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Inside knee pain

 Poster: A snowHead
Poster: A snowHead
So I'm due to get an appointment this Thursday but am due to go skiing next Thursday so am getting bit antsy.

I dislocated me right patella (third time on that knee) about seven weeks ago. I saw the doctor after a few weeks and he said skiing in January would be fine and passed me on to physio. I decided to use my insurance and went private. The physio told me that everything is fine (there is no patella maltracking), and that I just need to go to the gym and I should be fine.

I've been going to the gym since then, slowly building up and everything was fine until last Thursday. Thursday was the first time I decided to go on the treadmill again since the incident (mainly to get some confidence in really). I managed a couple miles and went to do my usual leg press exercises but stopped short cause something didn't feel right. Two hours later in home, sat on sofa and get a sharp pain on inside of my knee, it starts in the middle and goes just to the top, near the vmo.

Since then I've been popping ibuprofen and doing RICE twice daily and I can now actually walk and go up/down stairs fine. I only get pain intermittently at the moment and it tends to go away if I carry on walking.

There hasn't been any swelling or bruising either.

My gym routine up to that point was:

10-15 minutes Bike and/or step up machine
3x8 reps of single leg presses started from (left: 50 right: 30) and been doing (left: 60 right: 60) since a week before pain
3x20 reps of balancing on bosu ball (round facing up), on one leg and moving foot from tip toes to heel
3x15 reps of single leg step downs
3x15 reps of single leg squats (1 week before pain)
3x15 reps of squats with 6kg weight on bosu ball (flat side facing up)
3 reps of 1 minute wall squat, 5 second squeeze small exercise ball, 5 second just hold it (few days before pain)

Every third visit I would add:
3x10 reps of squats with 30kg weight


I guess my question is has anyone experienced similar, and what potential things could it be - or is it just a long list of possible things that I won't know until the knee gets scanned?
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Timmaah, have a google round "vastus medialis trigger point inner knee pain", for example http://acutakehealth.com/knee-pain-triggers-in-runners
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Timmaah, Different injury but similar situation! Ruptured Vastus Lateralis end of Nov.(playing badminton). Was going to go skiing over xmas but no chance. Recovery was going well (gym work not quite as advanced as yours) but then decided to go for a bike ride - MISTAKE! After getting home, pain returned and it was as though the muscle had been re-injured, although I didn't really feel pain when it happened.
Anyway, 2 weeks on and I'm almost back to where I was before (ie. I feel like I could ride a bike again - DOH).
Obviously every injury is different, but hopefully just a minor set back to your recovery (re-injury is very common during rehabilitation). I'd suggest RICEing it until you get a diagnosis. You can always build muscle later, but could easily do more harm than good if somethings not right.

Good luck.
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I would go back to the physio and see what they say. No swelling is VERY encouraging. it is entirely possible that it is muscular (muscles not quite firing at the same time - as I had that) and my physio identified and recommended a knee brace or taping - she demonstrated by taping that it was just that. I bought the knee brace and was able to ski (I at that point was 2months post op from meniscus cartilage tear).
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Timmaah,

Given history pain probably patella.
Doesn't sound like you were strong enough to run.
Check out with your physio
Jonathan Bell
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For those curious and others who might come across this who are in the same boat, the Doc said my patella looks good but thinks its a meniscus tear, so will have a scan in next few days but looks like I won't be skiing.
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Timmaah, best of luck with the scan, hope it gives good news. You have my sympathy.
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It looks like you could damage your knee with your intense routine. Too much too soon. I had a dislocated patella and associated muscle loss was very substantial as my doctor was very conservative and told me to wear a full brace for a month and only then referred me to a physio. I skied two months after dislocation but it wasn't until June that I could run - I was specifically told to avoid running and to let the muscle to recover gradually. I only started adding weights to training in September. Good luck with the scan.
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never summer, very fair comments and I think that's probably exactly what happened! I've been through the dislocations before and this one popped back in on its own so I threw the brace aside and kept full ROM and was starting to put weight on it by 2 weeks and was cleared to go to gym by 3 weeks. But I put that down to it only being partial and not destroying as much as it has when it's been fully out.

So in a bizarre twist of events, scan showed no meniscus tear.. Not really sure what the pain is unless the tears too small to pick up on. But been given all clear to ski with an evening to pack and get everything an order Shock To be honest, I'm not feeling entirely confident with my knee.. got an off the shelf brace but doesn't seem much use. Will probably skip the first few days I'm out there and see how it is anyway.. I'm out for a month so I need to try not to be greedy.

Wish me luck!
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Timmaah, as I said in my previous post, I was getting pains doing squats post my meniscus surgery. The Physio put some tape in certain places, and I could squat completely pain free. She explain it was one of my muscles being slightly slow to fire so it didn't move my knee cap cleanly as I bent. She offered to teach me how to do the taping or that I could get a particular brace to do the same thing. I didn't trust myself to get it right with the tape so bought the brace. That was 2months post op and only a couple of weeks before our ski holiday. It was enough to allow me to ski, not as much as previously but I was just great full for any skiing as if we cancelled we wouldn't gave got out at all that season.

Hence my recommendation for going to a Physio. That is great news about the scan results
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Timmaah, Mine popped back in on its own too, but the bone was bruised as shown by MRI, and brace was needed to stabilise the knee cap in its grove properly. My ROM was not affected at all, the only way I knew something was wrong is because I couldn't even think about clipping into bindings and getting the weight down properly. I was getting occasional pain in that knee for a good few months after, but nothing too intense, even now I can feel it from time to time, I just got used to it and I don't feel it when skiing, it's pretty random and not sharp. If you do ski on your holidays just take it easy. If you normally ski on fatter ski forget it, get easy turning piste ski and avoid situations when you might need sudden stops and sharp turns. Lower your DIN a bit so that you can get into your bindings with less effort and see how it goes from then. My leg was like a noodle but I could still ski last season with due precaution, I stared with 2 hours a day and built it up to 3-4. I even managed to get on powder skis as we had too much snow not to be tempted but after first couple turns I knew it was too soon, but I managed to ski down to change the skis. Actually walking in ski boots was harder than skiing, especially carrying the ski. I ski with a brace this season sometimes, it doesn't do anything and my doctor told me not to bother, but I like the pressure I feel from it. If you are not greedy and pace yourself I think you should be OK.
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never summer, interesting.. thanks for sharing! How did you find doing day to day things like walking up and down stairs? How long after the dislocation did you clip in the bindings and ski etc. ^
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Timmaah, Well, I went to see the doctor the next day after it happened as I couldn't figure out what was wrong but felt great instability in my knee when transferring weight, particularly up and down stairs. I was given a full-length brace straight away (and crutches) and sent for MRI. It was OK with a brace, but inconvenient as my leg was pretty much incapacitated. I got quite good walking on crutches after the first week:) February 20 I had my first visit to a physio (3 sessions) and February 27 I went to the gym, but I was only doing exercise bike on quite a low setting for about 40 min with some leg curls for hamstrings but with the minimal weight. I had dislocation on January 13, and clipped into bindings for the first time on March 19. I lowered DIN form 6 to 4 (I am back at 6 now) and changed skis from 100mm waist to 74.
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So ended up not being meniscus tear but grade II cartilage tear.. Trying to hear back from doctor is proving evasive! So think I might continue with hot baths and give skiing a try in few days and see how it holds up.. Managed to walk on it for around 10k yesterday with just ache rather than pain but I had that before this whole saga anyhow. Don't want to hop on skis too early as they're 120mm width and probably less stressful to ride off piste than on piste!
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Timmaah,

Might be worth "resting the 120mm skiis" for the first few days!
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Timmaah wrote:
So ended up not being meniscus tear but grade II cartilage tear.. Trying to hear back from doctor is proving evasive! So think I might continue with hot baths and give skiing a try in few days and see how it holds up.. Managed to walk on it for around 10k yesterday with just ache rather than pain but I had that before this whole saga anyhow. Don't want to hop on skis too early as they're 120mm width and probably less stressful to ride off piste than on piste!


It does tend to lend some more weight to my theory about fat skis:

http://www.powpowpow.org/could-fat-skis-cause-knee-problems-in-the-longer-term/
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feef, should be noted that the injury isn't related to skiing.
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Timmaah wrote:
feef, should be noted that the injury isn't related to skiing.


Doesn't matter.. my point is that fatter skis will increase the lateral loading on the knee, and irrespective of the source of the original injury, you don't want to be doing that.

In fact, I believe one of the comments on my post, from a biomechanicist, makes the same point, that he doesn't recommend wider skis to anyone with a knee injury.
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Ya I don't disagree, I think it's fairly obvious that skiing on larger, and wider skis will require more strength.
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Timmaah, Injured knee is an injured knee, regardless how you got the injury. This season's conditions don't require skis that wide too, even days that we call "epic" (and we had a few of those too) are not epic by the standards of last two winters, size down and you will do your knee a favour and your skiing won't be compromised. After a dislocation and a cartilage tear you want to minimise the lateral loading. The season so far is nothing to rave about, and with the amount of foehn that almost doesn't stop I doubt it will drastically change. What you don't want is to aggravate your injury to the point that a surgery might be required - then you are risking missing the next season which can be very different from this one.
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never summer, a moot point but the season is a little different in Japan! 5m in last month wink
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