up to that.

I can modify my workouts, such as go half the range of motion, such as 60-90 degrees, half the weight and reps I do for the legs.  I am thinking, box step ups, some deadlift/pulls ok (maybe some from a raised height)... Just making sure I do not feel anything in the knee, or knee soreness after workout, if I do, to lighten and modify what I am doing.

He recommended a physiotherapist, and said I could do 1-2 visits only, see how it goes, and do exercises myself to save cost, and as I am already active. 

Anyone out there who has dealt with this issue, (I am also searching the forums)...any feedback... thanks a lot for reading