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Knee ache after exercise

 Poster: A snowHead
Poster: A snowHead
Hi All

I'm currently trying to get ski fit at the gym for an Easter trip with the family, but I'm suffering some post exercise knee pain that I'm struggling to improve so hopefully one or two of you knee injury experts could give your thoughts and advice. Smile

A (not so) brief history of me and my knees, I'm in my early 40s, snowboarded badly in my late 20s/early 30s but not been since sprogs arrived. About 8 years ago I started having stability issues and pain around and behind the kneecap on both knees for several days after exercise (5 a side football), to the point where it was painful to walk up/down stairs for a few days and the knee felt like it would give out when locked. I had physio and was then referred to a consultant who diagnosed some rough/damaged cartilege behind the knee caps and put me on the waiting list for a double arthroscopy to clean it all up. Whilst on the waiting list I gave up football and started using exercise bikes at the local gym as my primary cardio exercise. With that change I found my knees improved dramatically over a few months to the point that both knees felt really good by the time I had a date for the op so the consultant agreed to put me to the back of the waiting list and revisit it in 6 months in case it returned.

That was ~6 years ago, I never had the op in the end and have had no issues at all with my knees until late November last year when I started noticing mild discomfort below my right knee cap and the knee started feeling a little weak and unstable again, although nothing like as bad as 8 years ago. I put this down to a much reduced gym routine due to work commitments up to Christmas, so in early Jan my gym instructor gave me a routine with skiing and my knee history in mind to strengthen my legs, hips and glutes etc (mainly bodyweight mat exercises) which I've combined with the exercise bike for cardio plus daily stretching and I was confident that a return to regular 3-4 times a week gym sessions would fix my niggle

However, I'm now 5 weeks in to that and my knee cap still occasionally feels uncomfortable and unstable when I push off that leg or twist and I also get a nagging ache in the middle / back of my knee which seems to disappear whilst actually exercising but usually returns a few hours after and lasts for several days. I've got no discernable swelling around the knee and as mentioned when exercising (as long as I avoid high knee load exercises) the knee feels absolutely fine so with Easter in mind I'm not sure whether I should continue exercising to try and fix this by building leg strength/stability or whether I should be resting completely for a couple of weeks to let the knee recover but risk setting me back in terms of general leg strength and fitness? Help Puzzled
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
@Locoblade, go back to physio
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 Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
Thats always an option but by the time I've had a doctors appointment and referal to physio any treatment is going to be too late to have a positive effect for the holiday at Easter.
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@Locoblade, i meant private...£40ish and an appt in a couple of days
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 Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
+1 to self pay. Though also a lot of areas let you self refer to Physio without needing to see you GP first, however there is still a long wait. I have had very good private Physio in the past.

When my knee was in so much pain, that I couldn’t bend or straighten or put any weight through it, i paid to see a constultant, paid for the recommend MRI and paid for the follow up with the consultant. This left me with a letter and MRI result stating what was needed during the three weeks took to see my GP (delayed due to the person on the desk forgetting to click save on my first appointment!) that meant the GP was able to then refer me straight to a consultant for the operation. The total cost was ~£500 (you get better rates when you tell them you are self funding) and worth every single penny! Obviously you aren’t quite so bad but highlights difference it make.

Best of luck!
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You sound like you are suffering from some overload of the knee, probably the kneecap.

This will require help with physio input. as you get stronger it will hopefully be behind you and the knee will behave.

If you can afford it it is much better to go privately as they are able to be much more accommodating to your needs and diary, which increases the chances of gaining some momentum

Jonathan Bell
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 Then you can post your own questions or snow reports...
Then you can post your own questions or snow reports...
sounds like you got meniscus tears
These can catch & give you the stability issues, or even make your knee give out completely without warning & you end up in a bundle of a mess on the floor.
Meniscuis rarely heal as there is little to no blood flow. So the damage is probably still there, just maybe it healed a little or wore down enough to stop your initial troubles.
I have a bucket tear myself, but wont let them cut me open. Knee still gives me jip now & again.

Maybe Ski-Mojos braces are your answer. Some french resorts allow you test them out.
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 After all it is free Go on u know u want to!
After all it is free Go on u know u want to!
Thanks for the comments all, I must admit I'd not really considered private physio so an initial consultation sounds like it will be worthwhile. The only concern is that may lead to regular sessions required to make any significant gains and won't just be a one-off ~£40, or would a single session potentially be enough for them to assess and give me an exercise/rest plan I could then do myself?

thanks
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You'll get to see more forums and be part of the best ski club on the net.
@Locoblade, I would say single session for assessment and plan with maybe one more to make sure you are on track...as long as you do the exercises properly
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 Ski the Net with snowHeads
Ski the Net with snowHeads
id be wary about private physio. If they do not have access to your medical records then they could end up doing more damage.
If there is debris in your knee, then there is debris in your knee. No amount of physio is going to fix it. It may settle down or it may flare up.
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 snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
Do private physios not have access to / update your medical records then?
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 And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
@Locoblade, they do not update your medical records. A good physio should be able to diagnose the problem. Mr Egg has no idea whether there is debris in your knee or not. Better to take the advice of Jonathan Bell above as he is a knee surgeon.
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 So if you're just off somewhere snowy come back and post a snow report of your own and we'll all love you very much
So if you're just off somewhere snowy come back and post a snow report of your own and we'll all love you very much
@holidayloverxx, yes, indeed, Jonathan Bell has always said on here that the best diagnoses come from a good physio rather than from a scan and my experience with Claire Robertson certainly bears that out. (Although she also suggested I had an x-ray, after my little fracas in November. Which she showed to Jonathan Bell for an unofficial second opinion. wink I feel so lucky to have them on my doorstep.)
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 You know it makes sense.
You know it makes sense.
I am no knee expert so please feel free to ignore.

Foam rolling (quads, IT band etc) have made huge difference to me and in addition I apply ice packs after every run. I now have no knee pain and am running marathans with some fairly rapid mileage increases in training (i'm also a football player and cyclist).

Sounds like you have an underlying structural issue however my understanding is the above won't make that any worse and may help manage the condition based on the timings of your ski holiday?
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 Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
Locoblade wrote:
Do private physios not have access to / update your medical records then?


The private Physio I saw after my shoulder op had access to my notes. Now that could have been because she worked out of the hospital when my op was down (nhs op out of a private hospital). I ended up getting private Physio as my post op Physio didn’t come through inside the time it was supposed to Sad
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 Poster: A snowHead
Poster: A snowHead
@Hurtle, @holidayloverxx, indeed, however the key word here is 'good'. A physio of the other type misdiagnosed my wife's knee injury and she only finally got it sorted following a visit to Mr. Bell and a referral back to a different physio.
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
Cheers, yep I've been foam rolling after exercise at the gym for the past couple of weeks and have now bought one to use at home in between, bit early to say if it helps or not but it can't make it worse hopefully.

Just to add that yesterday evening I had an hour long instructor led gym class that was pre-booked and didn't want to cancel, so I went along with the intention of dipping out of anything that might cause me issues but got caught up in the moment and ended up doing the whole circuit. Mr. Green With rowing, leg press, leg extension and barbell squat sets mixed in with other upper body exercises its the most I've stressed my knee for a few months so I was worried how it might react but today it feels better than pretty much any time since before Christmas, bizarre! With that I'm really not sure how much of an issue I have or not, it's only a discomfort and sometimes ache, I've never had any shooting pains that's made me wince or worse so perhaps I portrayed it as worse than it was, it's just that when it's in that discomfort phase it does feel a little unstable and I know that it's not quite right, I'll have a look into a local private physio and get a proper assessment.

cheers
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 Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
@Locoblade, I agree with the ice suggestion above. Exercise tends to make my knees swell, RICE helps with that.
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In absence of knees giving way / locking / big swelling, weak muscles is a common cause. Probably have a side of osteoarthritis which nothing can really help. although low impact exercises will mitigate damage. Stability of knee + patella should improve with all round strengthening of legs / hips since muscles contribute massively to joint stability (your patella is pretty much held in pace by your quads since it's such a nothing joint).

Ice is king.

R = restricted activity, not total rest (total inactivity -> muscle wasting -> more instability) in cases of pain / injury. (e.g. if is hurts to run, try a static bike / gentle indoor row).

Good physios are awesome. Hope things go well and you kill it on the ski hill!
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 Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
@Locoblade, +1 for private physio for at least an assessment. But I caveat that by advising you to phone and have a chat with them first. I've seen quite a few over the last year with knees, find that some really seem to know what they're talking about and some, well, less so. No disrespect to physios, but they don't all have the same specialisms or experience. Try to find one that you feel or know is a knee specialist or at least is experienced with knees and preferably also sports injuries or sporting persons. But then again a good general physio should be able to detect or (hopefully) rule out anything nasty.

But also, from personal experience, knees are tempremental little things and they don't stop bring niggly, painful, irritable etc overnight. So maybe for you it's just finding the right balance and type and timing of exercise and giving it time. No pain, no recovery, or summat like that ( subject to medical and physio concurrence).
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