Cartilage damage behind the knee cap

Hi,

I hurt my knee 3 weeks ago. I squatted down looking for something (so my knees were fully bent in a "bunny hop position") and felt discomfort near to my knee cap.

After this it hurt a little to sometimes walk down stairs and it also hurt if I squatted down so my upper legs were just above parallel to the ground. Walking around was fine, and I could jog on the spot. The pain was not a sharp pain, more an ache.

This pain went away after a week and I went to athletics which I really enjoy doing. Nothing hurt during the training session or directly after, and I thought I was fine. I finished training around 8pm, and by 10pm I could feel slight soreness in the muscle near to my knee cap, directly above where the orginal injury was. This soreness got worse the next day (all of my legs were sore, but this was more DOMS from the running as I had it in the other leg - but the soreness near the injury was more severe and not present in the other leg). So all this was two weeks ago.


After about 5-7 days (so around a week ago from today) the soreness in the muscle went. The knee however didn't feel right and there was a lot of creaking and clicking in the joint. I don't seem to have any pain in the joint.

I saw a Physio a day ago who said it is likely damage to the cartilage behind the knee - hence the creaking noise and it not feeling right. She gave me some exercises to to at home, such as leg raises and I'm seeing her again next week. She said for the injury it's usually 5-6 weeks before back to how the knee was, so she said another week or two and I should be getting there. She also said I can lightly jog on it if it doesn't hurt. Her reasoning was that new cells are forming and we want to prepare them for the activities and stresses etc. I went for a light jog yesterday which went okay, although near the end I had a slight ache in my knee so stopped.

I believe the physio is probably right with saying it is cartilage damage behind the knee - the noise does seem to come from there and the knee movement is not smooth. I am a little unsure regarding the timings of being fully better and also about the formation of new cells - does that sound right to physios on here??? I have been researching and a lot of places I look seem to say cartilage doesn't repair itself much, and if it does it is really slow? And I thought cartilage is hard tissue which protects the bones - so is this stuff about preparing the cells etc true? Or do people think such an injury will takes ages to recovery from, or won't get better at all as cartilage damage doesn't recover?

Sorry for the long post - trying to give as much detail as poss. I am really into my athletics, and this injury is really depressing me as I'm obviously not training and unsure when roughly I may be able to train again!

Articular cartilage does not repair.

However, if your problem is a retropatellar syndrome (maybe due to an excessive genu valgum or a flat feet or a combination of the two), then possibly strengthening and stretching of quadriceps (mainly the vastus medialis), hamstring and calves should be benificial. But of course this is true if the above is applicable on your case and it is obviously impossible to say from here :)


all the best

Thanks. My injury didn't seem to come from running - it happened from me squatting down at home, so it was an instant thing unrelated to my training as far as I can tell. I've not had any issue with my knee up until then, never had any bad feelings in it etc - seemed fit and healthy. I am also in my early 20s.

The thing which makes me question whether it is cartilage damage is that I didn't have this knee clicking feeling (or knee unsmoothness) when I first injured it. I started to feel this about a week after, and at the same time I noticed a strange texture at the side of my quad muscle - it was like a bubbly or netty texture just over the muscle (maybe the muscle fascia?), and it went into the joint where I couldn't get to it with my fingers. It disppeaered from the muscle when I rubbed it for a minute or so. Does anyone knoe what this could have been? If any of that texture is around/under my knee cap then I am pretty sure it would cause the issue of the knee not being smooth and also the clicking? I mention this because I felt the same texture today after I have been jogging.

Any help would be great, thanks

Hi there,
I may well be wrong but from what you've said I'm not yet convinced that it is cartilage damage behind the knee, I think that you have strained/torn the muscle jsut above the knee cap which is responsible for holding the knee cap in the correct position. I'm jsut not sure that you could damage the cartilage from a single squat. I think you need to work on the quads muscle, strenghtening as teh physio said but maybe also some soft tissue work to try and break-up the knots the "netting-texture" and see if the work on the muscle changes your knee cap symptoms (which I am hoping that it does!!!)
Thank you!

Many thanks!

Yes, looking online and reading up about injuries, I didn't think cartilage damage seemed the most likely, esp with the way I injuried it - seemed more likely to be soft tissue. I think the physio said this because I only had pain when I first injuried when I walked down stairs and squated down past a certain point. I did go back another time to the physio and explained the weird texture and they said it may be scar tissue, and the injury may be soft tissue, but the plan would be the same regardless interms of making it better.

It has got steadily better over the past few weeks, and I am doing the leg exercises and jogging, so I think I am on the mend! I also recently got a foam roller, so I've added stretching and foam roller work as well.

Thanks :)

Hi there,
I am happy to hear that you are doing better.
I more likely to think that damage to the cartilage behind the knee occurs over a longer period of time and is slowly worn down rather than one quick trauma (where damage to the cartilage in other parts of the knee may occur suddenly).
If the kneecap isn't moving smoothly on the bone below it however, this type of damage can occur, so I would probably get a different physio to check you out, they are likely to focus on quads strengthening also but may focus on different parts of the quads in order to ensure that the kneecap bone is moving correctly on the bone below it,
if that makes sense....?
Best of luck !!!