Login required to started new threads

Login required to post replies

Injury - Medial plica
Quote | Reply
Long story short. Had medial knee pain in my left knee in the beginning of October 2014. Took a couple of days off, but didn't work. Thought I'd just pedal through it, which meant that after a couple of weeks I had to stop during a session because my knee hurt way too much. The day after I experienced having knee pain when the knee had been bent for too long. Since then I've been to numerous PT's, tried the RICE principles, eased back into training, etc with no luck. As it is right now I don't have pain in my knee, but a really weird sensation. If I ride my bike for too long I get a very uncomfortable feeling in my knee - it feels like the plica is rubbing against my kneecap.

A couple of months ago I went to an orthopedic surgeon who told me it definately was a plica, although my MRI didn't show it. It did however show the presence of a bakers cyste - so something had to cause irritation in my knee. She wanted me to take some NSAIDs for 10 days to see if it would help. After 10 days, it hadn't really helped, so I got a cortisone injection. It's two weeks since I got the injection, and I've been told not to ride my bike, aside from getting to and from work, for 4 weeks. I can't really feel a difference in the knee - and if I could I would probably be hesitant to give the injection full credit. Afterall I've not been riding my bike for 4 weeks, so some decrease in inflammation should probably be felt.

I've been reading a lot about plicas. If I understand it correctly, an irritated plica can become fibrotic, which means that traditional means to reduce inflammation won't work. Anybody know if that is correct?

Also, is it possible for a plica to cause that much trouble without giving pain? Most litterature suggests that the plica is painful. Right now, my plica isn't painful at all, but I'm thinking that it has become so inflammed/fibrotic that it takes up too much room in my knee.

If the cortisone injection doesn't work, next step is either to give up riding my bike forever or getting surgery to have the plica removed.
Quote Reply
Re: Injury - Medial plica [Kermithimself] [ In reply to ]
Quote | Reply
You won't need to give up riding your bike, be patient. I have had two medial plicas removed with arthroscopy and one of them totally ruined the medial patella retinaculum/Patella femoral ligament and now I have severe knee problems. I may need this ligament reconstructed - but it can be done and I am seeing a specialist later this month in Toronto. My recommendation is to try PRP for this, it helped my other knee BIG TIME. What also helped was a bike fit where the fitter REALLY knew what he was doing. He was able to adjust my fit and off-load the joint so the plica in my better knee wasn't rubbing so much on the MFC etc. It saved my knee.
Quote Reply
Re: Injury - Medial plica [titemple652] [ In reply to ]
Quote | Reply
Nice to hear. What is PRP?
Quote Reply
Re: Injury - Medial plica [Kermithimself] [ In reply to ]
Quote | Reply
Platlet rich plasma injection.
Quote Reply
Re: Injury - Medial plica [Kermithimself] [ In reply to ]
Quote | Reply
Just wanted to get on this thread as I had been diagnosed by a couple surgeons with Plica issues. Pain would start about 4-5 minutes into running and felt like severe stabbing near the knee cap. Long story short negative x-ray, loads of PT, negative MRI, and no relief from Cortizone/local anesthetic. Arthroscopy specialist finally had to diagnose by surgery and found a couple flaps on my plica and trimmed some of the fat pad. Six weeks post surgery at this point and not getting any of the same pain doing a couch to 5K training plan as of a week and half ago.
Quote Reply
Re: Injury - Medial plica [indianatri] [ In reply to ]
Quote | Reply
I was diagnosed with medial plica about 10 years ago. My presentation was very similar to yours. I trained through it for a couple months to finish my first Ironman and it continued to get worse. Ultimately, the orthopedic surgeon convinced me he needed to operate on it to remove it. I was obsessively diligent with recovery, gradually returned to biking/running, and the pain came back, worse than before. I took years off triathlon.

I connected with a close friend who was orthopedic surgeon at Mass General Hospital, trained at Harvard, and was a Marshall Scholar at U Chicago. Brilliant brilliant surgeon. He said that plica removal is a complete BS surgery and that it's a "non diagnosis". He sent me some literature showing me that the odds are improvement are basically no better than chance, and you're better off taking time off the aggravating sport and really focusing whatever muscle imbalance led to the injury in the first place. In my case, it was a weak posterior chain (weak glutes and hammies). I saw a great sports med doc (a non surgeon) and great PT who hit me hard with exercises to do at home. I'm finally racing again after 8 years on my ass and have never felt stronger. No knee pain whatsoever. Running and riding faster than ever.

Find a new doctor. I'd suggest a sports med doc. As the saying goes, a dog digs; a surgeon cuts.
Last edited by: wintershade: Jun 26, 18 13:10
Quote Reply