"It's not in your knee" says ortho

[cyclechick2008]

Yesterday I went back to the orthopedic surgeon about my knee. We discussed the cortisone shot's effectiveness and the next step.

As he was examining my knee he was holding my thigh about halfway up. His thumb hit a spot where the gracilus and sartorius muscles meet on the way to the pes anserine. I literally came up off the table! I said "THAT'S WHERE IT HURTS!" Dr. said "That's not your knee." DUH

We discussed that, and he made the comment you really don't have the symptoms of a meniscus tear, but it could be damaged and referring pain up your leg. He thought the only option was to scope the knee anyway. Of course, I left with an I'll call you when I'm ready.....

I jump on the internet and type in gracilis pain medial knee. I get an article about saphenous nerve entrapment. I read it and I had a EUREKA! moment. It fits my symptoms to a tee! I printed off the article to give to both the ortho and my chiro. Between us we should be able to solve the issue.

The good news I can ride because it is only a sensory nerve and not a motor nerve!

Has anyone heard of this? or have treatment suggestions other than anti-inflammatory meds and time?

Kim

[OakLeaf]

I can't comment specifically, but when I've had nerve entrapments in the arms, it's always been because of muscle imbalances. Either the muscles themselves press a nerve, or they draw a bone out of place that then presses on the nerve.

Treatment in my case was strengthening the muscles that were "locked long," stretching the ones that were "locked short," and dealing with any trigger points in the muscles (usually LOTS).

Remember that - to paraphrase the old saying - when your only tool is a scalpel, everything looks like an incision site. I've had doctors of other specialties tell me that about surgeons, so I don't mind repeating my own prejudice. ;) (And remember that while a scope is minor surgery, it's still surgery, with all that that entails, including possibly aggravating any pre-existing muscle imbalances and/or even causing new ones because of pain, swelling and restricted activity.)

As with most soft tissue injuries IMO, I would think the first line of treatment would be a good PT. Knott's been off the forum for a few days, but hopefully she'll chime in with advice, a referral, or both... In the meantime you might just ask your surgeon for a PT referral.

[JennK13]

Gotta love the internet!!
Good luck, and with a good chiro, I'm sure you'll be back to normal. I have issues with all of my joints - they have a tendency to pop out, sublux, slip, etc (everything from my shoulders, hips, and back, to my ribs on both sides). Fortunately for me, I have incredible body awareness about "where" exactly it hurts, how deep, what side, what kind of pain, where it's radiating from (if that happens to be the case), lack of mobility in a certain part of my body, if it feels like it's pinched, itches, or stretched - you name it - my chiro thinks it's funny and laughs at me, but she always listens, and knows the right questions to ask to get more info on pinpointing the pain and cause, and puts me back together (of course, she sends me off with a strength training and stretching plan to keep whatever it is in place).
I've been amazed at how a "problem" in one part effects another.
Speaking of the chiro - off I go for my adjustment!! I dislocated my hip last week at softball, so I need a "tune-up" before my double header tonight :)
Good luck!

[Vega]

It seems some doctors are just eager to open you up. It's great that you found exactly what is wrong and hopefully you can find a treatment that doesn't involve surgery. It sounds like they just want to go in there with a scope and see if they find the problem. I'm not a big fan of exploratory surgery. I'd rather them tell me exactly what they are going to do to fix me before ever opening me up.