Knee Pain and Swelling After Intense Exercise: What You Need to Know

After intense exercise, the knee may become swollen and painful, making it difficult to straighten and exert force?

Hello Doctor, I have a habit of playing softball by the riverside.
This Sunday (May 5th), after finishing the game, everything was fine until I got back to my car.
When I was about to get out, my left knee started to swell and hurt, and I couldn't fully extend it.
I had a similar experience once after playing basketball, but after resting for a few days, the swelling and pain went away, and I could extend my leg normally again.
This time, from Sunday until today, after resting for 2-3 days, the swelling and pain have gradually decreased.
In April, I went to an orthopedic doctor for an X-ray, and the doctor said there were no issues with the bones.
The joint space was also considered normal.
I only experience this condition after intense exercise; normally, when I go for a light jog in the evenings (about 2-3 times a week), I do not have any knee discomfort.
I would like to ask the doctor what is happening with my knee and whether I can continue to engage in more intense activities.
Thank you for your professional opinion.

David, 40~49 year old female. Ask Date: 2017/05/09

Dr. Cai Shanglin reply Orthopedics

Swelling in the knee joint and inability to fully extend it may be due to synovitis with effusion.
It is recommended to perform an ultrasound next time for confirmation (as X-rays may not reveal the issue).
Regarding exercise, it is important to warm up before activities, wear appropriate footwear, and pay attention to the playing surface.
If there are any issues, wearing a knee brace can also be beneficial.

Reply Date: 2017/05/09

More Info

Knee pain and swelling after intense exercise can be concerning, especially when it occurs repeatedly. Based on your description, it seems that you experience these symptoms primarily after engaging in high-impact activities like playing softball or basketball. It's encouraging to hear that your X-rays showed no significant issues with your bones, and that the swelling and pain tend to subside after a few days of rest. However, it's important to understand the underlying causes of your symptoms and how to manage them effectively.

Understanding Your Symptoms
1. Overuse Injuries: The symptoms you describe are common in athletes and individuals who engage in high-impact sports. Overuse injuries occur when the knee joint is subjected to repetitive stress without adequate recovery time. This can lead to inflammation of the soft tissues around the knee, such as tendons and ligaments, resulting in pain and swelling.

2. Patellar Tendonitis: Given your activities, you might be experiencing patellar tendonitis, commonly known as "jumper's knee." This condition is characterized by pain and swelling around the kneecap, especially after activities that involve jumping or sudden changes in direction.

3. Bursitis: Inflammation of the bursae (small fluid-filled sacs that cushion the knee joint) can also cause pain and swelling. This is often exacerbated by repetitive movements or excessive strain on the knee.

4. Meniscus Injury: Although your X-ray results were normal, a meniscus tear can sometimes be missed on X-rays. This type of injury can lead to swelling and difficulty in fully extending the knee, especially after intense physical activity.

Recommendations for Management
1. Rest and Recovery: Since your symptoms improve with rest, it's crucial to allow your knee adequate time to recover after intense activities. Consider incorporating rest days into your routine, especially after high-impact sports.

2. Ice Therapy: Applying ice to the knee after exercise can help reduce swelling and alleviate pain. Aim for 15-20 minutes of icing, several times a day, especially after activities that provoke your symptoms.

3. Strengthening and Flexibility Exercises: Engaging in a regular program of strength training and flexibility exercises can help support the knee joint. Focus on strengthening the quadriceps, hamstrings, and calf muscles, as well as improving flexibility in the hip and ankle joints. This can help distribute forces more evenly across the knee during activities.

4. Cross-Training: To minimize the risk of overuse injuries, consider cross-training with low-impact activities such as swimming or cycling. These exercises can help maintain your fitness level while reducing stress on the knees.

5. Proper Footwear: Ensure that you are wearing appropriate footwear that provides adequate support and cushioning for your activities. Poor footwear can contribute to knee pain and increase the risk of injuries.

6. Consult a Specialist: If your symptoms persist or worsen, it may be beneficial to consult with a sports medicine physician or a physical therapist. They can provide a more thorough evaluation and tailor a rehabilitation program specific to your needs.

Conclusion
In summary, while it is possible to continue participating in your favorite sports, it is essential to listen to your body and take preventive measures to avoid exacerbating your knee pain. Incorporating rest, proper recovery techniques, and a balanced exercise regimen can help you manage your symptoms effectively. If you experience any significant changes in your symptoms or if the pain persists, seeking professional medical advice is crucial to rule out any underlying conditions. Remember, maintaining a proactive approach to your knee health will allow you to enjoy your activities while minimizing the risk of injury.

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