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Author Topic: Went from healthy to PFS and cant bear weight within 2 months?  (Read 621 times)

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Offline needgoodnews

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Is this PFS? 34 yo healthy male. I am living in a nightmare and am no one knows what is wrong with me  :-[ :-[

I had very mild chondromalacia in left knee from last year that caused a sharp pain when going down stairs, put off PT due to foot problems. I never had ANY knee pain that interfered with walking up until now.

3.5 months ago i start trying to rehab myself, i was doing terminal knee extensions on my left knee (bring the bar up with my right knee, then grab it with my left knee extended to strengthen my quad without creating the sharp pain associated from the extension motion). i did this every 3 or so days for a month and never had a single symptom of pain in either knee.  Could this have set my knees up for what i am dealing with now? Anyway, It made my left knee stronger but i still had the sharp pain going down stairs. So i decided to finally try PT

~2.5 months ago i finally go to PT, and doing the stretches and strengthening exercises started to cause weird friction sensations behind my left kneecap just one week in. I stopped PT after two weeks to chill out, did the exercises at home for about a week and did a stupid thing where i did a lunge with left knee in a rolled up towel in the ground (impact point actually above my knee cap) and my right foot stepping forward. I did it 3 times to stretch my groin and left quad. A half hour later i start to get a bad throbbing in my RIGHT knee which was the forward knee in the lunge, and which was my good knee that i never had pain in in my life. It didnt get better over a few weeks. I got an MRI and it said no chondral defects but some mild signal in the trochliar groove. Doctors just said no big deal it will get better. "you just scuffed some articular cartilage and it takes time to heal". Got a cortisone shot and felt ok after 3 days, so i thought. Went to the mall and after 15 mins started to get a pain in my right knee.

So i tried to lay off of it for a few days. Out of frustration after 3 days of not leaving my apt did not improve things much,  I did a REALLY dumb thing and tried to lift weights with my right knee, to strengthen quad and hamstring again. The next day my right knee joint is incredibly sore and it is hard to put weight on it. Not muscle pain but it felt like someone took a baseball bat to my knee pain. Painful to walk on it for the following week for more than a couple minutes at a time. See another sports doctor and says these seems too severe for PFS, scratches head and prescribes PT, which i know i am not going to based off of all the preceding events.

A week later i try to ride a stationary bike two times for 10 mins each, low resistance, hoping it will move the synovial fluid. The 2nd time i do it later in the day my left knee, which was very mild symptoms compared to my right knee, developed a shooting/stinging pain deep in the middle of the knee during the bike ride and when walking after. The next day my right knee which was already severely bad got extremely warm, swelled up a bit, and felt warm and inflamed for about a week. The last 3 weeks of my life i have been non weight bearing,  wheelchair or crutches , take crutches to shower, and it is not getting any better. It is extremely painful to walk with crutches even short distances. Had to move back into my parents and have them take care of me. If i lie in bed for two days, it is just a little less painful after taking a shower, but having to take a shower and use the toilet once a day sets me back to the prior day progress wise. So i am not making any progress because taking a shower with crutches every two days is my max level of activity. I am living a NIGHTMARE and feel like my life is over.

Here are my symptoms :
If i flex either of my quads and lock the knee cap into the groove,  i get sharp shooting/shock pain right away behind the kneecap. It is really painful and it makes my knee's worse for days if i do it.

When i bear weight even with crutches i get crunchy sensations behind the kneecap and maybe below the femur, like there are really thin potato chips getting crunched in my knees. I also get little sharp pains directly behind my kneecaps but in different spots,  just from taking crutches to the bathroom. If i do anything more than a few minutes on crutches, the area behind the kneecap will get ultra sensitive and painful while standing, and then ache when lying down.

Chronically all day i will feel little tingly/prickly sensations behind my kneecaps just lying in bed. Is this pissed off nerves or angry cartilage?

if I extend my right knee from 90 degrees it will start to ache within mins and feel warm, the ache is generalized all over the inside middle of the knee.

Questions
IS THIS PFS??? If so is my kneecap actually inflamed or is it the cartilage of my femur?

Do i need a new MRI or a different test like a bone scan so it can actually be diagnosed what is inflamed in my knees? Does angry cartilage without an actual defect show up in tests?

Would a hardcore arthritis brace take pressure off of my knee to allow me to simply walk around the house more? i already have stretchy braces and they are much better than no brace but i need something better to take the pressure off my knee joint
« Last Edit: July 17, 2016, 08:26:43 PM by needgoodnews »

Offline Vickster

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Re: Went from healthy to PFS and cant bear weight within 2 months?
« Reply #1 on: July 17, 2016, 07:07:29 PM »
Have you had full blood tests done to rule out a systemic inflammatory or autoimmune condition. Ultrasound to check for inflammation?

If it does turn out to be inflammation in the knee, rest may be the only thing. Presumably you've tried medication, ice etc? Injections?

Obviously stop doing anything that causes pain if at all possible, like the things you've described.

Maybe try to see a musculoskeletal rheumatologist? You mention a doctor but not what type of specialist? Or only primary care?
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 needgoodnews

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Re: Went from healthy to PFS and cant bear weight within 2 months?
« Reply #2 on: July 17, 2016, 07:32:43 PM »
Ive seen 3 sports orthos in the washington dc area and two of them said PFS but were also a bit perplexed. Saw the rheum last week and while i got a full round of blood tests a year ago , all negatives, he said this doesnt sound like any of those and didnt want to re-do the blood tests. Saw a neurologist and he said this doesnt sound like nerve pain in 40 years of practice, but offered an EMG. Going to test for lymes tomorrow on my own.

What medical exam is going to show knee inflammation? I thought MRIs just show objects, distances between them, if something is torn etc?

Offline Vickster

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Re: Went from healthy to PFS and cant bear weight within 2 months?
« Reply #3 on: July 17, 2016, 07:42:06 PM »
Ultrasound potentially, MRI can also show inflamed and damaged tissues

Has your bony alignment been assessed and your muscular balance by a physio?
Doing lunges etc is not sensible with kneecap issues, ditto weighted leg extensions. Too much loading
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 needgoodnews

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Re: Went from healthy to PFS and cant bear weight within 2 months?
« Reply #4 on: July 17, 2016, 07:53:00 PM »
Thank you vickster for your replies. I feel like i am all alone and it feels good to see that someone cares to try to help out.

Can ultrasound get behind the kneecap?

Ultrasound potentially, MRI can also show inflamed and damaged tissues
Has your bony alignment been assessed and your muscular balance by a physio?
Doing lunges etc is not sensible with kneecap issues, ditto weighted leg extensions. Too much loading

Ive had 3 sports surgeons look at my x-rays and they said they were normal, not sure if bony alignment is included in that. The thing is my MRI was before i really screwed up my right knee, and all the doctors just based everything off that so i need a new one. I have an appt with another sports ortho tomorrow, i am just so pessimistic at this point because i am 0/3 with knee docs so far and from my research no one in the DC area specializes in patella pain. They just want to fix ACLs and do knee replacements from what i can see.

As for lunges and leg extensions, i know and i am killing wishing i could go back in time, but the lunge was with my right knee which never had a single symptom in my life, and i had been doing extensions with my right knee the prior several months so had no reason at the time to think something bad was going to happen. I actually wonder if doing leg extensions on my right knee, and terminal extensions on my left knee trying to rehab it by myself for consistently the month PRIOR to PT primed my knee caps for a catastrophe. Is that the only reasonable explanation? Like, i could have been irritating my knee caps for a month but symptoms werent popping up yet until i did PT and did a bunch patella focused work?
« Last Edit: July 17, 2016, 07:54:44 PM by needgoodnews »

Offline Vickster

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Re: Went from healthy to PFS and cant bear weight within 2 months?
« Reply #5 on: July 17, 2016, 08:32:13 PM »
Have you read the patella primer?
http://www.kneeguru.co.uk/KNEEnotes/primers/patella-primer

I wouldn't think ultrasound could see behind bones. MRI better,  X Ray for bones, CT for detail and alignment from what I know. MRI for general soft structures

Perhaps try to find a patellofemoral specialist to review case, and a physio specialised in PFS
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 needgoodnews

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Re: Went from healthy to PFS and cant bear weight within 2 months?
« Reply #6 on: July 19, 2016, 05:24:20 PM »
for people with PFS does it hurt for you to simply straighten your knee from the 90 degree bent position? I can only get to 45 degrees before i start to get sharp pains under my kneecap.

Offline needgoodnews

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Re: Went from healthy to PFS and cant bear weight within 2 months?
« Reply #7 on: July 22, 2016, 10:14:11 PM »
just an update. About to get a new mri to find out of this excruciating pain is due to some damage or inflammation (assuming it picks it up), or could be it something like CRPS which a knee doctor suggested :(
Will update in the next week as i learn more