About three months ago when playing in my weekly basketball league, my knee felt slightly swollen inside for about a week. In recent years my knees would sometimes be a little sore or stiff after basketball, but this swelling sensation was new. Like a dummy, I played again the next week, and while I felt fine during the game my knee felt much more swollen the next day. Nothing I could see visually, but bending the knee more than 90 degree was difficult (felt very tight inside my knee due to the extra fluid). Three days later I was even more stupid and did a 5 K Thanksgiving Day run with my wife and family. I did wrap the knee and took the run pretty easy. Plus, the run was on grass and dirt. So, putting all my stupidness aside, here’s the real issue. After about 3 weeks and still feeling quite a bit of swelling, even after icing the knee and no running or biking, I went and got an MRI. I thought maybe I’d torn the meniscus, but the orthopedic surgeon (sports specialist) said I had mild osteoarthritis. She showed me various pictures and I could see the lighter line of cartilage was thinner on the bottom of the bone versus the sides. There was also still fluid retention and a Baker’s cyst (the extra fluid). There were no bone on bone issues. She said if I stayed away from hard basketball and took it easier on the running it should be manageable. My frustration is that now it’s three months later I still can’t really jog much. Biking is fine (although I’ve been taking it easier), but if I do a short .5 or 1 mile jog (maybe 10-11 minutes per mile pace) the knee just doesn’t feel right. I suspect if I did this more than every 7-10 days, or if I went farther my knee would start swelling again. I have not played basketball since and was hoping I could still do the occasional triathlon. It’s frustrating because running never used to bug me. I’d typically run twice a week, usually about 3 miles, although sometimes 5 or 6 miles if I had an Olympic Distance triathlon coming up. Is it normal that after my first major issue with my knee swelling up that it does not get back to normal? Could there be some other issue besides osteoarthritis that the MRI missed? It seems like my left knee clicks more often than it used to. I’m debating getting a second opinion on the MRI. I also asked the doctor about possibly getting my knee scoped in a few months if it does not get better, in case maybe there’s some little bit of loose cartilage in there that wasn’t obvious on the MRI. She said that’s an option. What are your suggestions?
Background: 40 years old, 5’11", 165 lbs. Triathlons for about 5 years (sprint and Olympic distance), training about 7 hours a week. Fairly competitive recreational basketball most of my life, although for the last 5 years it’s only once a week during our two basketball league seasons (about 3 months each).
Not an expert for sure… I’ve had synvisc injections in both knees and it has helped with osteoarthritis pain in each knee… I came from a running background with many miles accumulated over 30 years of running… I have other aches and pains but knees are good for now… Synvisc or similar treatments are temporary in that they have to be redone after a period of time…
What were the treatment recommendations besides laying off of basketball and decreasing running? Your story is common, but besides activity modifications, there hasn’t been anything to address the issues at hand. Typical recommendations at this point may include physical therapy, corticosteroid injection, viscosupplementation (ex. Synvisc).
Thanks for the various thoughts everyone. I didn’t give all the details of my training prior to this issue, but basically I was working out 1 to 2 times per day and 7-10 hours per week. I tried to get in 3 workouts per week of swim, bike and run, but often the swim or run was twice a week depending on my schedule. I’ve been leary of running more than once a week the last month because I didn’t like the way my knee felt and was worried I’d be doing damage or that it would swell up again. I may try doing a bit more. I was just used to very comfortably being able to run 3 miles in about 24 minutes and now there’s a bit of pain/discomfort, and my stride is not quite right (I’m sure I’m compensating). The doctor did say we could do injections if we wanted. I should probably have asked more questions but was still dealing with her news about osteoarthritis, so my brain was churning on that when she discussed other options. What would those of you out there recommend when first dealing with early osteoarthritis? I’ve been doing some more leg strengthening (hamstrings and quads). I’ve lately tried to run a bit on grass or treadmills. I can try increasing the mileage a bit on the runs and see how it goes. Would you recommend trying this routine first before going for cortisone and/or other injections?
I had an MRI done on my left knee over the summer which showed a mild case of osteoarthritis. I actually think it’s in both of my knees. My right knee would swell a bit after I ran.
I started doing a lot of leg, glute and hip flexor strengthening exercises. Plus for the past 4 months I’ve been taking a joint supplement called Wobenzym, along with Glucosamine, Magnesium, Calcium and a Fish oil. Before this I never took any supplements as I never really believed they worked. I’m still not sure they do but since I started the strengthening and supplementation I’ve had zero knee issues.
I run (still slow) 4 times a week with no pain or swelling.
Same problem here. I now run with a custom knee brace by OSSUR. Works fine, but, still have pain. Still doing Ironman…I’m on my way to my 25th, 26th and 27th, this year and maybe another one, hopefully Hawaii…
Way to go ninetoe. Before the injury I’d been thinking strongly about going for an Ironman. My main concern was fitting in the training. Work, family (4 kids under 12), involvement with youth (Boy Scouts), all compete for my time. With this setback I may put the Ironman on hold a few years till things calm down and to see where the knee(s) goes. For the short term if the knee will take it I still want to do some Sprint and Olympic distance just to stay involved and because I love the sport, the atmosphere at races, staying in shape, etc. Short term I’ll be taking it easy as I’m getting a slap tear in my shoulder repaired (bugs me every time I swim for the last year). Used to never have injuries and the last few years my age (or triathlon???) has taken its toll. Abdominal muscle micro tear, neuroma in the foot (nerve irritation/swelling), etc. Sort of sucks, but I’m not giving up.
For the others who asked, I started taking Glucosamine (1500 mg) a month ago. Plus I’ve been doing fish oil for a year. I may try Chondroitin too.
It is good to know that any of us in our 40’s would have evidence of some mild osteoarthritis on x-ray or MRI. However, that doesn’t always equate to pain. It is quite possible that you have a small articular lesion (damage to the articular cartilage)…these are always appreciated on MRI. The advice is all good…glucosamine, synvisc, even cortisone injections to reduce the inflammation. Ultimately, you are going to need to get on a good strength program. It’s the pay to play concept: if you want to continue to play, you’ve got to pay your dues by doing your strength work. Our primary “shock absorbers” for our joints are the muscles around that joint (as well as those above and below). Until then, lay off the running for a while (until you can do it without a limp), continue some easy riding, and get someone to give you a good strength program. I’d suggest an evaluation by a good sports PT…but, then again, I’m somewhat biased that way. And no more hoops…too much cutting, twisting, pounding.