synovitis of knee anyone? looong

Hi TE'rs.

This week i had an mri of my knee & met with orthopedic doc. For a year & a half I've been dealing w/ burning/dull/sometimes sharp pain under knee cap and around my knee off & on and now pretty much constantly.

My first (sports doc) over a year ago had told me to exercise through the pain (to strengthen quads & glutes) & didn't think an mri was necessary. Her diagnosis was bursitis & femoral patellar pain. I also saw the Podiatrist for inserts.

New Orthoped. doc -who specializes in knees & rec. by cyclist friends- thinks through a process of exclusion that it's synovitis and likely it was caused by the trauma of our 100 plus lb. dog crashing into it Jan. of 08'. He described it as the fat pad under the knee cap as being pinched. & the irritation showed up on the mri's -somehow comforting to SEE it!

He said i have 2 choices/approaches 1.) further modify my activities for several weeks and have no pain for couple weeks and then very slowly re-intro. exercise 2) exercise w/ pain & incr. of pain but there shouldn't be further damage to my knee.

So this means no spinning on my trainer since i'd feel pain afterwards. (i did get a great pro bike fitting by our wonderful VeloGirl). Walking only on flat streets-hard to do around here! Swimming w/ little kicking.

I'm so bummed because i don't have much faith that the reduction & slow introduction of activities will work since i've been doing that for the past year. i know I have to stay/get positive! (btw i've developed an stomach intolerance to ibuprofen so icing the knee has helped a little)

i'm looking into doing another round of PT to strengthen other muscles to help my knee maybe?(& my lower back since it's being affected) & into pilates since even the yoga class i've been doing (Yoga for runners & cyclists) hurt my knee afterwards & 2 days later it still feels like a burning pain (the instructor did try to modify for me). i also think that several lbs. i've gained has prob. not helped my knee & back.

So i have a few questions- for those of you who have had a similar injury or who just know more - can a pilates mat class help? has anyone tried "the dailey method" (mix of pilates,yoga,ballet barre work) and would that be okay for knee? when you depend on exercise for your sanity/well-being how do you deal being without it? is it realistic to try to lose weight w/o cardio?

i put out several email inquiries yesterday to instructors but just thought i'd ask here.

thanks for any advice!

I'm not sure this helps, but... I have patellofemoral syndrome in my right knee. My knee had pretty much hurt dully for about 6 months before I took myself to a knee doctor... The first one I saw thought that I had a tear in the knee or something and would need arthoscopic surgery and recommended an MRI. I got the MRI, there was fluid on the knee in the MRI and I went to another doctor with it.

He had me lie down and bend my leg while he was watching it and said, okay, your knee isn't tracking right because the muscles are stronger on the outside vs. the inside of your knee. That was causing the pain and the fluid.

He then prescribed physical therapy... So I went without exercising for a bit and did the physical therapy recommended exercises, they taught me how to tape my knee cap to the side so that my knee cap would track right and I was pain free by the end of that course of physical therapy.

Of course, I haven't kept up those exercises, so I still get the same type of pain and I need to do them.

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Originally Posted by Catriona

I'm not sure this helps, but... I have patellofemoral syndrome in my right knee. My knee had pretty much hurt dully for about 6 months before I took myself to a knee doctor... The first one I saw thought that I had a tear in the knee or something and would need arthoscopic surgery and recommended an MRI. I got the MRI, there was fluid on the knee in the MRI and I went to another doctor with it.

He had me lie down and bend my leg while he was watching it and said, okay, your knee isn't tracking right because the muscles are stronger on the outside vs. the inside of your knee. That was causing the pain and the fluid.

He then prescribed physical therapy... So I went without exercising for a bit and did the physical therapy recommended exercises, they taught me how to tape my knee cap to the side so that my knee cap would track right and I was pain free by the end of that course of physical therapy.

Of course, I haven't kept up those exercises, so I still get the same type of pain and I need to do them.

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I had this same problem in 2007 (both knees but worse on the left). I did at least 6 weeks of 2x PT that Fall and then kept up the taping and some of the exercising on my own for a few more months. I've been good for swim/bike/run ever since.

I'm mostly fine - however if I use the wrong size cranks on a bike, I feel it pretty quickly in that knee or if my position is wrong on the bike (seat slipped or whatever). After about 50 miles or so, I feel it in that knee. If I've been skiing hard, I feel it in that knee. Hiking or backpacking in the steep eventually, I feel it in that knee.

Thanks for your responses HillSlug & Catriona. I just talked to my orthopedist doc on the phone & he recommended Pilates before PT & if/when I do PT to do it very cautiously w/ lots of patience.

i guess the backpacking trip with hub & dog in the Sierra Nevadas will have to wait & the triathlons & my first century. whine whine. thanks for letting me whine!

Trinena-
Who is your doc (feel free to email me privately if you prefer)?? I live in the SF bay area and am recovering from a bad, bad fall that battered my knee and has kept me off of the bike for almost 4 weeks so far. I have a orthopedist already, but would love to keep a cycling friendly ortho in mind for possible second opinion. thanks

I'm not familiar with the Dailey Method but I give Pilates a high rating for helping with back pain.

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Originally Posted by NadiaMac

Trinena-
Who is your doc (feel free to email me privately if you prefer)?? I live in the SF bay area and am recovering from a bad, bad fall that battered my knee and has kept me off of the bike for almost 4 weeks so far. I have a orthopedist already, but would love to keep a cycling friendly ortho in mind for possible second opinion. thanks

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Hi NadiaMac - my doc was/is Dr. Charles Strotz over at Alta Bates in Berkeley (510) 845-3856. He's a knee specialist. I also have a few other recs from our cycling club but I have to locate them. I wish you the best with your recovery mine is going even more slowly than anticipated! grrr

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Originally Posted by Zen

I'm not familiar with the Dailey Method but I give Pilates a high rating for helping with back pain.

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Hi Zen -

I went to a beg. Pilates mat class & ended up badly straining my neck. I had talked to the owner of the studio beforehand-explained my issues- but I should have asked more questions about the specific instructor. The class right away did the "100's" & I did not do it correctly & ended up with almost a month of pain.

Anyhow, I'm pretty sure I finally hit the jackpot - that is to say a good match with a physical therapist & I've been to quite a few good ones. This physical therapist is has had extensive training in Pilates & has opened a Pilates studio. She comes highly recommended. I met with her Wed. and we spent quite a bit of time taking my history, on breathing & really understanding what a neutral position feels like. I'm also comforted that she has similar back/knee issues like me which led her to Pilates as an experienced P.T.. & since she's a P.T. I can get some insurance coverage.

I also found a small beg. pilates mat class for folks who have been injured at Working Body & my P.T knows her/has worked with her so I'm in good hands.

I'm still trying to get to the point of no pain & hoping a stronger core will stop the cycle btwn my lower back & knee.

Wish me luck & more patience!

A bad insrtuctor can make things worse (as you found out :( )
I got lucky. I take classes at the gym but my instructor is the same age as me and scans the room to make sure everyone is doing things right. If not, she'll talk the whole class through proper positioning.

it sounds like you're on the right track but it takes time, be patient.