Doc for knee injury - better or faster?
January 8, 2016 10:11 AM   Subscribe

My knee area started hurting after a long run. It slowly seemed to be getting better but suddenly got worse. I'm in moderate but not dire pain. I'm not certain if it's better to see someone soon or wait for a specialist. I'm concerned I'm doing more harm limping around on it.

The situation: I'm a runner who had pain behind the left side of my left knee (whatever that hard vertical thing is - a tendon?) during and after a really long run (13 miles) two weeks ago. I usually do a 10-mile run every week or so, so this was a bit of a push over what I've been doing the past couple months, but in general I've run a couple half marathons every year, the last in October. (Staten Island Half, 2 hours, thank you very much). The next day it was sore, so I rested, and then it was fine. I went running again a few days later and had to stop running because of the pain. Then it started hurting even when I was walking, which has persisted for the last week. So I've not been running and only minimal walking. Yesterday it was feeling better, so I walked more. It felt fine until a mile in then I had to stop. This morning it did a funny kind of pulling thing, and now it hurts more than before, but in a different place. I am limping.

The question: I got a recommendation for a sports medicine doctor, but I can't see him until next Friday. Should I try and find another one that I could see sooner? (Any recommendations - NYC?) I could probably get in to see my PCP this afternoon, but I'm not sure what good that would really do. Ditto for urgent care or ER. Right? Clearly nothing is broken. Could a physical therapist tell me anything or do you always see a doctor first? I guess I probably need an MRI?

The injury: As I said, it hurt in the area behind my left knee, on the left side, in that hard thing that goes up and down (is that a tendon?) right where the knee bends. The pain would go up my thigh in the back an inch or two, but more down into the side of my knee, then crisscrossing a bit to the front under the knee. Now though, the pain is behind my knee and more to the center and right, and I've been feeling this kind of "catching" when I bend a certain way, like when walking, and now when just sitting down and trying to straight my leg.

I can limp around okay, but I need to walk a lot to get around. I don't want to hurt myself further if I really need to be immobilizing it.

Thank you!
posted by unannihilated to Health & Fitness (15 answers total)
why not both? see the pcp now and the specialist on friday.
posted by andrewcooke at 10:15 AM on January 8, 2016

If it suddenly got worse, definitely see someone sooner rather than later. My husband injured himself several months ago and was trending better for a couple weeks until he got sudden pain. He had two blood clots, most likely from the blood rushing to the site of his injury to help heal.
posted by St. Hubbins at 10:25 AM on January 8, 2016

Do you have good insurance? If so, why not just try the primary care doctor. I went to my primary because of calf strain and she couldn't help despite otherwise being a great doctor, but to be fair, I then went to an ortho/sports medicine doctor who didn't help me either. My primary did agree to test for blood clots to rule them out, only because I brought up the concern, and I of course was fine, but that kept me from freaking out while I waited a couple weeks for the ortho. I think you do probably want a sports medicine doctor though.
posted by AppleTurnover at 10:39 AM on January 8, 2016

Yes, I have insurance. It's more of the hassle factor of wasting an afternoon.
posted by unannihilated at 10:42 AM on January 8, 2016

I wonked out my knee last summer, saw the PCP who had suggestions, but in the end recommended I go to the specialist and had some PT. But going through my PCP was the right course of action for me as it helped triage if I needed the specialist or not.

It is a hassle factor of wasting an afternoon, and will be many afternoons if you end up needing PT like I did, but your health and well-being is worth the hassle. Don't fuck around with possible overuse injuries, especially if being a runner is a good part of your identity.
posted by jillithd at 11:00 AM on January 8, 2016

It sounds like a really bad case of tendinitis, but I am not a doctor mind you. Personally, I would give it liberal amounts of rest (no sports) and see a doctor in another week. That way if it is slightly improving or showing no improvement at all, you have that data point to share, which can be very valuable in diagnosing a tissue tear or just inflammation injury. I have had several runner friends with the same symptoms: moderate pain on the side of the knee during/after long distance running. In both cases, it turned out not to be a tear injury, but an over tightness in the hip and t-band that was cascading problems up and down the drive train. Hopefully all you need to do is to heal and then get PT to sort out imbalances and muscle tightness, if that is the root cause of your problem.
posted by incolorinred at 11:11 AM on January 8, 2016

Not a medical professional, just a runner, but every single fellow runner that I know who has had something like that has ultimately discovered some sort of hip/glute weakness that was driving the knee pain. PT on the knee got the knee right, and then hip/glute strengthening prevented recurrence.

Anyway, I'd rest and wait to see the specialist.
posted by gaspode at 11:14 AM on January 8, 2016 [3 favorites]

Rest and see the sports medicine doc. I'm impressed you got in to see her only a week away - I have to wait 3-4 weeks to get in to mine.
posted by matildaben at 11:33 AM on January 8, 2016

Also not a doctor, but a runner. Your brief description sounds like IT Band pain. A PCP would simply either 1) tell you to give up running forever, or 2) give you a referral for physiotherapy. Skip the PCP (unless your insurance requires the referral) and just go to the sports medicine doctor, or any physiotherapist.

If you swap body sides (my right, IT Band was the issue, but I'm left handed) I had a similar problem. My right side of my body was systemically weaker than my left side; specifically the hips as gaspode suggests likely. I reduced my mileage; cut out long runs (anything beyond 5k guaranteed pain) while doing physio. It was a non-trivial amount of at-home commitment. Initially I was doing about 30-45 minutes of exercises twice a day for a month (this much work "helped" cut down my mileage by leaving me less time to run). After that it was 40-50 minutes of exercises daily for 1-2 months after before I was kicked out of the nest (I.E. "you don't need to come here any more for this"). All of the work was body-weight stuff that I could do at home. Towards the end my PT recommended investing in ankle weights and therabands (which I did), but didn't require it. I already had a foam roller which my PT also recommended.

After those 2-3 months not only did I not have pain, but I felt much stronger and my running form was way better. My long runs were then 16-20k ; now they're 20-40k and I do 60-80k per week total without pain. I still do various at home body weight strength training 2x a week, but it's more like 10-20 minutes.
posted by nobeagle at 11:43 AM on January 8, 2016

It's not my IT band. I've had that before. Feels nothing like it.
posted by unannihilated at 11:47 AM on January 8, 2016

Did you take any drugs for it - advil, aleve, etc ?

I don't run more than 4-5 miles any more, because injuries. After enough time, pain, cost, have learned: take pain meds right away when it starts hurting, take at least 2 weeks off (or more, depending on pain/swelling, etc), and REALLY ease back into it. That's what my body has taught me.
posted by k5.user at 1:25 PM on January 8, 2016

I'm a runner who had pain behind the left side of my left knee (whatever that hard vertical thing is - a tendon?)

Could it be a torn meniscus? I tore mine last year and that's exactly where the pain started. I have a great PT so I went to a local little urgent care clinic and left with a prescription for PT. Within two months I was better.
posted by Room 641-A at 5:58 PM on January 8, 2016

Could be an overuse injury of one of the hamstring muscles. Maybe the biceps femoris, which has a long section of tendon (lateral hamstring tendon) attaching it to the head of the fibula (smaller of the two long bones in your lower leg).

Look up hamstring tendonitis and see if that fits.

Whatever it is, I'd rest and see a specialist as soon as possible. I personally would also use ice. It will help decrease the pain level and possibly help prevent swelling from causing any secondary damage. The "I" part of the RICE acronym for treating injuries has been somewhat denigrated in recent months (long story), but I would definitely at least not use heat in the area, even if I weren't going to use ice.

You might also want to get a soft knee brace over the counter from a local pharmacy or sports store, it may help to have extra support there.
posted by mysterious_stranger at 1:03 AM on January 9, 2016

I injured my knee last fall. I tried to just deal with it and limp through the pain. It got worse. I went to an orthopedic physicians assistant and he said take ibuprofen and walk normal, even if I have to walk slow don't limp. The limping was keeping me from healing. Also to elevate my legs so my feet were above my heart for a half hour a day to reduce inflammation. I was surprised how much these things helped.
posted by Melsky at 3:31 PM on January 10, 2016

The exciting conclusion, for any future question searchers:
I actually ended up going to the ER the evening I posted this question because my leg swelled up and I got sick and dizzy. I initially went to an urgent care that freaked out that I had a blood clot and sent me there. No blood clot. Since I could walk nothing was done with my leg.

The next day I was walking better so I just waited it out for the specialist.

He thinks I may have a torn meniscus, but based on his twistings and pokings didn't seem to think it was anything serious that would need surgery. I have to get an MRI to confirm. In the meantime, any activities are fine as long as they don't cause me pain. He gave me some prescription anti-inflammatories. No need for PT or a knee brace at the moment.
posted by unannihilated at 12:56 PM on January 17, 2016 [1 favorite]

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