My knee diagnosis?

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Sorry for the long post, but I tried to include the most essential info I can think of, and since everything is connected to everything. it seems hard to keep it short. :D Happy to give more details too of course. I am trying to find out what exactly is injured in my knee / behind the knee / hamstring area and/or what would be good treatment.

I (male, 33) injured my knee in a football match 3 months ago. For the first couple of months there has been all kinds of symptoms, like pain in different areas around the knee and popping sounds from different areas in the knee in certain movements. Now for the past month, the pains have slowly been reducing, but the popping sounds remain. Although I still do get some sort of pain daily.

The doc looked at it 2.5 weeks after injury, and he said the ligaments felt strong and that maybe some minor tear on the mcl area or so, but it seemed like he based that just on my symptoms. He just said that get back at doing things as long as you dont feel pain.

I have tried to jog couple of times, but other than that, I havent been able to go back to sports. Also when I had gone out jogging, the pain have come back after some 500m or so. Also if I go out for a walk, the knee (or shin bone/tibia) will start to feel loose and eventually generate pain around the knee. By consciously focusing on my hamstring and other leg muscles to kind of keep the tibia intact, I don't get the feeling of the tibia making some 2mm movement when I "throw back my leg during a walking step".

The pains that I have had have usually not been at the same time, but taking turns. One day I have a pain on outside of knee, and then the next day I have some other kind of knee pain. As if my leg tries to heal over night, but instead the adjustments that were made just moved the issue elsewhere. Usually when I go to bed, I can feel my body pumping blood to the area that has had pain or aggravation that day, so the area is like beating along with my heart rate or so.

Some pains that I have had in the knee include: 

Very strong pain on inside of knee. This is usually when I have put too much weight on inside of knee. After this "sidestep", I have to put weight on outside while walking, or otherwise I will get the sudden strong pain on inside when giving weight. This will usually heal a bit slower. Might take some days until I feel no pain when stepping with putting weight on inside. This has also come in many flavors. The inside pain could be at the area next to or lower of kneecap, or it could be a 5-10cm higher in side of upper leg (though still kinda knee region)

Pain above kneecap. I got a strong pain above the kneecap some 2 months ago when I tried to do some squatting. After this, squatting or walking up stairs had a strong pain sensation above knee. It got better in couple of days. 

Other pains associated with this injury have been something that has transformed to another pain in day or less, but have been common and reoccured. Pain outside the knee, pain on top area of tibia, pain just below kneecap, pain/fatigue/straining feel in back of knee, fatigue/pain in hamstring aggravating on walks, fatigue/pain in calf region aggravating on walks. Probably some other pains, but I can't rememeber right now.

About the popping sounds.

In the past 3 months I have had more different kind of popping sounds or weird grinding sensations in my right knee than in my whole life (33 years) combining all pops in my body. Most of these I can't really predict, and they have come from all sides of knee. There is one particular popping sound that keeps recurring much more than others. When I stand and hyper-extend/straighten my leg, and then bend it a little I get a pop below kneecap, I can generate it at anytime. I don't actually even need to hyper-extend to do it. So daily there are situations where I stand, and then unconsiously bend my legs a bit, and the right knee will make the popping sound. It won't generate pain, but if I do it intentionally some 4 or more times in a row, there will be dulling pain below kneecap like 15 minutes maybe. 

Now sometimes if I squeeze my upper leg muscles in certain fashion while straightening my leg in standing position, and then bend, I wont get the popping sound, just like in left leg.

Then one weird sensation I get is sometimes when I drive a bike and pedal with my right leg, it feels like some liquids are moving above my kneecap. Like boiling and bubbling sensation with maybe minor popping sound feel. Now if I straighten my leg and squeeze my upper leg muscles for a seconds or so, and continue pedaling, the weird sensation is gone. 

I suspect I also have some discrepancy on my upper leg muscles, because my healthy left leg feels more tighter and intact also on upper leg. It is like my right upper leg muscles are not behaving as they should. Especially the vastus medialis muscle in standing position is sometimes automatically in different "squeeze level" as what it feels in left leg. Also the lower area of hamstring muscle or something is kind of very stretched with my right leg, because if I do the standing hamstring stretch. I don't feel much stretch on right hamstring. 

I have a history with a hamstring injury just year ago, which might be related. Some details of it are below in the background of this injury.

background: 

July 2014:  I strained my right hamstring and also injured backside of my knee when kicking a ball with that just injured hamstring. That was in a football match, and I went to bench only after that.  I couldnt walk normally for couple of months, also briefly had pain on front of knee at that time, but everything got back to normal, and I felt and played sports 100% later.

March 2015: While lifting a heavy object, I got a sudden pain on leftside of back. It resisted several weeks. I had some sciatica symptoms on left side. It has occasionally come back, and just this week when doing burpees exercise I got it back again. I self-diagnose having a slight anterior pelvic tilt, and exercises that physios give for sciatica and anterior pelvic tilt has probably helped with this particular pain.

begin of knee problems:

26th july 2015: In a football match, I got a kick on the inside of my right leg that was in air kicking a ball. So the MCL got stretched there maybe? I didn't hear or feel pain, and I played the rest of the match normally. I didnt notice if something else happened in the game.

Next day during a round of disc golf I noticed the back of my riight knee had swelled some, and I had minor pain in front of the knee, but I continued. The swell subsided the next morning but minor pain in front remained. Couple days later I went to a football practice to test if I could play, and I could. I did 2h of football with injured knee! The day after that during a walk, the pain felt worse, and I couldnt walk normally anymore. 

The next couple of weeks I tried to rest, and only did some 500m walking or 2km biking with some pain occuring. Once I had a step where I put too much weight on inside of knee and it gave a really strong pain sensation on the inside. It slowly got better.

Things didnt get better, so 2.5 weeks after the football match I went to a doctor. He did the strength/stability tests with his hands and concluded that my ligaments were strong and ok. He said that if it doesnt get better, I should come back.

3 months gone, and I'm still having all kind of symptoms, and the knee is not back to normal. 

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4 Replies

  • Posted

    I would definitely go back or even get a second opinion from another doctor. I know for me they couldn't really tell anything with either knee but suspected it might be a meniscus tear.  They couldn't tell until they did a knee arthoroscopy and made small incisions to get cameras in to see. That is when they saw what it was (both knees had torn meniscus) and fixed it.  Your situation is different but I would say yes, get in to be seen.  
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  • Posted

    Honestly your symptoms seem to me that they warrant further investiagtion, and the best way for them to do that is with a magnetic resonance. If I were you, I would be very insitent that you cannot just go on for months and months with pain in the knee, popping sounds etc. and that you want something done about it.  It really doesn't sound as if it is just going to get better on its own, and the arthroscopy operation is so simple  that if it would put it right, it would be excellent for you.  You cannot really tell from the outside and the symptoms what is going on inside . . . Not sure where you are . . I know in the UK you have to be pretty bad before they will refer you, so insist, exaggerate if necessary, and get them to give you the proper treatment.

     

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  • Posted

    I'd go back to the doctor and have him order an MRI, pronto!!! I also wouldn't be stressing my knee like you have been doing. Knees are easily damaged and not so easily fixed. Of course they can replace knees but that's not a lot of fun. It also takes up  to a year to heal. Have your doctor order an MRI and don't fool around any longer...pain is not a normal thing. Hope you find out what is wrong soon.
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  • Posted

    Thanks for your answers and time! I'm in Finland, and it is same here. Now it has been a while since my injury, so maybe hopefully they also see that a scan or other measures are needed.

    I wonder if some people are intentionally left with a knee that makes popping sounds and maybe feels a bit loose. If the surgery or other option could complicate things more? A kind of a leftover from knee injury where the knee wont generate any pains anymore, but is just feeling different than the other knee. That is the direction it seems to be going. I can walk a bit longer without some kind of pain appearing than month ago etc. Maybe it would become pain free, since some people need a year or more to heal from a knee injury.

    Then for the cause, I wonder if it is possible to not rule out, that I would only have end up now with a very bad muscle imbalance in glutes, calves etc causing these knee pains and poppings, or if it is certain at this point that there is still a problem in a knee.

     

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