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Plica syndrome?

Peter NoyesPeter Noyes
in General Training Discussions

Hello,

I have been having knee pain for about 6 weeks now that originally started on a race rehearsal ride. Cycling seems to aggravate the knee more than running. Initial diagnosis was just Patallofemoral Pain Syndrome I have been going to physical therapy for 4 weeks now, and it has helped. I did re-aggravate it by doing a HIM race 2 weeks into therapy, but there was no stopping me, this was my 'A' race. The physical therapist is now thinking that I probably have plica syndrome, based upon where the pain is and everything else. My hamstrings are exceedingly tight. My chiropractor seems to think that it is related to tight piriformis and psoas muscles. Basically I am tight everywhere. Has anyone else had anything like this?

Thanks!

Comments

  • Michael JohnsonMichael Johnson

    Orthopedist here:

    Obviously difficult to be certain if you have plica or not. But, if your PT  thinks its the case then I would defer to them. Typically there is pain in front of the knee along either side of the patella tendon or patella itself. Sometimes when you have your thumb in this area, when the knee is flexed and extended, you can sometimes feel a thick band of tissue motion up and down.

    MRI is not helpful. If it was me I would

    1. Continue the stretches your PT showed you involving the anterior aspect of knee

    2. NO kneeling, crawling and Limited squatting as much as possible

    3. Avoid/Limit hill running

    4. Take antiinflammatories such as ibuprofin, etc regularily until after the race.

    5. Ice after exercise.

    6. Could consider a cortisone injection from an orthopedist to get you through the A race (it's an option)

    7. After A race, you may need to consider knee arthroscopy, where, if a plica band is present, it can be removed. Would take about 4 weeks to return to full activity afterwards.

  • Peter NoyesPeter Noyes
    Thanks. I have gotten through my A race, and my next A race is not until March 29th, so I have some time to fix this.

    Pain is along the inside of the patella. Kneeling on it is definitely painful. I am not quite sure what to feel for when flexing/extending the knee. I have been doing laser and ultrasound therapy at the PT. I am currently on diclofenac for imflammation.

    After resting for a few days the pain is completely gone, and everything seems fine, but then I cycle for even 10 minutes and then the pain comes back.

    I will see my doctor in a few weeks, he is on vacation image

  • Michael JohnsonMichael Johnson

    May need to consider a knee scope. See what orthopedist says.

  • Peter NoyesPeter Noyes
    Thanks. I have an appointment for Monday. I will post an update with what the orthopedist says.
  • Peter NoyesPeter Noyes
    Since I last posted suddenly my knee drastically improved. The doctor said it might be a plica, but since my knee is showing improvement its best just to wait and see. Very strange, its like all of a sudden the inflammation is gone and certain movements in physical therapy are suddenly pain free. I had pain for 6 weeks straight, and then between a tuesday and a thursday in the same week I went from pain to no pain. I went for an 18 mile ride on Sunday and everything is ok. Ever heard of anything like this?
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