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Author Topic: Something in my knee is catching and popping after extension  (Read 95 times)

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Offline RyanC

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Something in my knee is catching and popping after extension
« on: January 12, 2021, 03:43:49 AM »
Hi,

I put a post up recently about fat pad impingement and the surgery I had 7 weeks ago. You can find it here:
https://www.kneeguru.co.uk/KNEEtalk/index.php?topic=78521.0

As mentioned, I am 7 weeks post op and struggling with flare ups of my knee. I have been religiously icing my knee and taking some anti inflammitories which seem to help settle the knee a little. I was at a friend's party on Saturday night, trying to stay off my feet as much as I could. I was standing at one stage and I felt a 'pop' under my kneecap after it being extended. It felt like it was getting caught or something. Ever since that night, whenever go into full extension with my right leg, something below my kneecap seems to get caught and sometimes pops as it gets uncaught. Part of my rehab is doing seated quad extension exercises. I am now getting a lot of anterior knee pain as I do those exercises which I didn't have pre or post operation. I originally thought that maybe the fat pad is inflamed and is getting caught under the knee cap but now I am thinking that maybe that tendon the comes down from the kneecap is somehow getting caught..

Has anyone experiences this/knows what this is? I feel like my knee was starting to settle but this has just added a new element to my knee issues.

Thanks
Ryan
Ryan from Adelaide, South Australia
23/12/2020 - Right knee arthroscopy: Fat pad impingement trimmed and minor chondral breakdown tidied up

Online vickster

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Re: Something in my knee is catching and popping after extension
« Reply #1 on: January 14, 2021, 09:19:32 AM »
You mention in your diary that the MRI showed meniscus tear... was that trimmed? If so, the change in the biomechanics in your knee could be impacting your knee, you may need to get used to that change and work on the muscles and your gait to compensate. Have you had your feet assessed by a podiatrist? If not, might be an idea in case orthotics would be helpful.

Popping is pretty normal, but if thereís no pain, itís likely not a concern. Discuss with physio, in case itís mechanical and exercises would be helpful to address any maltracking or weakness

Thereís info about knee noises in the learning portfolio
Eg in here https://www.kneeguru.co.uk/KNEEnotes/articles/general-articles/2017/common-knee-symptoms
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 RyanC

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Re: Something in my knee is catching and popping after extension
« Reply #2 on: January 14, 2021, 09:49:42 AM »
Hi Vickster,

Thanks for the reply. I didn't end up having a meniscus trim as there was no tear. The surgeon said it looked like there may be some abnormality, maybe something genetic, but couldnt be sure. It turned out it was just a fat pad impingement and my meniscus was fine, as the physio said post op 'You have a perfect knee'. I have orthotics, I got these about 6 months pre op, however, I havent been wearing them that much as it has been so hot here in Australia and I have just been bare foot around the house (working from home) and wearing flip flops on the weekends.

I was having lots of popping and clicking post op but this seems to be a deep pop which is happening really regularly with pain in an area that wasnt operated on (below the knee cap on the medial side - the surgery was on the lateral side). I see my physio tomorrow afternoon so I will see what he says. I have a feeling it might be something to do with my patella tracking as my quads are weak (even though I do my rehab exercises religiously). I'll let you know what he says and for anyone in the future that is reading this and has similar symptoms.

Thanks for the link, ill check it out!

Ryan
Ryan from Adelaide, South Australia
23/12/2020 - Right knee arthroscopy: Fat pad impingement trimmed and minor chondral breakdown tidied up

Online vickster

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Re: Something in my knee is catching and popping after extension
« Reply #3 on: January 14, 2021, 10:29:15 AM »
Normal flip flops are horrible for grumpy knees (and feet and ankles) as they offer no support!
I donít know if you can get them there but a highly regarded U.K. PF specialist physio recommended wearing FitFlops to me (instead of bare feet or slippers which are also horrible for knees potentially)

https://www.fitflop.com/uk/en/shop/mens-sandals-uk

Does look like there are retailers Down Under

https://www.fitflop.com/uk/en/australia

Patella maltracking seems a possible culprit, perhaps the physio can tape the knee to resolve and also move the patella away from the fat pad in case there is impingement again (the fat pad scars up easily). Are you doing regular patella mobilisations as part of your rehab?
« Last Edit: January 14, 2021, 02:40:33 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 RyanC

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Re: Something in my knee is catching and popping after extension
« Reply #4 on: January 15, 2021, 08:35:04 AM »
Thanks Vickster.

Yeah I thought they might be. I do have some Birkenstocks I got when I was over in Germany so I will try and wear them more often. I am also going into the office more now where I obviously wear shoes all day with my orthotics so maybe that will help.

My physio didn't seem overly concerned about this catching and popping. He said the most likely culprit is a weak quad that isnt supporting my patella like it should. My fat pad is starting to settle, and I have been religiously icing it, taking anti-inflammatories etc so my physio suggested getting into a few more quad exercises. He is really keen for me to get back into cycling, about 3 times a week for about 45 minutes. He also suggested I get a foam balance mat and do some balance exercises on the mat. I tried them out when  I saw him and they felt really good. Going to see how that goes!

I am not doing regular patella mobilisations as a part of my rehab. I just looked them up, is that just moving the patella up and down and from left to right?

Ryan
Ryan from Adelaide, South Australia
23/12/2020 - Right knee arthroscopy: Fat pad impingement trimmed and minor chondral breakdown tidied up

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Re: Something in my knee is catching and popping after extension
« Reply #5 on: January 15, 2021, 08:42:35 AM »
Weíre all different but I was advised against Birkenstockís because they are so hard, while the FitFlops are cushioned so less jarring but see how you go.

Good the physio isnít concerned, muscle weakness can cause all sorts of weird things, itís better to not over focus on one muscle group though. Quads arenít usually such an issue for cyclists but hamstrings and hip flexors can be. Not sure what a foam balance mat is? Bosu ball?
Iím about to start my post op ankle rehab so expect to get to know the wobble board soon!

Yes on the patella mobilisations.
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