April 2024 Update

Just going to keep this short and sweet since not a lot has happened since last time.

I had another follow up for my knee injury. It’s been trying to get better, so I opted not to talk with a surgeon at that appointment. It’s still limiting me enough that I’m still considering surgery, but I figured if it seems like it’s trying to improve, it would be best to hold off for now. The lateral knee pain has gotten better in that it’s not every day anymore, but it does still bother me if I stand with too much weight through my left leg, or it I have my knee bent a while and then straighten it. I haven’t noticed major issues with the lateral pain after I workout. The posterior pain is an ongoing issue, as is the joint as a whole feeling swollen after I run, and sometimes if I bike more than an hour. I’m usually good to run for a mile to a mile and a half without having pain later, but more than that and it isn’t pretty. I’ve pushed my running to three miles a few times, and while I usually feel okay during the run itself, I have pain soon after stopping and I hurt for the whole rest of the day, sometimes into the next day.

My doctor still thinks a lot of my issue is my IT band, but I’m just not so sure. When I get the lateral pain, it’s different than when I’ve had IT band pain. The pain I get now is lower. Back near the beginning of everything, I did have that very classic IT pain, but now I just don’t know. He explained that the IT band can cause pain where it attaches lower down the leg from that “textbook” area, but I’m hesitant to cut it until I feel sure. Still no clear idea of the cause of the posterior pain. May be my torn meniscus, may not be, especially since the area of pain doesn’t overlap the tear most of the time. If I have surgery, they’d look at everything first and then the plan would be to release some tension on my IT band and fix/cut out the tear in my meniscus, along with fixing whatever else they find while looking inside. It just scares me to mess with my IT band because what if it isn’t the problem after all and then it’s too lax? I don’t want to set myself up for future injuries.

I follow up with the doctor again at the end of May, and honestly if there isn’t ongoing improvement, I’ll likely just go the surgery route. The surgeon he wants me to see is very busy, so I assume surgery would be pushed out a couple months anyway. If in the lead up to it I feel things have improved, I could just cancel. It sucks to be at this point where I don’t have conservative options left and I’m just playing a waiting game. I’m having a hard time knowing what the right decision is here for myself.

One Final Push

Had another follow up with the ortho clinic two days ago. I’ve had very minor improvement in my knee since the last injection, but I’m still getting pain with even walking still sometimes. I can walk farther most of the time before it starts bothering me, but I still have days where it just doesn’t like me to walk on it at all. After every activity that involves weight bearing, I have pain. I get pain after walking, after running, and even after standing twenty minutes to cook or greet people at the doors at church. Biking is almost normal, but I’ll still get pain after that if I ride longer than about 45 minutes, but shorter rides are okay 85% of the time.

All that said, I feel like I’m back to where I was before I injured myself further at the 5K race in November, but even before that I was still struggling with these same issues for 3 months. Now we’re at 7 months, and it’s not looking great that they will resolve without help. The doctor told me there’s still a chance that they can improve, but told me to look at it from the perspective of how much it’s limiting me from the activities I want to do. The truth is that it’s holding me back.

At my appointment, I had fully planned to discuss my surgical options, but I was so undecided about it. The doctor was really understanding about it and told me to take the next month and see if things improve, and during this next month, he told me (directly quoting him) to “beat the shit out of it as a field test”. He told me to increase my activities and see how it responds. Just based on how the weekend went, I think it was stupid of me to push surgery off another month, but I want to be sure I need it. I really don’t see things improving in the next month, but I’ll make suer I run consistently and keep doing my rehab exercises and see what happens.

Steroid Shot Round Two

I had my ortho follow up yesterday. I did get some relief from the steroid injection into my knee joint last time. It gave me some off my range of motion back and helped with some of the pain, but it didn’t help with everything. I remain unable to bend my knee all the way, or straighten it all the way, so trying to do some of the stretches the doctor gave me hasn’t been going well. It’s still too painful to attempt a quad or hamstring stretch, but I’ve been able to do most of the strengthening ones pretty decently.

Given continuing symptoms at my appointment today, the doctor injected my distal IT band to see what that does for me. I’m still getting lateral and posterior pain, and walking still isn’t comfortable, but biking has been feeling a little better. I’m having less pain and stiffness after a ride as long as I keep it slow. Although any amount of pain is still too much, it’s at least a step in the right direction.

If this steroid injection doesn’t fix the problem and get me starting to run, I’ll be discussing surgery when I go back in 6 weeks. Hopefully it won’t come to that, but that’s the very last option. I’m not crazy about the idea of surgery when we don’t even know for sure what’s going on, but I’m pretty sure arthroscopy can aid in diagnosis, and they can fix the problem if they find something right at the same time, so I’m trying to be as positive as I can. The doctor mentioned possibly releasing tension on the IT band, but that’s assuming that’s the cause. The area where it hurts isn’t the same as where I had IT pain before; that was a little higher up on the knee and this is lower. He still doesn’t think it’s likely to be my meniscus even though it is torn since it’s on the medial side, which is the opposite side of my knee. I also have a Baker’s cyst that could be the cause. Basically, we’re both just crossing our fingers and hoping we can at least narrow down what’s going on. Unfortunately, it could be one or all of those things.

I felt pretty good when I woke up this morning (waaaay too early at 2:45 am thanks to insomnia being a side effect of the injection), so I took myself out for a walk at 6 am and managed to hit two miles. I was really slow, but only mildly sore while I walked without a noticeable difference in pain later on, so that’s a good sign. If I can get the pain while walking to disappear over the next two weeks, I’ll try slipping in a couple tenth mile intervals into a walk. I don’t want to rush back into trying to run and make it worse again, but I also need the information for when I go back for my follow up. If I still can’t run, I’ll let them cut me open and see if they can find the problem. I’m far too young for this to be the end of my running, so I’ll give it a try if I have to.

I’ll let you guys know how things continue to go as always!

Knee Consult

Today I finally had my specialist consult for my knee, which I was ridiculously excited for. I’ve been waiting for at least some answers, and while I didn’t get as much information as I hoped, just having some sort of plan in place right now is helping keep me grounded.

As I mentioned in my last post, I was scheduled to consult with a sports medicine doctor at an orthopedics office. The appointment began with taking x-rays, which I didn’t fully understand because I had an MRI done already, but I guess they show different enough information. After that, I went to a room to await the official start of the appointment.

Their office works with a physician assistant coming in first and getting a history, asking questions, and doing a physical exam. I was fine with that since I was going to be seeing the doctor after that. However, this PA was so fixated on my X-rays showing the beginnings of arthritis developing that that was all he was focused on while he was talking to me. He made it sound like that was what he thought the cause of everything was, even though I specifically was able to point to it developing after a run, and specifically worsening when my knee snapped at my Thanksgiving 5k. There was no way I was about to walk out of that office with anyone trying to tell me arthritis was the cause of my problems. It’s nothing new to me when someone in healthcare sees my body still being overweight, sees something like that in an X-ray, and just can’t see past it. He also kept trying to tell me it would be better for me if I didn’t run and switched to biking or swimming.

Thankfully, the doctor listened to me a lot better and I felt like he actually heard my concerns. He also asked some questions and did an exam. He then pulled my MRI and X-rays up and showed me exactly what the findings in them looked like on the images and talked about why he wasn’t 100% sure that my meniscus tear was the cause of my pain and deficits. The place where my meniscus is torn is the medial side, yet I’ve had a lot more posterior and lateral pain. He did say the posterior pain could be from the meniscus, but also said it may not be and that rushing to do surgery on it may not fix it. I told him that I was willing to try conservative treatments first, and whatever it takes as long as I can run again.

We settled on trying a couple of injections spaced apart by a month. He let me decide if I wanted one that would help the pain in the back of my knee first or the lateral pain first. I chose to treat the pain the back first because he said getting rid of the inflammation in the joint, whether from the tear or something else, would help clear up the Baker’s cyst since it’s a result of too much fluid production from inflammation. I was hoping he would drain it, but he said this would work better.

So, I had the steroid injection done on my knee joint itself, and it was surprisingly mostly painless. It was a little achy when he was actually entering the joint, but very mild— much more mild than the pain I’ve been living with daily. The doctor said it would take up to two days to see full benefit. He also said that if this didn’t address the pain, he would try an injection laterally to see if it’s my IT band causing pain in a different spot than before. I at least appreciate his honesty that he’s not sure exactly what it is, but he’s willing to try a few things. He did say that if the injections don’t work, then it would probably be wise to consult a surgeon.

I go back for a follow up in a month. In the meantime, he gave me about a dozen different exercises to work on at home. I am allowed to try some walking and biking as tolerated after taking it easy the next couple of days to let the injection take full effect. Right now I can’t do either without pain, so we’ll see what happens in the next several weeks. My only fear for the long-term is that these injections do help, but it just puts a band-aid on a bigger problem. The steroids will help the inflammation and therefore the pain, but what if just masking the symptoms causes me a false sense of well-being and I end up injuring myself more? I don’t like thinking about something like that, but I also know that I’m extremely unlucky when it comes to injuries. At this point, it would be naive of me NOT to think of it.

As always, I’ll share with you guys when I know more!

Knee Damage

I had an MRI done this week after I injured myself even more at the Thanksgiving 5K. I got the results back and there’s a whole lot going on. The most serious issue is a meniscus tear, but I also have a moderately sized cyst behind my knee and a joint effusion. Basically, the whole thing is a mess. I had already set up an appointment with the orthopedics office before the testing, but they didn’t schedule me with a surgeon, they scheduled me with someone in sports medicine. They put me with him because I had no previous history of knee surgeries and a no specific diagnosis, which makes sense. Now that I have the results back and know it’s a tear, I asked my pcp if I should reschedule to one of the surgeons, and that is what he would prefer.

I called the office and asked if I could be rescheduled to one of the surgeons, but the wait is out to March and April, which is way too long to let this go. I decided to just stick with the doctor I was scheduled with for now so I could at least get some questions answered about the severity of the condition, if the tear itself is likely to be causing the issues (it’s my medial meniscus that’s torn, but mostly I have lateral and posterior pain), and if it’s possible to try conservative treatment. My appointment is only two weeks away; at this point, it just makes sense to see what he says and I can always ask to book with someone else if I want another opinion. Letting this pain and loss of function go on for three more months is unreasonable. I can’t bend my leg all the way, I can’t straighten it all the way, and it’s affected my gait for a month now.

Honestly, I’m scared of what I’m going to hear. I know that a lot of people with meniscus issues still have trouble with it even after a repair. I also know that it’s unlikely to just heal itself, so I don’t know what I’m facing. I would love to know how severely it’s torn, and would like to hopefully get the cyst and/or fluid drained so my knee doesn’t feel so stiff and swollen. I think just that would go a good way toward me feeling better.

I’ll keep you guys updated. I had dreams of doing a color run in April, but it really all depends on how this consultation goes.