It was a whirlwind of a morning yesterday. I had an appointment with an Orthopedist in town for my knee after 16+ months of hurting and over a month of waiting on a solution. I first went to a doctor in early April and after an appointment, an MRI and lots of waiting I was referred to a specialized (gee, no surprise there). I didn’t know what to expect. My primary care physician called me on Monday and said that the MRI was too advanced for her to read – um, ok? She had originally thought it was a torn meniscus which was easily fixed with minor non-inasive surgery. But alas, that was not the case.
The appointment was…different. I spent almost 2 hours with the doctor talking, doing x-rays, having him play with my knees and waiting in anxous anticipation. I just wanted him to tell me what was wrong and then tell me there was an easy solution. That did not happen.
Instead, he told me – in a very long-winded/roundabout way – that I am a “problem child” for him as far as injuries go. Most of the time when people come in the injury and solution are obvious. Like a torn mensicus – easy to spot and easy to fix. Of course, I had to be more trouble. I have some acute cartilage damage that has caused edema of my patella. It’s actually something called chondromalacia patella with bone edema which sounds a lot more legit than plain ol’ knee pain. Long story short…it’s hurt. Duh. However, there was no signigicant reason for the damage so there was no easy way to fix.
Instead, I’m starting off on some anti-inflammatory meds (NSAIDs) and 6 weeks of twice weekly physical therapy. Plus I need to go buy some fancy orthotics for my shoes. Basically I am injured because I am an active, pronating woman runner. Biology and lifestyle are not on my side. Because I am a woman, my skeletal anatomy is different from a man – my hips are wider causing a difference in alignment of my legs/knees. I also pronate on my feet, meaning that my feet turn inward when I walk & run. These two facts combine to cause imbalances in my alignment. This has lead to repetivie motions which eventually caused damage to cartilage which eventually caused edema (swelling/trauma) to my kneecap.
not actually my MRI but it’s similar. the light color at the bottom of the patella (red arrow) is edema or bone trauma and swelling. mine was a bit more severe, about half the patella has edema
Wanna know the kicker? I dug myself into a mighy fine hole by waiting so long to get it looked at. Because it had been well over a year since the injury began, it has been well over a year that I’ve been favoring my right leg over my left. This has caused signigicant muscle loss in my left quads which is aggrevating the issue even worse.
It hurts —> I limp and put more pressure on my right leg —-> left leg muscle tone decreases —-> imbalances increase —-> it hurts
When the doctor was testing my knees and legs he had me hold them out straight and flex my muscles. For the first time I really looked at them and the difference in tone is so obvious. His exact description was “your right quads are strong and big like top sirloin and your left quads are more like ground beef.” I’m working with ground beef leg.
So the answer, for now, is physical therapy to fix the muscle imbalances and dramatically increase the size/tone/strength of my left quad (specifically the inner portion). Also, my hamstrings need some work.
Long story short – if you are injured just go see a doctor. Had I gone a long time ago it may have been easier and quicker to fix. Now, I’m in for a long road ahead of me. He said I had significant work to do. But the good thing is that it can probably be fixed. The bad news is he told me I may have to do some soul searching and figure out just how much I love running and if I can do without it.
I’m frustrated, overwhelmed and a bit sad. I had to fight off tears in the parking lot after the appointment. It’s been so long since I’ve felt good while being active that I was hoping for an easier solution. However, it’s going to be a long road to recovery and I’m going to have to work hard. It may fix itself, it may not. All I want to do is run, jump, hike or dance and I don’t know if I will be able to any time soon. My first physical therapy appointment is tonight after work so I will soon have a better understanding of just how this whole thing is going to go.
On a good note, I met with our realtor Wednesday and he said he was confident we’d have an answer on our house today. So if you need me, I’ll just be over here obsessively checking my phone and email for the next NINE hours. I hope everyone has a happy Friday and a wonderful weekend!