Knee Pain and Weakness: A Guide to Recovery and Exercise

What is wrong with my foot?

Hello Dr.
Zhou, about six months after I turned 20, I experienced two inexplicable incidents that resulted in severe impacts to my left knee.
One incident was a fall from my bike, and the other was a fall from a chair.
At that time, I had X-rays taken, and the bones were fine.
I also underwent an arthroscopy at a veterans' hospital, where the doctor said everything was normal, but there was swelling in the bursa (I believe that's what it's called).
Because the swelling in my knee did not improve after a year, I visited the rehabilitation department at En Chu Kong Hospital.
The physician noted some atrophy in my left leg, fluid accumulation in the knee, and damage to the medial ligament.
They performed ultrasound and MRI on the joint and said everything was fine.
The doctor advised me to exercise more, but every time I brisk walk or jog, my knee feels uncomfortable.
However, if I don't exercise, I feel my overall health deteriorating.
I'm unsure how to exercise properly.
Despite numerous tests showing no issues, I wonder why my knee is inflamed, painful, weak, unstable, and uncomfortable.
Recently, in the past six months, my knee has started making sounds when going up and down hills, and I hear it when walking or squatting and standing up, averaging at least five times a day.
Additionally, when I make significant movements with my hips (like squatting and standing), my left hip also makes a slight noise, and I feel a bit of numbness.
After sitting for a long time, I also experience some numbness.
The rehabilitation doctor mentioned that I have a herniated disc compressing the sciatic nerve, which could explain the numbness in my hip.
However, after the MRI, they said my lumbar disc is fine.
Yet, I still experience numbness in my left hip after sitting for a while.
Usually, when I feel numb, I also have a tight sensation in the left hip muscles.
This is more likely to occur in cold weather.
It seems that whenever I exert my left hip for an extended period, certain "muscle pathways" in my left hip become tight, leading to a very uncomfortable numbness.
I would like to know what might be happening with my left lower limb (knee and left hip) and how I can maintain my health and exercise properly.

LU, 20~29 year old female. Ask Date: 2003/01/29

Dr. Zhou Hongzhi reply Orthopedics

In general, injured joints may have some damage that is not immediately apparent, but changes may occur later.
Therefore, it is recommended that you come back to the hospital for further examination.

Reply Date: 2003/01/29

More Info

Hello! It sounds like you've been through quite a lot with your knee and hip issues. Let's break down your situation and discuss some strategies for recovery and exercise.

From your description, it seems that you have experienced multiple traumatic events to your left knee, which have led to ongoing pain, swelling, and weakness. The fact that you have had imaging studies (X-rays, ultrasound, and MRI) that show no significant structural damage is a good sign, but it can be frustrating when you still experience symptoms.
The swelling in your knee, often referred to as "effusion," can be caused by various factors, including inflammation of the synovial membrane (the lining of the joint), irritation of the ligaments, or even issues with the cartilage. The presence of fluid can lead to a feeling of instability and discomfort, especially during activities like walking or running.
The sounds you hear in your knee (crepitus) and hip can be due to several reasons, including the movement of tendons over bony structures, the presence of air bubbles in the joint fluid, or even minor irregularities in the cartilage. While these sounds can be concerning, they are not always indicative of a serious problem, especially if they are not accompanied by pain.

Your symptoms of weakness and instability in the knee, along with the tightness and tingling in your hip, suggest that there may be some muscular imbalances or weaknesses that need to be addressed. The fact that your rehabilitation doctor mentioned potential issues with your lumbar spine and sciatica indicates that there may be a connection between your lower back and hip symptoms.
Here are some recommendations for managing your knee and hip issues:
1. Physical Therapy: Since you've already seen a rehabilitation doctor, continuing with physical therapy is crucial. A physical therapist can provide you with a tailored exercise program that focuses on strengthening the muscles around your knee and hip, improving flexibility, and enhancing stability.
2. Strengthening Exercises: Focus on exercises that strengthen the quadriceps, hamstrings, glutes, and hip stabilizers. Exercises such as straight leg raises, bridges, and clamshells can be beneficial. It's essential to perform these exercises with proper form to avoid further injury.

3. Low-Impact Cardio: Since running seems to aggravate your symptoms, consider low-impact cardiovascular exercises such as swimming, cycling, or using an elliptical machine. These activities can help maintain your fitness without putting excessive strain on your knee.

4. Flexibility and Mobility Work: Incorporate stretching and mobility exercises into your routine. This can help alleviate tightness in the hip and improve overall joint function. Focus on the hip flexors, hamstrings, quadriceps, and calves.

5. Listen to Your Body: Pay attention to how your body responds to different activities. If certain movements cause pain or discomfort, modify or avoid them. It's essential to find a balance between staying active and not exacerbating your symptoms.

6. Weight Management: If applicable, maintaining a healthy weight can reduce the stress on your knee joints and improve your overall function.

7. Pain Management: If you experience pain, consider using ice after activities to reduce inflammation. Over-the-counter anti-inflammatory medications may also help, but consult with your healthcare provider before starting any new medication.

8. Posture and Ergonomics: Be mindful of your posture, especially when sitting for extended periods. Use supportive seating and take breaks to move around to prevent stiffness and discomfort.

9. Consultation with Specialists: If your symptoms persist or worsen, consider seeking a second opinion from an orthopedic specialist or a sports medicine physician. They may provide additional insights or treatment options.

In summary, while your imaging studies may not show significant damage, the symptoms you're experiencing are real and warrant attention. A comprehensive approach that includes physical therapy, strengthening exercises, and mindful activity modifications can help you manage your knee and hip issues effectively. Remember to be patient with yourself as recovery can take time, and it's essential to prioritize your overall well-being.

Similar Q&A

Understanding Knee Pain: Insights for Athletes and Active Individuals

I have practiced judo and track and field at school, and I often engage in intense activities that involve my knees hitting the ground. I have been experiencing a recurring issue: when I squat down and then stand up, I often feel a sharp pain in the area around my knee joint (it&...

Dr. Wang Zhaomin reply Rehabilitation
Knee pain can have many causes, as surrounding bones, muscles, tendons, and ligaments may be injured due to intense exercise or external impact. A proper assessment can only be made through an in-person examination. Online consultations cannot replace an actual visit. Please cons...

Overcoming Knee Injuries: A Basketball Player's Journey to Recovery

Hello, Doctor. I am a basketball player living in Taichung. My height is 178 cm and my weight is 78 kg. I have had surgery on both knees: my left knee underwent anterior cruciate ligament reconstruction a year ago, and my right knee had a patellar fracture and meniscus tear six y...

Dr. Shi Qiming reply Orthopedics
Hello: It is recommended that you continue with rehabilitation and avoid any vigorous activities for the time being to prevent re-injury. Some benefits of rehabilitation may not be immediately apparent and require a prolonged treatment period. If you have any questions, please vi...

Understanding Knee Pain and Weakness: Seeking Effective Solutions

I experience pain in my knee when going up and down stairs or squatting. Sometimes, it feels weak. I have consulted many doctors and had X-rays done, which showed no issues with the bones. However, my left knee is more prominent. I have seen three doctors, and each diagnosed me w...

Dr. Chen Yongxue reply Orthopedics
Hello, when experiencing pain during bending or exertion, it is important to first conduct some examinations (physical examination, special angle X-rays, and even MRI) to identify the root cause of the problem.

Knee Injury: Understanding Related Calf and Foot Discomfort

Hello, Doctor. A week ago, I visited a rehabilitation specialist due to an old knee injury that has persisted for four to five years. This injury occurred after I fell while playing basketball, landing on my knee. Since then, I have experienced weakness and mild soreness in my kn...

Dr. Shi Guozheng reply Orthopedics
An MRI must be performed based on a physician's assessment of necessity.