Anyone out there experienced Plica Syndrome? I’ve joined the club and am interested in your experience or advice.
My story: dealing with a chronic stabbing knee pain that strikes without warning while running. Running uphill helps, running downhill is a sure way to set it off. A year of PT, taping, and running exclusively on a TM at 1% grade hasn’t solved the issue. Recently saw a credible ortho who diagnosed the condition and injected cortisone into the affected area using ultrasound imaging. That confirmed the diagnosis through 4 weeks of pain free running. That experiment concluded yesterday with the old familiar stabbing pain as I began my run.
The only long term solution appears to be surgery, which is a non starter for me as I don’t want to risk my ability to swim and bike. So, that leaves me with the choice of hanging up the running shoes or continuing to limit my running to a few easy kms on the treadmill at grade.
What did your ortho say about your ability to do multi-sport after surgery? 15+ yrs ago my knee kept swelling like a grapefruit (I was only riding at the time, and not a lot do to work and family). The Dr drained the knee and used cortisone a few times, it helped for a week then it would swell back up. Nothing on x-rays or MRI. The only solution was to ‘go in and look’ as the MRI doesn’t always show the problem. Had the surgery and the doc said he removed the plica and cleaned up the joint, there was nothing else wrong. Did some PT and I couldn’t tell you which knee it was without looking in my records. The scars from the 3 little incisions aren’t even visible, and both knees feel the same.
My first thought is to try visiting other professionals if it’s within your means. PTs differ in their clinical experience with different joints and injuries. For that reason, I think it’s worth getting different opinions - not necessarily for the diagnosis but for the treatment strategies. I have had much better experiences with PTs that mostly treat athletes and focus on stretching/strengthening rather than flashy modalities. Also, most if not all orthos will suggest surgery for most injuries as it’s implied that a patient has tried everything else first.
So if it was me, I would reluctantly give running a break and continue to focus on the PT. A year-old chronic injury that isn’t getting better deserves some quality rest as hard as that may be.
(Also, repeated corticosteroid injections can have long-term consequences to joint health. One or two times, especially for dx is no biggie but otherwise something to keep in mind as it’s often a glossed-over part of the informed decision making.)
He said it’s a very simple procedure. Regardless, the risk of a complication, no matter how small, just isn’t worth it when I consider the possibility of a problem crossing over into my swim or bike. I may be able to live without running, but would be miserable without those activities.
My answer would have been different in the past. I’ll age up to 50 next season, so the clock is ticking on my racing days. I’d love to have another 5 years of competitiveness, but not at the price of staying active long into the future.
Interesting tidbit given you mention the degenerative effects of the corticosteroid injection. Doc’s position was that is actually a potential benefit in this case.
Apparently, the Plica is an element of fetal development that is often completely absorbed. Any remnants are generally minuscule, and he’s had experience (or aware of situations) where a bit of degeneration solved the problem by eliminating the problematic tissue. A bit of a long shot, but that certainly addressed my general predisposition against the procedure.
No doubt there is benefit to the injection and I’m not implying any wrong-doing. I just mention it because some people get star-struck by the effectiveness of corticosteroid injections and forget to weigh the risks and benefits as they start to think about that *fourth, fifth, etc. *procedure. Anyway, I’m not a doctor.
If it’s any consolation, I’m hopeful that triathlon continues to gain popularity and more big swim-bike events pop up in the future.
I had knee pain for 5-6 years. My doctor thought it was from a torn meniscus confirmed by MRI. I put off the surgery and missed the 2017/2018 tri season unable to put together any quality biking. I changed doctors and in desperation went in for the surgery August 2019. Post-surgery the doctor said that the meniscus wasn’t the source of the pain, but it was Plica Syndrome. He cleaned up the tissue (or whatever he did to fix it) and I finished IM FL last weekend pain free, so it worked out well for me.
Anyone out there experienced Plica Syndrome? I’ve joined the club and am interested in your experience or advice.
My story: dealing with a chronic stabbing knee pain that strikes without warning while running. Running uphill helps, running downhill is a sure way to set it off. A year of PT, taping, and running exclusively on a TM at 1% grade hasn’t solved the issue. Recently saw a credible ortho who diagnosed the condition and injected cortisone into the affected area using ultrasound imaging. That confirmed the diagnosis through 4 weeks of pain free running. That experiment concluded yesterday with the old familiar stabbing pain as I began my run.
The only long term solution appears to be surgery, which is a non starter for me as I don’t want to risk my ability to swim and bike. So, that leaves me with the choice of hanging up the running shoes or continuing to limit my running to a few easy kms on the treadmill at grade.
What would you do?
Why is swimming and biking getting risked? Not following that part.
I had a PCL surgery and while he was in there he removed the plica at the same time. I was swimming in like 6 weeks. Biking in maybe 4 and running in 6.
Yeah you have to recovery from the surgery but this should be a really quick recovery. My assumption is they just scope it and cut it out.
Anyone out there experienced Plica Syndrome? I’ve joined the club and am interested in your experience or advice.
My story: dealing with a chronic stabbing knee pain that strikes without warning while running. Running uphill helps, running downhill is a sure way to set it off. A year of PT, taping, and running exclusively on a TM at 1% grade hasn’t solved the issue. Recently saw a credible ortho who diagnosed the condition and injected cortisone into the affected area using ultrasound imaging. That confirmed the diagnosis through 4 weeks of pain free running. That experiment concluded yesterday with the old familiar stabbing pain as I began my run.
The only long term solution appears to be surgery, which is a non starter for me as I don’t want to risk my ability to swim and bike. So, that leaves me with the choice of hanging up the running shoes or continuing to limit my running to a few easy kms on the treadmill at grade.
What would you do?
The surgery will free you!!! (typically not a go-to statement, but for this it is!!)
Drop me a PM and I’d be happy to give you a call! I have been so lucky to have both my knees cleaned of plica syndrome and have had no adverse affects, and, honestly, quite the opposite since the plica syndrome was literally preventing me from doing anything! My first round is very similar to you with trying everything and finally get a confirmation with the cortisone shot!
I think you need to recalibrate your assessment of risk/benefit. You would essentially give up running and by extension multisport, because you fear an arthroscopic excision of a plica would destroy your knee? I just want to make sure I’m understanding your thought process.
Well, I’d say you’ve captured my position. But I have to say I’m surprised at the direction of this thread. I clearly need to put more thought into it. My fears are based on emotion rather than logic, and it seems I need to explore the true risks of the procedure before making a decision.
Now, all need is one horror story of a procedure gone wrong and the emotions will take over. Anyone out there with a bad surgery experience to share?
Anyone out there experienced Plica Syndrome? I’ve joined the club and am interested in your experience or advice.
My story: dealing with a chronic stabbing knee pain that strikes without warning while running. Running uphill helps, running downhill is a sure way to set it off. A year of PT, taping, and running exclusively on a TM at 1% grade hasn’t solved the issue. Recently saw a credible ortho who diagnosed the condition and injected cortisone into the affected area using ultrasound imaging. That confirmed the diagnosis through 4 weeks of pain free running. That experiment concluded yesterday with the old familiar stabbing pain as I began my run.
The only long term solution appears to be surgery, which is a non starter for me as I don’t want to risk my ability to swim and bike. So, that leaves me with the choice of hanging up the running shoes or continuing to limit my running to a few easy kms on the treadmill at grade.
What would you do?
Hang on, hang on…theyre assuming because you had no pain for 4 weeks after injection that that was the cause? No shit you didnt have pain, you had a cortisone injection. And the ultrasound-guided injections are not something magical.
How did they diagnose the plica? Any imaging?
Where in the knee is your pain? Any other associated symptoms?
Running downhill is also a specific reproduction of pain in any patellar tendon issue. Occam’s razor.
You need a more in-depth approach here. Please shoot me a pm if youd like, Im happy to help.
Thanks for chiming in. Diagnostics included a physical exam, radiology to rule out other causes, ultrasound and the cortisone.
Fwiw, the doc is credible and someone I have history with. I also have a fantastic physio working out my kinks and imbalances. I’m sure both would welcome any theories and alternatives.
The pain is sharp, sudden and precisely in the same spot just below and inside my left kneecap. Like something gets stuck or pinched and released. Bam! Then nothing.
Sometimes it hits me 5 minutes into a run, sometimes it doesn’t happen and sometimes it hits later. The “when†is consistently inconsistent, while the “what†is exactly the same every time. I usually shut down the run whenever it happens to preserve my next run. And I’m talking 15km per week of zone 1 “running†on the TM. It’s a joke.
No other symptoms, although I do have a history of problems with that leg. Bad case of plantar fascia on that side shut me down for all of 2018, while this issue has impaired every attempt to rebuild my run since. Just writing that makes me realize just how long I’ve been struggling and puts into perspective why I’m on the brink of giving up.
Thanks for chiming in. Diagnostics included a physical exam, radiology to rule out other causes, ultrasound and the cortisone.
Fwiw, the doc is credible and someone I have history with. I also have a fantastic physio working out my kinks and imbalances. I’m sure both would welcome any theories and alternatives.
The pain is sharp, sudden and precisely in the same spot just below and inside my left kneecap. Like something gets stuck or pinched and released. Bam! Then nothing.
Sometimes it hits me 5 minutes into a run, sometimes it doesn’t happen and sometimes it hits later. The “when†is consistently inconsistent, while the “what†is exactly the same every time. I usually shut down the run whenever it happens to preserve my next run. And I’m talking 15km per week of zone 1 “running†on the TM. It’s a joke.
No other symptoms, although I do have a history of problems with that leg. Bad case of plantar fascia on that side shut me down for all of 2018, while this issue has impaired every attempt to rebuild my run since. Just writing that makes me realize just how long I’ve been struggling and puts into perspective why I’m on the brink of giving up.
Oh man I’m sorry to hear about the rough go of it the past few years. The fact that you’ve had some plantar surface issues previous to this is noteworthy. I usually attribute most atraumatic knee issues to foot/ankle or hip issues if its not a strength issue. I’m glad to hear you’ve got some good healthcare pros on your side. I know a number of excellent professionals but would always refer my runners to someone who “gets it.”
I’ll come off my soapbox a bit, I re-read my initial reply and it was preachy, my apologies. The “stuck” and medial part does lend itself to something more akin to a plica issue but it is by no means the only plausible explanation. Differential diagnosis of medial knee pain does offer other options. But I do not think you need to consider end of the road. The shit I’ve seen runners come back from.
Where are you located? I’m happy to help find a specialist in my network. Shoot me a PM, lets get you sorted out.
Had your exact issue and went through 18+ months of trying to solve via various routes (PT, steroid injections, etc). Bit the bullet and had surgery (Dec 2005), was a TOTAL game changer. IIRC it was about 6-8 weeks before I was back to full training (lighter stuff while recovering). Raced my first IM almost a year to the day from the surgery.
Yeah I’m confused. This really isn’t a big deal in the scheme of surgeries assuming that’s the correct diagnosis.
I know I’m an outlier and I recovery very quick from surgery. But this is significantly more minor than what I had done to my knee in addition to the plica removal, and I’m not seeing how it would ever be an option to not do that surgery.
“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 problemsâ€
This thread has me rethinking the risk/reward, but anecdotal stories like this illustrate the worst case scenario of what could go wrong.