Lateral Knee Pain

Post-Arthroscopy

 

Arthroscopic findings

 

The arthroscopic findings revealed:

• minor degenerative changes of the medial tibiofemoral compartment and patellofemoral joint / Grade 4 chondromalacia of the medial patella facet,

• a radial tear in the lateral meniscus which was trimmed to a stable base / a small degenerative tear involving the inferior surface of the posterior third of the lateral meniscus.

 

There seems to be some confusion over what is and what isn't degenerative... This is discussed in more detail under Degenerative vs traumatic.

 

I noticed that there were some changes to my leg:

• The peripheral nerve sensitivity that I had had when I brushed my hand over the lateral side of my knee had stopped.

• The feeling of things moving under my kneecap that I had had, when I was lying on my stomach doing hamstring exercises lifting my heel up to bum, had stopped.

• BUT I was too scared to see if my slightly bent knee would still click on internal rotation of the tibia on the femur with my foot fixed.

• BUT my knee was still painful along the lateral knee joint and fibular head, but I was very, very timid about forcefully touching it.

 

Nevertheless, I thought that I was really improving about 6 weeks after the arthroscopy. I was still using my crutches because I felt that I might occasionally veer off in the wrong direction, usually to the right, and using the crutches like ski poles was helpful.

 

 

Weak muscles

 

I have continually been given Straight Leg Raise (SLR) exercises to do by physiotherapists. However, it is only relatively recently that I have been able to do them. Initially I was told to 'Lift my leg about 6 inches off of the bed, and hold...' but I just could not lift my leg up at all. Then in the London hospital, the physiotherapist asked me to lift my leg up as high as where he was holding his hand... and, to my amazement, I kicked my leg up into the air at least a meter, and I could hold it there too... Thereinafter I lifted my leg up high and lowered it slowly down. Eventually I could lift it about 6 inches, and it seemed to be improving.

 

However, I have had servere pain in my right groin area and occasionally some in the left side. Note that I would also do SLR exercises for my good, left leg too, to keep both legs equal. I was surprised to find that when I stopped doing Straight Leg Raises, this pain greatly deminished, but it was still be a bit painful after any form of activity. 

 

 

Brisk walks

 

At my next appointment, which was supposed to be the last one before discharging me, I was told to 'keep up the physiotherapy exercises' and to 'take plenty of brisk walks'. So the next sunny day I walked briskly to my local supermarket, maybe coming up to 1/2 a mile away.

 

However before I reached the shops, my foot and ankle behaved differently. It was as if my foot was slapping down, but in slow motion... exactly as it had slapped down during the initial injury, but with much less force. I had to use the crutches to get home. A bit later that day, I noticed soreness and swelling around the medial side of my right ankle.

 

I made an appointment at the hospital for the next week. They took an x-ray and I was told that nothing was broken, and that I had probably sprained my ankle. I was too engrossed with the notion that these were the exact symptoms of the original injury to consider the fact that this may well have been an ankle sprain... in fact a third ankle sprain...

 

Anyway, after speaking with my allocated physiotherapist, I determined to take a second brisk, but a shorter one, as maybe I had overdone the distance the first time. However the same thing happened, this time also resulting in twitchy, stabbing pains mainly to the medial side of my ankle, but also to the lateral side.

 

I haven't done any more brisk walks since those two and am confined to very, very, very slow walking. And, although my gait may look normal, it doesn't feel normal. I describe it as not working properly. It feels to me like it is still slapping down, as when I was jogging, but with far less force and velocity. I don't have any control over it. It just goes down to the floor... And there seems to be swelling along the medial side of my good, left ankle, perhaps from helping out the injured leg...

 

 

Exercise bike

 

After the brisk walking episode, I asked about using my exercise bike, and was told that this was a good idea, but with minimal resistance at first. I had to lower the seat so that it was easer to get on.

 

However, I had a sharp, stabbing pain in the lateral side of my knee when I was pushing down on the peddle. This happened on 5 depressions, after which I stopped because I was scared. The physiotherapist said that I should rest and leave it for a while, and then try again, but I am just too scared!

 

 

Gait-training

 

I was then given gait-training exercises to do...

• heel, flat, toe;

• heel, flat, toe...

which I incorporated into my slow walking.

 

I had an appointment at the Sports Injury Clinic, at last, and it was suggested that I have an injection into my fibula... But in the mean time my gait-training exercises seemed to be causing additional pains to the lateral side of my knee and at the back. At the lateral side I had throbbing / pulsing feelings; pulling, twitching feelings; and sharp, stabbing pains. There have also been sharp, stabbing pains on occasion on the medial side of my knee. The back of my knee felt tight and painful a great deal.

 

 

Physiotherapy exercises

 

As instructed, I was still continuing with physiotherapy exercises of my choice to strenghten my lower limb muscles:

1. Straight leg raises

2. Lying on back with bent legs and lifting tummy into the air

3. Lying on tummy and lifting heel to bum.

4. And gait-training exercises!

 

The physiotherapist had discharged me saying that there was nothing more that they could do, and that I must continue as I had been taught. But these exercises didn't seem to be doing any good... so I stopped doing them. And then, surprise, surprise... I became aware that the horrendous groin pains that I had been having had stopped, bar a few twinges from time to time.

 

A senior physiotherapist set me some further muscle-strenghening exercises, one being Squats with back leaning against the wall. I seemed to be doing quite well with them, until I realised that my good, left leg was doing most of the work. I tried to ensure that the work was evenly covered by both legs and repeated the exercise. This produced severe pain in the lateral side of my bad, right knee... so I stopped doing them...

 

As I continued with gait-training, all my pre-arthroscopy problems became apparent. They are not proprioception and vestibular system issues; they are all part of the original problem...

 

 

Painful beginning to 2015

 

Currently, at the beginning of 2015, my knee and foot are both extremely painful.

 

My knee has:

• throbbing, stabbing and pulling pains at the lateral side and towards the back,

• pulling pains that can be quite 'sharp' around the fibular head, especially on palputation,

• permanently painful / in agony... always... when walking, even when sitting.

 

My foot has all sorts of painful places:

• soreness behind the Achilles tendon,

• soreness and often 'sharp' pains around the areas both lateral and medial ankle,

• aches on top of foot, towards the toes, and underneath the heel towards the lateral side.

 

It seems to me that ankle pain will provoke knee pain, and knee pain will provoke ankle pain. I am sure that, if I were to accidently twist my leg with my bad, right leg in stance phase of walking, I would be in great pain. I have felt this happening on serveral occasions and pulled back to stop it...

 

 

Gross discomfort!