Yikes! Swollen knee

[erinmeri]

So… Should I see an ortho or sports medicine doc or PMC doc???

A few months ago, I had a bad fall over a crack in the sidewalk and really messed up my knee. It blew up like a cantaloupe, but resolved within about two weeks. About a month later I started lifting weights, and a few weeks after that I started riding again after a long hiatus. In that time, my knee really hurt, but I didn’t notice any swelling. It got better for maybe a week or two.

A week ago after a jumping lesson, I noticed a bit of swelling on the anterior lateral bit of my knee (essentially the outside, just next to or below the knee cap). It felt tight, but didn’t hurt.

On Friday, I worked out with a trainer at the gym, following a rider-centric program and aiming to work on the muscles around my knee (quad, hams, adductor, abductor, etc)… and then ran on the treadmill. By the time I got out of the shower afterwards, my knee was huge.

My knee is still very swollen and doesn’t respond to icing. It is swelling on the outside (lateral) anterior - both proximal and distal. It doesn’t hurt… just feels tight and like it might give out.

Sorry for the novel. My question is: what kind of doc do I see? This is freaking me out…

Thanks in advance!

[ReSomething]

I always have to see the family dr first and then get a referral. (Insurance req.) then I think you’ll be off to an orthopedist, or perhaps a knee specialist. Good luck.

[erinmeri]

@ReSomething

I always have to see the family dr first and then get a referral. (Insurance req.) then I think you’ll be off to an orthopedist, or perhaps a knee specialist. Good luck.

Thank you! I have weird insurance, so was hoping to bypass the PMC doc because they let me do that. Will see if I can get into the primary care doc tomorrow, but will anticipate that they will refer me elsewhere. Thank you!!

[4LeafCloverFarm]

As a multiple knee surgery recipient, there are several things that might have been caused by your initial fall. The first thing that came to mind is a floater - a small piece of bone or cartilage that is floating around and under certain circumstances, can irritate the knee, cause swelling, pain, discomfort, heat or all of the above. But the only way to know is to have the knee imaged. That could mean going to you PCP or getting a referral to an Ortho or both (depending on your insurance).

Or it may be nothing at all - its just still healing from your fall and it got irritated from over exertion.

The swelling can be managed by elevating the knee at or above your heart, icing with a gel pac or frozen bag of peas or whatever, and avoiding the activity immediately prior to the big swelling event (until you get an evaluation/ diagnosis anyway). I’d ride without stirrups, so you aren’t putting any undo stress on the joint until they figure out what it is. Avoid twisting or pivoting on that leg (like tennis, for instance, would be a bad idea right now).

Consider getting a donut stabilizing knee brace. This keeps your kneecap tracking properly and helps stabilize the knee. I like McDavid braces myself (found at certain sporting goods stores). Any good drug store should have a good variety too. Even a wrap with an elastic bandage will help stabilize the knee. Just make sure its not too loose - it should feel snug, but not not hurt.

Good luck to you. Hopefully its a minor issue that some specific PT can solve.

[erinmeri]

@4LeafCloverFarm

As a multiple knee surgery recipient, there are several things that might have been caused by your initial fall. The first thing that came to mind is a floater - a small piece of bone or cartilage that is floating around and under certain circumstances, can irritate the knee, cause swelling, pain, discomfort, heat or all of the above. But the only way to know is to have the knee imaged. That could mean going to you PCP or getting a referral to an Ortho or both (depending on your insurance).

Or it may be nothing at all - its just still healing from your fall and it got irritated from over exertion.

The swelling can be managed by elevating the knee at or above your heart, icing with a gel pac or frozen bag of peas or whatever, and avoiding the activity immediately prior to the big swelling event (until you get an evaluation/ diagnosis anyway). I’d ride without stirrups, so you aren’t putting any undo stress on the joint until they figure out what it is. Avoid twisting or pivoting on that leg (like tennis, for instance, would be a bad idea right now).

Consider getting a donut stabilizing knee brace. This keeps your kneecap tracking properly and helps stabilize the knee. I like McDavid braces myself (found at certain sporting goods stores). Any good drug store should have a good variety too. Even a wrap with an elastic bandage will help stabilize the knee. Just make sure its not too loose - it should feel snug, but not not hurt.

Good luck to you. Hopefully its a minor issue that some specific PT can solve.

Thank you! There was pain until two weeks ago. Now it just feels tight and weak - especially when, as you mention, pivoting. I was so excited to get back in the tack and now am really worried about the knee. I had a dreamy ride yesterday and have a lesson tomorrow… but it sounds like I need to get this taken care of. I will definitely look into those braces and wraps, but am also hoping I can find a doc who doesn’t want to sideline me. Thank you!!!

[erinmeri]

@4LeafCloverFarm

I’d ride without stirrups, so you aren’t putting any undo stress on the joint until they figure out what it is. Avoid twisting or pivoting on that leg (like tennis, for instance, would be a bad idea right now).

Am only just getting back into this so doubt I can… but will try! We are talking one month of riding after 17 years off. My leg and seat are very weak!

[4LeafCloverFarm]

When my knee acted up badly or was hot and swollen, I just rode without stirrups. Sometimes it was so swollen I couldn’t get the left leg of my chaps zipped all the way. But if you’re a knee pincher when you ride, even riding may not be a good idea.

The tightness you feel is swelling inside the joint. There are pockets of fluid that cushion your joints and when those get swollen up, they put pressure on the joint, causing stiffness, sometimes pain, and a full or tight feeling in the joint area. That is where the term “water on the knee” comes from. You can also help reduce swelling by not eating an excessive amount of salt and make sure you drink plenty of water.

[4LeafCloverFarm]

@erinmeri

Am only just getting back into this so doubt I can… but will try! We are talking one month of riding after 17 years off. My leg and seat are very weak!

Well, you can always have a lunge line lesson (unless it is a group lesson of course). Just some walk/trot on a lunge line without stirrups might be fun. You can work on some exercises to strengthen your legs and seat, walk/trot transition, trot/halt, halt to trot, etc.

I’ve been dealing with bad knees since I was 13 years old. I’m now in my 50s. And other than immediately post-surgery, it has never effected my ability to ride or slowed me down. But I’ve got 40+ years experience with my lousy knees! I know my limits and what pitfalls to avoid and how to care for them.

But you know you. Do what you feel comfortable with.

[erinmeri]

Thanks! I have actually been wanting to ask for some lunge line lessons… I just know they will be hard so have been avoiding!

I know I don’t miss riding without stirrups, but I also hate the gym! My philosophy is you go big or you go home. Do the things you don’t like. So, sounds good to me! Will see what trainer thinks tomorrow, thank you. I have been dropping my stirrups at the walk during breaks, just to stretch my legs. Definitely not the same, but at least reminding me to relax. But clearly my knees are angry still. Stirrup-free September?

[Wicky]

Sports medicine doc or orthopedist who does at least 50% knees. You do not want an orthopedic upper extremity specialist.

[erinmeri]

@Wicky

Sports medicine doc or orthopedist who does at least 50% knees. You do not want an orthopedic upper extremity specialist.

Thank you! I would never have thought of this. I booked the earliest available appointment with an orthopedic surgeon specializing in sports medicine and focused on knees and ankles.

Thanks again, all! Fingers crossed it isn’t anything major.

[Where_sMyWhite]

@erinmeri

Thank you! I have weird insurance, so was hoping to bypass the PMC doc because they let me do that. Will see if I can get into the primary care doc tomorrow, but will anticipate that they will refer me elsewhere. Thank you!!

This is why sometimes it is good to see your PCP first. Maybe not for treatment per se but they may know just the right specialist that would fit your needs

[erinmeri]

Quick update, and I will definitely be reading related threads… but I just got the results of my MRI and it appears I have a torn meniscus.

Doc says I can keep riding and working out as long as it doesn’t hurt. Riding has been fine thus far, as is most exercise. Certain things are less comfortable, so I will be paying more attention to that.

I have a script for PT, so I am signing up for that too. We will recheck in a month to see if it has healed, but I just read an article that said a recent study has shown PT has great outcomes. Hoping to avoid surgery at all costs.

Any advice would be greatly appreciated! Will be searching the forums rabidly as well…

Thanks again for all of the advice to date!

[dog_amp_horsemom]

I had a torn cartilage after falling off of a horse somewhere around 1983ish. I’m opposed to surgery and even though the ortho doctor said I would not walk unless I have surgery, I stayed on crutches for about two or three weeks and used a lot of bigeloil - it has been fine ever since with maybe one bout with some pain on the inside of the knee. I use a brace when it acts up, an advil to get rid of inflammation, and I think orthotics in shoes are helpful because as we get older our arches change and put stress on the knee.

[erinmeri]

@dog&horsemom

I had a torn cartilage after falling off of a horse somewhere around 1983ish. I’m opposed to surgery and even though the ortho doctor said I would not walk unless I have surgery, I stayed on crutches for about two or three weeks and used a lot of bigeloil - it has been fine ever since with maybe one bout with some pain on the inside of the knee. I use a brace when it acts up, an advil to get rid of inflammation, and I think orthotics in shoes are helpful because as we get older our arches change and put stress on the knee.

Thank you!

I did start using orthotics a few months ago and they seem to have helped all around, with my knees but also especially with my arthritic ankles!

I am hoping because I spent a long time out of shape (have been lifting weights for 2 months and riding for about 1.5 months after a very long hiatus), that if I get the muscles around the knee strong I can avoid surgery, too.

Aside from not loving the idea of being put under, I don’t want to be out of the saddle - or the gym - for any duration if I can avoid it! So it’s encouraging to hear your experience!