Inner Knee Pain: Meniscus Injury and Patellar Tendonitis

Medial knee stabbing pain and meniscus pain?

Dear Dr.
Chen,
I would like to consult you regarding an issue I previously inquired about five years ago concerning my knee injury sustained abroad.
Following your advice on applying heat and resting, my knee returned to normal after five months, and I am truly grateful for that.
Over the past five years, I have had no issues with my knee and have been able to walk, run, and jump like a normal person, which has allowed me to live my life with peace of mind.
However, at the beginning of last month, after working from home for two weeks, I experienced an inexplicable sharp pain on the inner side of my left knee when I returned to the office.
Initially, I did not pay much attention to it, but the sharp pain persisted.
After a week, I began to feel sharp pain around my patella and the inner side below it.
The pain occurs intermittently; it may flare up while walking or even while sitting and working.
Whenever the sharp pain occurs, stretching the muscles above the patella or changing my position provides some relief.
This situation continued for two weeks until I visited the hospital, where the doctor arranged for an MRI and X-ray examination.
The results indicated a mild meniscus tear and patellar tendonitis.
Following the doctor's instructions, I rested for two months and was allowed to walk short distances.
However, if I walk for a longer duration or for an extended period, the sharp pain returns.
1.
According to the doctor, patellar tendonitis and a mild meniscus tear do not require surgery.
However, given the recurring sharp pain, is it possible for me to heal and return to my previous lifestyle of walking long distances?

2.
After two months of rest, I now experience pain in the inner side of my knee, specifically where the meniscus is located, upon waking up in the morning.
This pain subsides after some time.
Additionally, when I get up and walk in the morning, I feel a pinching sensation near the patella.
Is this a normal phenomenon? Will it resolve on its own over time?
3.
Following the doctor's advice, I have been practicing leg raises while seated.
However, I may have overdone it, as I now experience intense pain in the inner side of my knee, near the patella, the meniscus, and the pes anserinus tendon after practicing.
Is this also a normal occurrence?
I apologize for interrupting your busy schedule.
Your advice five years ago was incredibly helpful to me.
Currently, I am abroad for recovery and plan to return to Taiwan next week.
After the quarantine period, I would like to schedule an appointment with you for an examination.
I would greatly appreciate your response before then.
Thank you very much.

Ya, 20~29 year old female. Ask Date: 2021/03/30

Dr. Chen Yongxue reply Orthopedics

Hello, the meniscus does not have nerves, so a tear does not cause pain.
Based on your description, it is possible that there is inflammation of the medial collateral ligament and the pes anserinus.
Symptoms are likely to occur when bending or straightening the knee.
Localized tenderness can be found.
If this is the case, please stop exercising and use a knee brace to protect the collateral ligaments during daily activities.
Additionally, heat therapy and oral pain relievers are effective.
If these measures do not provide relief, a local corticosteroid injection may also be considered.
Thank you.

Reply Date: 2021/03/30

More Info

Understanding inner knee pain, particularly in the context of meniscus injury and patellar tendonitis, is crucial for effective management and recovery. Based on your description, it appears that you are experiencing a resurgence of knee pain after a period of being symptom-free. This situation can be frustrating, especially after having successfully managed your knee issues in the past.

Meniscus Injury and Patellar Tendonitis
1. Meniscus Injury: The meniscus is a C-shaped cartilage in the knee that acts as a cushion between the femur (thigh bone) and tibia (shin bone). A meniscus tear can occur due to trauma or degeneration over time. Symptoms often include pain, swelling, and a feeling of instability in the knee. In your case, the MRI indicated a mild meniscus injury, which could explain the intermittent pain you are experiencing, especially during activities that put stress on the knee.

2. Patellar Tendonitis: This condition, often referred to as "jumper's knee," involves inflammation of the patellar tendon, which connects the kneecap (patella) to the shinbone (tibia). It is common in athletes and can result from repetitive stress or overuse. Symptoms typically include pain at the front of the knee, particularly below the kneecap, and may worsen with activity.

Treatment and Recovery
1. Non-Surgical Management: Given that your doctor has advised against surgery for your mild meniscus injury and patellar tendonitis, it is essential to follow a conservative treatment plan. This typically includes rest, ice, compression, and elevation (RICE), along with physical therapy to strengthen the muscles around the knee and improve flexibility.
2. Physical Therapy: Engaging in a structured physical therapy program can be beneficial. Focus on exercises that strengthen the quadriceps, hamstrings, and calf muscles, as these provide stability to the knee joint. However, it’s crucial to avoid overexertion, as you mentioned experiencing increased pain after certain exercises. Gradually increase the intensity and duration of your exercises, and communicate with your physical therapist about any pain you experience.

3. Pain Management: Over-the-counter pain relievers, such as NSAIDs (e.g., ibuprofen), can help manage pain and inflammation. However, consult your physician before starting any medication, especially if you have other health conditions or are taking other medications.

4. Activity Modification: While it’s important to stay active, modifying your activities to avoid those that exacerbate your pain is crucial. Low-impact exercises, such as swimming or cycling, can help maintain fitness without putting excessive strain on your knee.

Addressing Your Concerns
1. Recurrent Pain: The intermittent sharp pain you are experiencing may be due to the underlying meniscus injury and patellar tendonitis. It is not uncommon for these conditions to cause flare-ups, especially after periods of inactivity or increased activity. With proper management, many individuals can return to their previous activity levels, but this often requires patience and adherence to a rehabilitation program.

2. Morning Stiffness: The stiffness and pain you feel in the morning, which subsides after some movement, is a common symptom of joint issues. This phenomenon, known as "morning stiffness," can occur in various knee conditions and is typically a result of fluid accumulation or inflammation. As you continue to move throughout the day, the joint may become less stiff and painful.

3. Exercise Pain: Experiencing pain after specific exercises, especially if they target the knee area, can indicate that you may be overdoing it or that certain movements are aggravating your condition. It’s essential to listen to your body and adjust your exercise routine accordingly. If certain movements consistently cause pain, consider discussing alternative exercises with your physical therapist.

Conclusion
In summary, while your current symptoms may be concerning, they are not uncommon for someone with a history of knee issues. With appropriate management, including rest, physical therapy, and activity modification, there is a good chance you can recover and return to your previous activity levels. It’s advisable to follow up with your healthcare provider for ongoing assessment and to ensure your rehabilitation plan is tailored to your specific needs. Your proactive approach to seeking advice and treatment will be beneficial in your recovery journey.

Similar Q&A

Understanding Lateral Knee Pain: Tendon Strain or Orthopedic Issue?

Pain on the outer and inner front side of the knee with a sensation of swelling when squatting. Could this be a sports-related tendon strain or an orthopedic issue that requires a visit to a rehabilitation specialist? Thank you.

Dr. Hong Ximing reply Orthopedics
Pain on the outer and inner sides of the knee in overweight individuals is most commonly associated with patellofemoral pain syndrome, which includes conditions such as chondromalacia patellae. These issues are related to body weight and center of gravity, and it is advisable to ...

How Long Does It Take to Recover from Ligament or Meniscus Injuries?

Two months ago, I injured my knee while playing basketball. An X-ray showed that the knee bones are fine, but now when I squat and bend my knee, I experience pain in the inner side of the knee. Some say it might be a collateral ligament strain, while others suggest a meniscus dis...

Dr. Hong Ximing reply Orthopedics
Injuries to the collateral ligaments and meniscus require magnetic resonance imaging (MRI) for diagnosis. Please visit a hospital equipped with MRI facilities for evaluation.

Understanding Meniscus Tears and MRI Protocols for Knee Injuries

Hello, I injured my knee while running last May, and despite undergoing rehabilitation treatments, including electrical therapy and strength training, the results were not satisfactory. It wasn't until I changed hospitals in March of this year that I was diagnosed with patel...

Dr. Yin Xinbei reply Rehabilitation
I am not sure if you have been running for a long time or have suffered an injury that has led to multiple knee issues. It is possible that problems with your knee are causing biomechanical changes while walking, which may also affect the area around your hip. This situation can ...

Understanding Patellar Chondromalacia and Ligament Tears: Treatment Options

Hello Doctor: I am a Taekwondo practitioner and have been experiencing softening of the patella on the inner side of my right knee, as well as a tear in the medial collateral ligament (MCL). I have undergone MRI and X-ray examinations, but the medial meniscus did not show any abn...

Dr. Shi Qiming reply Orthopedics
Hello: Based on your description, it seems that your main issue arises from practicing Taekwondo, with problems in the anterior knee joint caused by overuse and accidental injury. Here are my recommendations: 1. Temporarily suspend Taekwondo and other high-impact activities such ...