I was doing so well this summer! Regular light exercise, joints working smoothly, no aches or pains…and then last night, something went bad in my right knee, with no warning, no sudden snap, nothin’. I have a very specific, localized pain on the lateral aspect of my right knee, just one spot smaller than the palm of my hand.
I tried to figure out what’s going on, but have you ever looked at knee anatomy? It’s madness.
As I sit here, it doesn’t hurt, and there’s no obvious swelling, but if I try to stand on it, it’s a sharp, tearing pain, and worst of all, the joint has lost some stability, and I keep feeling like it’s going to buckle and send me to the floor.
My non-medical diagnosis is that one of the many rubber bands that Nature has strapped around 3 bones and a kneecap to hold them together has snapped. Intelligent design, my ass. It’s like a 5-year old tried to put some sticks together by wrapping them up with lots of duct tape.
Well, I’ve always figured the lower back and shoulders were sufficient to disprove intelligent design, but the knees also work.
I was having all sorts of knee issues, then found a sports medicine doctor on YouTube who said the trick is to strengthen specific muscles which support the knee since it’s just a joint- even though it’s a complex mess as you point out. But if the muscles are weak it takes all the stress and you rip something.
I can only speak for myself, but after two weeks of doing these simple exercises I have no more knee pain- after two years of it. You may have torn something, though, so it probably has to heal. I’ll post the link if you’re interested, but either way I hope you feel better soon. Being immobile sucks.
I once in a while get some odd knee pain that makes me limp a bit for around a week then goes away. It never rose to the level of pain you’re experiencing.
I don’t know if damage is always reflected in swelling. In my case it was, back when I was 18 I popped a knee pushing my car on a gravel driveway. Ligament and meniscus damage. Bad swelling. Intense pain. Doc drained blood. Needed surgery.
I’ll have to check out the exercise video in @2. I found some useful exercises online to help with shoulder issues I aggravated with free weights. That stemmed ultimately from a poorly executed military press from when I was…around 18. Damn that kid! The exercises (when I was around 42-3) helped.
Youtube recently decided I needed to see videos on fascia hopping. I do this once in a while at my own risk. My calves and ankles are tender for a few days after.
I get odd health related videos on occasion, often on the benefits and risks of certain vitamins and supplements when you get into your 60s. God knows what will happen if I watch the video in @2. A while back I started waking up to Huberman videos, no matter my starting point, thanks to autoplay and the algorithm. I saw some videos critiquing Huberman and told Youtube to stop showing me Huberman’s videos anymore. Youtube is a weird place.
Outer meniscus would be my guess. If it doesn’t settle down in a couple days, it might need some imaging. Hope it does settle down!
Also I have gotten that wobbly about to buckle feeling in a knee. Not for a while though. Maybe it resolved.
Definitely a soft tissue injury. The question is, did you sprain/strain a ligament, muscle or a tendon. Remember a sprain/strain is a tear. An orthopedist will be able to tell you what you did based on a physical assessment. They may order an MRI to confirm their diagnosis, also to determine the severity of the strain/sprain. The MRI will help them verify what type of treatment is needed. Immobilization followed by physical therapy or if there is a need for surgical intervention.
It’s either one of the ligaments or a torn meniscus. I’ve torn both my right MCL and meniscus in the past 10 years. Of the two injuries, the torn meniscus was by far the worst. I did that while doing yard work. I was slinging bags of soil and mulch and did a lateral twisting motion of the right knee. It felt like a knife had been thrust into the back of the knee. I was immediately down for the count. The doctor did a CAT scan and determined surgery wasn’t warranted, yet. It’s mostly recovered, but I have to be careful going up stairs and, of course, avoiding rapid twisting motions. The MCL tear was bad, but eventually healed on its own.
Six weeks ago my wife had “complete knee replacement” surgery. She was told 8 years ago she would need this, but a little accident at the first of the year tipped into must do now. That’s probably when she tore her meniscus. She did get some pre-op PT that helped her walk but there was really no choice. Fortunately the surgery went well, but the recovery is long and arduos. Lots of PT every day…hours of it. Basically you have to cause yourself pain to improve. The opioids to cope with the pain are another problem, but she’s almost done with that.
I feel you. My back has attacked me twice in the last six months. First I was pouring some tea from a gallon jar and suddenly felt like I’d been stabbed. Every movement, from rolling over in bed to sneezing made my back muscles clench like a fist. Had some old hydrocodone from a dental procedure left over and that got me through. But a couple weeks ago, out of the blue it got me again, but somewhat different. Could not stand upright, and spent a few days hobbling around with a stool for upper body support: move the stool forward, take two steps, repeat. It’s better now, I can stand and walk around, but it’s still not right, and feeling some nerve pain in my legs at times. Been doing some back exercises, which helps.
I may end up needing surgery (again), but mostly I’ve found unless something is unbearable and/or getting worse by the day, back issues do tend to resolve themselves given time (my neurosurgeon told me the same).
I lost the anterior cruciate ligament (ACL) in my left knee thirty some years ago, and since I was over 40 and not doing leg impact sports anymore, I decided not to go through the surgery and yearlong rehab to get it back. Instead I keep my leg muscles built up to stabilize my knee. I bicycle a lot but no longer run. It’s sore sometimes, and sometimes I have to stay off it a day or two, but it does get better eventually each time. But keeping the muscles strong is an essential backup to the ligaments.
#8–thanks for the heads-up about knee replacement. I’ll be undergoing one a week after Labor Day in Sept, and am not looking forward to it. I tore my meniscus almost 4 yrs ago when I tripped over a stray pile of unshelved books, which problem then ground into arthritis–til now. Nobody, including the orthodoc, really wanted to do the knee replacement, but at this point it seems the only option. I’ve had two hip replacements and I’m told that the recovery from the knee surgery is longer and more painful than the hips, even though they keep you in the hospital for a shorter time. Sigh.
I hope you take care of that knee and it heals quickly. Your walks are important. And, yes, the knee is a terribly complex joint.
Then there is that silly old joke about a A doctor is examining the painful knee of a pretty young lady and he remarks “What’s a crummy joint like you doing in a nice girl like this”
Also, just a word of caution, most people I know have had poor results from knee surgery.
One more note: I’ve always agreed with the opinion that humans becoming bipedal is the cause of so many back and joint problems because we are putting all our weight on our spine and joints that originally were designed for a horizontally distributed load.
Yes, I remember, when I was a TA (back during the Younger Dryas), having to remind my students that evolution doesn’t traffic in the perfect, but rather in the “good enough.”
@13 – i had a total knee replacement after microsurgery in 1980 and before that knee injuries from age 12 on. The micro surgery worked well, lasted a long time but by the time I had the total replacement (wasn’t even a candidate or the partial) my knee was a 9 out of 10 damage-wise, nothing left to save. Had the surgery (GREAT surgeon btw) and have called it the devils bargain ever after. Before the surgery i could walk maybe a mile before my knee swelled to the point of agony. Had to ice it every time i went for a walk. Tough, very tough for a person who hiked, biked and jogged regularly. After the surgery can’t jog, can’t ride a regular bike (bought a wonderful recumbent though) but can again hike with the best of them. Trade off? Yes. worth it? Took me a few years to mourn a number of activities that i can’t do anymore – but – yes, worth it.
As I’ve gotten older, it has become apparent that injuries that once happened because I over-stressed myself with tough hikes into the backcountry, or playing handball, riding a century on my bike, or building fences now seem to occur whilst laying in bed, or walking to the fridge to grab some iced tea, or rising from my comfy chair after reading. It’s most annoying!
anxionnat @ #11 — It’s my understanding that hips are easier than knees. Even her orthopedist said so, and he does both.
shermanj @ #13 — Many of the people my wife talked to about the surgery have had good results and recovered from it. The reason my wife was told 8 years ago to put it off as long as possible is because the procedure keeps improving. Sadly after the little accident in January she went from walking a lot…up to 10 miles a day in London the previous October…to barely able to walk. As I said, she had little choice. Hopefully she can get back to London next year and walk her heart out.
Knees are Evil.
I’m having my second one totally replaced in a week. Can’t hardly wait—that that “about to buckle” feeing may not be mucking about.
My own knee surgery went well. But I was a teenager still. I have small arthroscopic scars. Wish I had the video of that procedure now! It was a huge event in my life. Even now that knee seems ok, but now I’m much older it has its moments. I think it might be my other knee that bugs me. A few years after my surgery I was doing squats. That would wind up busting my lumbar area in my early 20s, which still lingers. Damn that kid, though I wish I still had his resilience. I can’t even imagine doing the shit to myself I did then. Bigorexia!
If I needed knee surgery now I don’t think I could bounce back as I did then. I can’t even with hip surgery. I still have vicarious trauma from that ordeal with both parents. Well that got dark fast.
I’m being so unproductive today. Being confined to a chair or bed, with any essential trip to the bathroom being an exercise in excruciating pain, saps one’s will to do any work. I feel fine as long as I don’t move, but I like moving around. Also spider feeding day is tomorrow, which will be a struggle.
So I’m going to the doctor tomorrow. One day of this is too much.
“Intelligent design, my ass. It’s like a 5-year old tried to put some sticks together by wrapping them up with lots of duct tape.”
That’s “design by evolutionary processes”, which is indeed rather like sticks and duct tape, but works FINE up until you’re done having kids, then starts falling apart.
If your pain is that bad then yeah a doctor visit ASAP. I kinda remember you posting about the boot before after something with your ankle. Not fun on either count. I’m like a decade behind you in age so I guess maybe that is what will be in store for me too. Or some other agony.
Hope this turns out to not be so bad.
Torn meniscus. A steroid shot can help but it will need a surgical repair.
Yeah I recall this not so fun ordeal:
https://freethoughtblogs.com/pharyngula/2023/08/04/resigned-to-a-new-normal/
Well, hell. I wrote a brilliant, lengthy essay as a reply, and WordPress lost it. This one will be shorter.
Hi, PZ. Recently-retired ER PA, here.
It seems like everyone is diagnosing you with what THEY had, so I’ll join the mob: torn Menscii suck.
But what you really need is to get seen. A good MD/DO, NP, or PA will get more info out of you (like, what exactly you were doing with the knee) and put the knee through maneuvers to test all the bits shown in the ridiculous image up top, and then probably a plain X-ray to start. Only then will you get a tentative diagnosis.
In the meantime, strictly limit weight-bearing because there are some things you can make worse, walking around on them. Use crutches if you have an old set, as long as they are sized for you. Or a cane.
Tylenol and/or Motrin help with pain, but each has contraindications so be sure and read the labels. If both are okay, it’s okay to take them together if needed.
Good luck, and speedy recovery!
I also had a torn meniscus in 2008. I could never pinpoint what I did to it, probably one of the times that my ankle or knee gave out and I fell in front of my classroom.
I had arthroscopic surgery in December, 2008. The problems began six weeks later. When I had my check-up, I was still in a lot of pain. I didn’t see the actual doctor, just his PA. When he told me to exercise the knee, I asked for a referral to PT.
He refused, and told me to go to a gym. I didn’t have a gym, and I didn’t know what exercises to do.
Six weeks later, still in pain, I made another appointment. The same PA angrily told me to “Get my butt out of bed earlier before work and go to a gym.” When I asked how I could know what exercises to do, he said “That’s what the personal trainers are there for.” He also informed me that I was no longer a patient at that office.
It took a couple of years for that knee to feel anywhere near normal.
PZ, my advice to you is to agree on PT with your surgeon before the surgery, and find the best PT that you can find.
Um, premature speculation is premature.
The agony is probably a good indicator that it should be seen by a professional, sure.
(Then worry about surgeries and whatnot, when it’s merited)
magistramarla @27
Personal trainers at a gym? WTF! I feel fortunate in retrospect for what I went through with a pretty serious knee injury. My parents let it go a few days as I stayed on the living room couch. My dad was trying to be helpful by manually helping me straighten my leg and the howl I let out probably scarred him for the rest of his life. I still remember it. After that my parents didn’t screw around. Took emergency services to the hospital the next day. Went to an orthopedist. Had PT before and after surgery. My mom’s insurance covered much if not all of it, but this was mid 80s. Took a few weeks after surgery to walk again. PT introduced me to electrostim, which is a sort of exercise that seemed to help a lot, but the pad placement is key.
They did NOT send me to a gym with a personal trainer. Physical therapists are evil bastards. Believe me. Memories still. But they are well trained and know what they are doing.
This clip is informative; I make it Trump is not as mentally incompetent as is generally claimed.
(https://www.bbc.com/news/videos/crl0x0y0ew3o)
—
Bullshittery and evasiveness and bluster and the rest, sure. Not the same thing, but.
Also, I notice the lack of substance with negative indicators, and the non-committal nature of the response.
* “She asked whether the US would be supplying Patriot air defence systems to Ukraine”
* , quoth he.
Anyway.
I think too many people confuse the persona with the person, though it’s by now known it’s his shtick.
[oops, that was meant for TET — sorry!]
John Morales @30
Oh dear, you go and post that on a thread about PZ’s knee issues yet would keelhaul any of us for anything remotely not topical. Teachable moments.
Remember: god also invented ageing. Praise the lord and triangulate it with nuclear weapons.
Hemidactylus @ #29
I know a lot about PTs now. After each of my spinal fusion surgeries, I demanded PT.
After the first one in 2015 (which failed because the surgeon put in adult sized pins and I have tiny bones), I saw the recommended hospital-based PT. I learned that those are usually the worst.
When I wasn’t healing, I found my own, who was a real gem. At that practice, the protocol was to first see the tech who was gifted at massage for 15 minutes. Then the tech applied the TENS pads and the heated pad over them and left me in a darkened room for another 15 minutes. After that Palmyra (The Princess of Pain) put me through my exercises.
The business partner of the PT is a MD/acupuncturist who shares the building. Some days, I would stop in to see him and he would work his magic on my back, but I didn’t improve.
I found a better surgeon in another Texas city who did the revision surgery in 2016. He told me that he used smaller pins which he normally uses on young teen scoliosis patients.
I went back to the PT center, and my spine finally healed. However, the first surgeon seems to have done a lot of nerve damage, so I live in chronic pain, travel in a powered wheelchair and I require PT twice a week.
The PT in Texas helped me to feel better while we lived there. We moved to CA six years ago. I got very lucky and found a PT center a few blocks from our home that has a similar protocol. Sadly, no massage and no acupuncture, but boy, do I love the heat and stim! Many lessons learned!
[meta]
In my case, it was inadvertent and I apologised as soon as I became aware of it, Hemidactylus.
Never ever have I chastised, however indirectly, that.
What I chastise is blithe ignoring of topicality.
Deliberate contravention of etiquette.
(Your dig at me is boorish0
Boorisho sounds like a strictly abided by warrior code. I like it. Thanks.
It’s a closing parenthesis
)where my finger slipped off the shift key. Thus the zero.(Your inferential prowess is well and truly demonstrated by that retort)
Just spoke to my orthopedic surgeon friend; suggests lateral meniscus and/ or collateral ligament; recommends MRI if that’s achievable……
Hope you get the care you need man.
Most knee injuries can be diagnosed by a good history and examination. This is not in the skill set of most GPs, but a good physio or an orthopaedic surgeon would be able to tell. Imaging is usually to confirm the diagnosis, exclude differentials, assess the extent of the injury, and decide on treatment options.
anxionnat@11– I’ve looked after a lot of people who had knee replacements post-op. It’s pretty tough for the first few weeks, but almost everyone is extremely pleased long-term.
robro@18– Knee replacement is surgically a bit trickier than hip replacement, but the main difference is that the hip is naturally a more stable joint (a tight ball and socket) as opposed to the knee (a slanted hinge that sometimes has to cope with sudden, unexpected lateral or rotational forces), and also the femur is a much bigger anchor than the tibia.
tallgrass05@24 — Surgery is not automatically required, not even for bad meniscal tears. Studies over the last few years have shown that surgery is not superior to conservative treatment (i.e. physio, exercise) at 12 months post-knee injury in most cases — even for ruptured cruciates! There are of course situations that are best managed surgically, but that should be discussed with a surgeon with the necessary investigations at hand.
magistramarla@27– That sounds like terrible treatment. I hope you fed it back to your doctor. I completely agree with your assessment of physiotherapy. In the vast majority of musculoskeletal injuries, PT is the best treatment and even if surgery is needed, PT will speed recovery and improve long-term function and pain minimisation. Of course, you can get a dud PT, but my experience is that PTs have one of the best competency ratios of almost any health discipline.
Ouch! Can relate having had an arthroscopy a couple of years ago now.
Best wishes for as smooth and as speedy a recovery as possible PZ.
@36. Hemidactylus : Sounds like Bushido, the Samurai code.
Re total knee replacement. I had it a couple years ago (age 68). Recovery was unpleasant for about a month, but then eased back into stationary bike and, mirabile dictu, walking without a cane/crutch!
I’d rate it as an easier/quicker recovery than I had with ACL repair at age 24.