knee pain, meniscus damage?

[runner1]

Hello,

My injury problems started back in january. I compete as a heptathlete so do a lot of varied training to cater for all the events I cover. I had a bit of a 'niggle' in my right knee one training session after doing sprint starts. I was driving out of the blocks and i felt a sharp pain in the back of my right knee. I decided it was best to apply RICE and take a couple of weeks of training to sort it out. During day to day activities the knee felt ok, maybe a little weak but no pain so i went back to training. First run anything more than a jog and the same happened again, but this time i could feel a 'popping/clicking' sensation behind my knee. Consulted my doctor and was sent for physio. No one seemed willing to tell me what the problem was and physio had no effect.

In february i went skiing for a week and the knee was ok, felt a few aches and pains but all seemed ok. Again came back to train and this time it was even worse so i went back to the doctors and was sent to physio again. This time i was told it was hamstring tendons and told to do stretching and strengthening exercises. The exercises had no effect, the only relief was due to minimal weight bearing and no sport.

Now i have got to the point where i have seen the doctor again and been referred to a specialist and physio again. It's going to be about 6 weeks before i can see the specialist and i start physio next week.

The pain has gotten worse. The pain occurs when pushing down with the leg when it's bent and extending fully whilst weight bearing. After running i notice a dull ache. There's no locking. I feel a small clunk when coming to near full extension in weight bearing.

Any help will be greatly appreciated

Thanks

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[PhysioAdvisor]

Hi runner1,

Based on your description of symptoms, a meniscal tear sounds like one of the more likely diagnoses. Many of these settle well with conservative measures including appropriate physiotherapy treatment / guidance, rest from aggravating activities especially twisting / weight bearing / squatting, flexibility and strengthening exercises and a gradual return to activity. Anti inflammatories / regular icing can also be useful in the initial 72 hours. Be aware that the meniscus does not have a very good blood supply which subsequently slows healing. In the event that appropriate conservative measures fail, surgical review for a possible arthroscope is usually the next line of treatment.

Hope that helps and good luck,

[runner1]

Hi again

Thanks for the advice. Just wondering how long would you recommend conservative treatment before further investigations such as mri?

[orthoped]

Ideally if you are in pain and experience symptoms regularly then I would recommend evaluation right now. If your symptoms are not that severe and do not prevent you from following your normal routine, then you can take the conservative approach.

Best approach would be to have an MRI if possible, cause even a small tear can propagate itself and increase in severity, so why take the risk.