Because I knee-d your opinion.

December 21, 2018 4:30 PM

Many years ago, I fell while running. I hurt my knee. What kind of injury is it? Nobody here is giving me medical advice. (You are not my doctor. I am aware the sensible course of action is to consult an actual doctor and not internet strangers. Etc.)

Basically, I crashed onto concrete while running full-bore straight ahead, because my ankle twisted. (Not the greatest decision and not one I have repeated.) I scraped my elbow up and it bled profusely and I gave it all my attention. I knew I had also fallen on my knee but did not know to give it attention as it wasn't bleeding. I no longer remember if it was swollen or not. Weeks passed, then months, and I realized the knee felt off. I could walk and it didn't lock up or anything, but - and this persists to this day - if I press on the front, just below the kneecap, it causes a VERY unpleasant sensation. It doesn't hurt, per se, but it feels very... wrong. Specifically when I press it (or, in the early days, bumped it, usually against some part of a desk - I am now adept at not bumping it, ever), I feel a tickly twinge to the top right of the kneecap. About ten years ago now, I went to a specialist in sports injuries and explained the problem. He poked at it, had x-rays done, and shrugged and said nothing was wrong. At the time I didn't know to be more persistent. He was right in that I could function with it. However, he never said anything at all about tears or what could be damaged besides bone. These days I am noticing the knee more. I wear a knee brace while cooking, because the twisting required to go from counter to counter makes it sort of... twinge. If I do not have a brace I hold the leg straight while moving which means I move like Frankenstein. It works, but... Frankenstein. What kind of injury could this be? Ballpark ideas will help me to do research and then go to a (different) specialist.

Thanks.

posted by Crystal Fox to Health & Fitness (8 answers total)

Response by poster: Ugh, renegade parenthesis. I meant: (Nobody here is giving me medical advice. You are not my doctor. I am aware the sensible course of action is to consult an actual doctor and not internet strangers. Etc.)
posted by Crystal Fox at 4:31 PM on December 21, 2018

Likely chondromalacia patellae - a degenerative condition of the cartilage on the underside of the kneecap. An occult patellar fracture would likely be symptomatic earlier, as would traumatic damage to the anterior tibial tubercle (attachment of the patellar ligament).

However, these suggestions are provisional but physical exam and MR would be diagnostic.
posted by sudogeek at 6:20 PM on December 21, 2018 [1 favorite]

Could be a meniscal tear (maybe a mild one, with scar tissue built up) or any of these. The person to see (in my area anyway) would be a sports medicine specialist. Maybe an athletics-focused physiotherapist, they can also assess and refer back to a doc for imaging if needed. (You don’t live in Canada, do you? [Sounds like your doc took a very Canadian approach to investigations.] If you do, good luck getting an MRI. They might concede to an ultrasound, which is only as good as the operator. In the absence of gold-standard imaging, and in the context of rampant quackery and variable quality in the rehab field, you will need someone with really solid clinical asssessment skills, so a local referral is super important. Go where the athletes go.)
posted by cotton dress sock at 7:09 PM on December 21, 2018 [1 favorite]

I fell while snowboarding about 15 years ago, full on impact right on my left knee. I got a crazy amazing bruise but not that much swelling and didn't think anything of it, except it always was stiff and sometimes would get painful. Last year was the worst it has ever been, so I finally saw a doctor about it. I was diagnosed with patellar tendonopathy (also called jumpers knee). PT and strength training has helped a lot.
posted by peanut_mcgillicuty at 7:14 PM on December 21, 2018

My husband twisted his knee once while playing indoor soccer. Years later, he had it examined more closely. It turned out that when he twisted his knee, he ruptured his ACL bad enough that it just went away -- his body absorbed it over the ensuing years. He had to have a cadaver ACL implanted back into his leg. He just knew something was "off" and the doctors never treated it as any big deal. When he finally got one to listen to him it turned out to be very serious.
posted by Ostara at 8:59 PM on December 21, 2018 [1 favorite]

I am not a medical doctor, but if this is causing quality of life problems you should go see a MD/Orthopod for a MRI. When I injured my knee and they suspected a meniscus tear, they had me stand on one leg and twist -- if I could do that no problems they said it probably wasn't a meniscus tear (See also) . It seems you're having problems with this motion, which would suggest it to me.

Also if you saw a doctor he probably did a drawer test for your ACL. My understanding is that missing/torn ACLs can cause knee instability.
posted by Comrade_robot at 2:05 AM on December 22, 2018 [1 favorite]

Having to wear a brace during daily activity such as cooking warrants an MRI and a consultation with an orthopedic surgeon. Arthroscopy might an option, essentially it can clear out old damage and any bone or cartilage chips that might be floating around causing trouble. And it is fairly minor, not at all like an ACL reconstruction. My father had lots of orthopedic issues and has been using crutches for several years, and his advice is "whatever you can do now to help prevent joint problems in the future, do it".
posted by emd3737 at 5:39 AM on December 22, 2018

Response by poster: Cotton Dress Sock: no, I do not live in Canada. Back then I assumed that doctors, being highly trained, would always do their best to uncover the basis of a problem. Also the knee was working mostly without twinges/pain, except when I banged it accidentally. So I was not persistent.

Based on these answers I have a better idea of what to look up and ask a doctor this time around. Thanks for your replies.
posted by Crystal Fox at 8:13 AM on December 22, 2018