Knee Swelling - Little/No Pain
My situations/questions below, but first a big Thank You in advance for any advice/suggestions!
I did my outseason interval on the dreadmill 2 days ago and have had a good amount of swelling in only my right knee since. I felt no twinge or pain while doing the intervals and didn't have any reason to think there was a problem until I woke up the next morning and saw the swelling and slight degree of pain (uggh!). There is no bruising. I am feeling the pain on the inside of my right kneecap while walking and definitely don't feel as though I could run any length w/out feeling a fair amount of discomfort. In addition to minor swelling all around my right kneecap, the majority of the swelling is below my kneecap on the upper/outside of my tibialis anterior muscle and it feels as though it's fluid as it's spongy when depressed (i'm suspecting gravity in action here?).
I did 40' on the bike/drainer today all at very easy IF (.6) and it felt great throughout. Actually felt really good afterwards 
.
Since the injury, I've been RICEing at regular intervals and vitamin I. My questions are:
1) Any ideas as to what actually might be the injury (e.g., knee strain?) and course of action?
2) If this continues, at what point should I think about having this looked at by a doc?
3) Anything else I could be doing to assist the healing?
4) Are easy effort bike/drainer rides just plain stoopid at this point in terms of healing?
Again, Thanks in advance for any advice and please, no rush!
Jim
Comments
dear Jim,
1) Any ideas as to what actually might be the injury (e.g., knee strain?) and course of action?
fluid accumulation in the knee can from excess production of fluid in the bursae (fluid sac outside of joint) or knee joint lining (fluid in the knee joint itself. lots of causes are probable, but whatever the cause, the result is an inflammatory response that produces fluid, which then accumulates. REST is good, as well as NSAIDs, if you tolerate this medication well. once the inflammation subsides, so will the fluid production and the swelling will decrease.
some things to ponder:
-did you warm up properly? was the treadmill set at an incline of 1.5% for your interval? running on the treadmill at 0%, puts a lot of strain on the knee (like running downhill), better to incline it a bit. did you spend any time recently on your knees? like cleaning the floor by hand or laying tile or carpet? or maybe you are an all star on the curling team? pressure on the knees can irritate the bursae. if you have a prior history of mensical tear, then this could be a cause for the fluid in the joint. etc, etc, I am sure you get the picture.
2) If this continues, at what point should I think about having this looked at by a doc?
if the fluid continues to accumulate to the point where it limits your movement, make an appointment. if the skin around the area gets red and painful to the touch and you feel feverish, then go to urgent care or ER, but i doubt it'll get to this point. at least you know what to do if so.
3) Anything else I could be doing to assist the healing?
REST and NSAIDs should do the trick.
4) Are easy effort bike/drainer rides just plain stoopid at this point in terms of healing?
that's a tough one. most docs would say rest completely. sports med docs would say avoid pressure on the knee, as in kneeling, but otherwise continue activity as tolerated. up to you.
hope this helps and i am sure my more tenured colleagues can offer additional insight.
GH
Hey Jim.
Goal one is to get that swelling out of there. ice ice ice. compression (if you've got recovery tights put 'em on and wear them all day under your regular clothes). stretching your knee will also help flush the fluid out (that's why the easy bike felt so great- loosened everything up). Easy bike will be great for it. Just lay off any intensity as you don't want to go the other way and increase the swelling by having the knee work too hard. make sure you can bend your knee all the way and keep everything stretched out in the back.
Here are some stretches to help you out-
http://www.athletestreatingathletes.com/stretching-series/five-favorite-stretches-for-runners/
As for the cause? who knows. more than likely, the big muscles tightened up enough that the tendons produced some irritation rubbing over each other or the bone. the knee cap just sits in your quad tendon for example, so if things are tight it can get irritated by being yanked over the front of the knee. If you can't get that swelling down or start to have weird stuff (buckling, locking of the leg)...then it's time to look inside the joint and see if something happened in there.
Gilberto and Leigh ~ Yet another reason why EN is such a great place to be. Excellent stuff!
I'll wear my compression tights all day (didn't even think of this one) and will definitely plan on icing much as I have one of those large gel ice packs. NSAIDs and stretching to accompany this too.
@Gilberto ~ I had the dreadmill set on a 1.0% grade and did about a 15 min warmup. Interestingly, I didn't spend any time on the floor before the interval but, on the next day I spent a couple of hours putting my son's bicycle together (gift from Santa). I really noticed the tightness/pain while doing this. I haven't previously injured my knees, but will most certainly visit a doctor if the swelling persists/worsens. Would you be offended if I went with Leigh's response to question #4?
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@Leigh ~ I'll definitely stick to low intensity rides but will even stop these if I start to feel buckling and go see a doc. Thanks for the link to the stretches too!
Again...can't say it enuff. Thank You for taking time out of your weekend to respond. Sound advice and it's very much appreciated!
Best,
Jim
Jim,
you are welcome.
yes, sure, i recommended that it was 'up to you' whether to ride or not; implying that there likely is no danger in doing so.
handsmaid's knee is the old school term given to the condition you describe, when the diagnosis is a patellar bursitis. so, any type of extended period on ones knees can irritate the bursae in this way. these days, people who work like this wear knee pads. it's possible that building your kid's bike (i.e. the pressure on the knee cap from extended kneeling) could have caused this, since this was the outlier activity you participated in vs. your daily running routine.
stay strong, injury free and happy holidays!
GH
Thanks again Gilberto! Experiencing much more pain yesterday/today actually
, mostly the in medial part of my knee. The swelling is still there so I'll continue to wear my compression and have decided to stop even my easy riding to see if this helps things along. Man, I'm really hoping this doesn't progress into something serious!