knee swelling

[akam.]

Having posted about this in the general forum and having had zero feedback, I thought I'd try here.

I'm having a problem at the moment with recurring knee swelling. I am unsure as to the exact cause, but I am sure that my arthritic kneecaps are a major contributor.

My left knee has had three surgeries: an arthroscopy, a lateral release and a patellar debridement/tight fibrous band cutting. The latter was the most recent, performed in April of this year. Since then I regularly get a small bulge of fluid underneath the two external scars - is it possible that the knee is still healing here, eight months post-op? This bulge is not a major cause of concern, however.

At the beginning of November my left knee ballooned with no apparent cause. I rested it, iced it, took my medication (diclofenac and paracetamol) and it recovered. Two weeks later, it happened again. It happened yet again one week later, which was this Wednesday (28th November). As work are being a tad pedantic with me over this, I decided to have no time off with this latest flare-up, as they are threatening to cut my hours, which I cannot afford.

I wear a neoprene open-patella knee-brace to work in order to support it and give some compression. I have also been wearing it in the gym, to ensure it is properly supported when I am using the cross-trainer.

Two days ago the swelling in my knee had become so uncomfortable, it was starting to affect my walking. I couldn't bend it properly to walk normally, so I saw a doctor and had it drained. 25ml of fluid came off and it felt soooo much better afterwards!

The swelling is now slowly reducing again, though I am unsure as to why this keeps happening. Since the surgery, I returned to the gym eight weeks post-op and have had no major incidents like this with it, until now. I cross-train twice a week in what I call my "intense cardio" sessions, burning a minimum of 1000 calories per session. Obviously if this was a factor I would have been suffering this swelling a lot sooner, and far more often.

The undersides of my kneecaps show chondromalacia, and the surgeon has informed me that the early signs of osteoarthritis are present.

Does anyone here have any ideas as to why my knee is starting to rebel like this? Could it simply be the time of year? Does anyone have any other suggestions to aid/speed up recovery? I have suspended my weight-training activities for the moment while it recovers, I brace it at work, I take my medication and use iced gel-packs when resting it at home.

It is very frustrating for me as I enjoy training! I weight-train every weekday to strengthen my quads, and cardio-train twice weekly to maintain my fitness and keep my weight steady. I am one of the rare few who thrives on it, I feel I am betraying myself if I do not train, so to suspend training activity really does frustrate me!

I'd hate to have a permanent cycle of knee swelling so if there are any other things I should be considering, please advise me!!!!

[Nettan]

Any problems with other joints ? Do you have a lot of pain with this and where if so ?
You tried stay off leg completely for some days with using crutches ?
What does your doc think..is that an OS or GP that you are see ?

[akam.]

So far, my other knee is bearing up well, although if I am continually reliant on that leg for support I am sure I will have some pain here too.

I am not using crutches, as I can walk properly. The swelling has started to reduce again now but I am hoping that it will stay reduced now for some time as I cannot have any more time off work without drawing their attention to the fact that they mentioned cutting my hours.

I am not seeing my surgeon any more; the last discussion with him was to leave the knee alone for a year or two, let it completely heal up and allow me to fully regain quad strength in that leg. In order to find the cause of the popping pain they would have to do more invasive (ie. open) knee surgery which I am not prepared to have just yet. The doctor I saw on Friday was unsure of the cause of my swelling problem, she did say that the fact I have arthritic kneecaps is not helping matters!

I'm not getting too much pain with the knee at the moment, the only major type of "pain" I was having was when I tried bending it while swollen, then I was getting pain above the kneecap and to the lateral side, which is where the fluid was compacting into the muscles.

Could cross-training (even though I am bracing the leg) be aggravating the swelling, should I stop my cardio until it is completely reduced? I trained it on Thursday and it made no difference to the swelling, it neither increased nor decreased nor did it hurt any more for doing it. Would using the bikes be a better option for it, or the rowing machines?

My right knee has also had a LR in the past (April 2006) but since then, apart from the odd random swelling (which happens VERY infrequently) the knee has behaved itself. The popping that I had on that side disappeared after surgery and so har has remained so. I'm sure this is arthritis-based but wanted some info and advice from the people here, as you guys have a lot more experience with problem knees than I have!

[eaglemom]

Just a thought, are you sure you are using the proper type of knee brace, and that it is fitting exactly as it should? I know that sounds simple - had had a neoprene open-patella knee-brace that I thought was fitting properly. However, I just kept having more and more issues. At the time I too was walking a huge amount because I enjoyed it and frankly was being vane about loosing weight! I went to a bracing specialist who is listen to my story and watched me walk. He then fitted me with a totally different type of brace - I think a Donjoy playmaker maybe - and that did solve the swelling issues I was having. Now I still needed and am recoveing from surgery but just the simply thing of changing the brace could help you. Good luck.

[akam.]

Hi eaglemom,

I only use the brace when my knee plays up. In between bouts of knee swelling/pain, I am completely fine and can do everything as a"normal" person would. I can run up and down the stairs like an athlete.
I use it at work and at the gym if I feel I need a bit of extra support. Otherwise, I simply don't need it.

Having had yet another incident of knee swelling that started only yesterday, I am using a compression (tubigrip) bandage with iced gelpacks, and keeping it elevated for most of the time.

I'm not even sure there is a bracing specialist here in the UK, but I'll have to enquire. I do find, though, that I find walking and bending the knee a lot harder when I have either the brace or the bandage on it, so I only wear them when I am really bad.

[UK_Girl_!]

Maybe the crosstrainer is not the right piece of equipment to keep you fit as far as your knee goes - yor gym should ahve physios and a nurse working with it - might well be worth a chat with them. Maybe also you should give your knee longer to recover - sometimes a couple of weeks just isn't enough!

Has your OS / GP said to wear the brace - giving your leg extra support if it does not need it can work the opther way and weaken the muscles from underuse.

[akam.]

Hi anja,

It's funny because my surgeon said that cross-training, rowing and cycling are the best low-impact exercises for my knees. I used to do step-aerobics but of course once I was diagnosed with a knee problem everything changed - hence my enquiries into the best ways to keep fit, and the answer I was given.

I've not been specifically instructed to wear the brace, today when I saw a doctor (for yet another knee swelling - it 'popped' at work yesterday and then ballooned within half an hour, grrrr) he said I am best wearing something with compression to help relieve the swelling, so I am using my tubigrip now instead of my brace while the swelling is chronic.

I cross-trained on Thursday, only two days ago with no adverse problems before, during of after the session. No swelling, no pain, only that residual muscle-ache that you get from a good workout. My knee only got bad after that incident at work yesterday afternoon.

I think I should try just laying off all my leg training for a while. It is frustrating, on Thursday I had a lovely normal knee again with all the contours of muscle definition gliding all the way into my kneecap, then yesterday it pops and I get elephantiasis of the knee again. It's really, really annoying!

[akam.]

Hi, just an update on this situation - yes I know it's been ages but I've not had any major knee issue this year that required the specialist assistance I can get here.

My knee flared again on 29th December, and again on 7th January; I saw a doctor on 9th January who had me return to him a day later to drain fluids and also to put in some cortisone. He drew off 37ml of fluids, shot me with cortisone, and it felt like I had been given a miracle cure! I limped into the surgery, and walked out as though nothing was wrong.

On his advice I abstained from lower limb training for two weeks, then resumed my usual exercise regime. In fact I have increased my training this year since that incident and, apart from the odd bout of lateral knee popping (which I've always had) and the odd bout of achy patella (arthritis grumbling) I've been okay. I've even lost some weight too! (5-6kg).

As it is nearly a year since my recurrent knee swelling first happened, it will be interesting to see if it does happen again which would suggest weather and time of year as contributing factors.

[Jennifer258]

Is there any clicking in the knee? If it's the case then it might me meniscus problem. When I was first injured with my back, my knee swelled up so much that I needed to take the treatment from a physiotherapy treatment clinic in Mississauga and was back to work after two weeks. It will be always better to seek professional advice for a fast recovery.

[Sport_Science_Temple]

Potentially the recurring swelling in the knee may be caused by a muscular imbalance. I know my knees were made worse by extra torsion in the knee during exercise caused by a lateral imbalance. Seeing as you are so active it may be worth seeing a physio to assess whether this may be the case. Aside from this I recommend including turmeric and ginger in your diet - raw ginger not processed. These are both great for inflammation control! Furthering that avoid sugar, limit alcohol and maybe try investing some supplements. Glucosamine is my favourite, these supplements work to lubricate the joint and I personally haver found great success using these. Best of luck to you!