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September 10, 2008 11:07 AM

My knee is screwy. Help!

For a couple of years my right knee has been grinding whenever I walk upstairs, but lately it's gotten louder. Also, it's started popping out of place at seemingly random moments. I don't guess it's truly dislocated, but there's a definite shift, then a sharp pain, then it's fine again. But wait, there's more! At night I'm waking up to intense pain that seems to start in my outer right thigh above my knee, and shoot through my knee to about halfway down my calf.

So what kind of doctor should I be seeing? An orthopedist? A physiotherapist? Could anyone recommend one in Manhattan?

Thanks all.

posted by Evangeline to health & fitness (10 comments total)

When you say "popping out of place," do you mean your patella (kneecap) is moving (bad but not as bad), or that your femur (thighbone) and tibia (shinbone) are separating (VERY VERY bad)?
posted by kittyprecious at 11:39 AM on September 10, 2008

Are you sure all your knee tendons -- especially your ACL -- are still connected?
posted by M.C. Lo-Carb! at 11:50 AM on September 10, 2008

Sometimes when I move my upper body, it feels like my leg is staying in one place and my patella is going in the other direction. This can be a very small move. I was in the shower and I turned to the left to reach a towel, and I felt a very quick pain and a shift that made me gasp. It was fine again once I faced forward.

In other words, I don't think my femur and tibia are separating.
posted by Evangeline at 11:52 AM on September 10, 2008

Gosh, I'm not sure how to tell if my tendons are connected! I'm guessing I would know if they weren't, right?
posted by Evangeline at 11:53 AM on September 10, 2008

Not a doctor, but it sounds like you have a whole host of knee issues, not the least of which may be a torn ACL. After unknowingly tearing my ACL (thought it was just a sprain), I experienced similar "popping out" feelings, which I was told had to do with the patella tendon coming out of the slight grove on the kneecap in which it resides. Turns out the ACL is kind of the anchor of the knee, and without its stablizing effects, all the other parts start going screwy, hence patellar slippage. The grinding could be from a torn miniscus, the cartiledge that sits between your femur and tibia. When this breaks down, the rubbing of the bones together can cause that pain you're describing waking up to.

Definitely see an orthopedist and find your way to an MRI machine to diagnose and prevent further (knee replacement!) damage.
posted by undercoverhuwaaah at 12:05 PM on September 10, 2008

Orthopedist, definitely.

In the meantime, ice in the evenings with your leg elevated, allowing a slight bend in your knee.

If you have no reason to worry about such things, take a combo of ibuprofen and naproxen sodium before bed. You can safely take up to 800mg of ibuprofen per day for a short period if you've no liver, kidney, or allergy issues. I'd just start with one of each and take no more than 2 naproxen per day. Always, always drink a full glass (8oz) of water after taking either of these.

It sounds like you're getting some instability, too, so it might be worth your while to use compression bandages as a wrap around your knee. I wouldn't get any compression sleeves or OTC braces until seeing what the orthopedist says, because you could well be in for some surgery and/or a custom brace.

The sooner you see a doc, the better. Good luck & good healing!
posted by batmonkey at 12:26 PM on September 10, 2008

Thanks guys - great advice!

Is there a difference between an orthopedist and an orthopedic surgeon?
posted by Evangeline at 1:02 PM on September 10, 2008

Another thing you might consider is chiropractic. I was having some similar sounding knee issues a while back from hiking, and while I was waiting for weeks for an orthopedist appointment, my chiropractor "adjusted" my knee. Haven't had any trouble with it since, and didn't bother going to the orthopedist.
posted by chez shoes at 1:06 PM on September 10, 2008

The standard test for ACL/PCL tears is the Drawer Test. (The ACL is a ligament, which connects bone to bone, and not a tendon, which connects muscle to bone.)
posted by Comrade_robot at 1:27 PM on September 10, 2008

You live in New York, right? MeMail me if you need an orthopedist suggestion (she does surgery, too, but I know she tries to steer people away if they don't need it).
posted by dame at 4:47 PM on September 10, 2008