Rare "Diagnosis" - Knee Pain &

Bones, joints and muscles
1

I'm a long-time tennis player / coach who has had an occasional bout of left knee stiffness  a few times a year during cold weather (post 1984 skiing knee twist). After taking up cycling on a serious level (2010), there have been ZERO issues...That is, until I spent a week on my hands and knees painting the outer/roof portion of my pergola. I also started playing a new, knee-intensive sport, pickleball over the summer...No problems with that, however.

SYMPTOMS BEGAN AFTER CRAWLING ON HANDS AND KNEES 2-4 hrs/day over the course of about 5-7 days.

I experience varying levels of pain intensity from level 1 (waking in the morning) to level 9/10 "tooth-achy" (debilitated/difficulty walking) after light on-court activity for 1-2 hrs.

 have been in PT for one month with minimal improvement. My 2015 X-ray of the left knee reveals an "excellent looking joint" (according to my ortho).

I was poking around the pain site (1/2 mid to lateral section of left knee) and discovered a node-like structure- later determined by the PT to be the peroneal/fibular nerve - I made my diagnosis, "peroneal nerve entrapment..." 

Here's the weird part: Whereas PNE typically has sensory & motor abnormalities (tingling, numbness, burning, drop-foot, etc), I experience NONE of these, ONLY PAIN AND STIFFNESS!!! I have normal range of motion.. No electric shock, no tingling, no burning, no numbness. Is this Voodoo LOL?

Weight bearing activities cause the most debilitation.

Also getting up from sitting position and upon extension. Cycling causes minimal problems.In fact, I can cycle all day. But, I stand on the tennis court for an hour and I'm DONE!

I have an appointment with my orthopedist in two weeks, who will probably order an MRI, but, like many of us here, inquiring minds want to know ASAP!

Thanks in advance for your time and attention!

 

2

Your "inquiring mind" ain't gonna "get no satisfaction" (Rolling Stones, 1965) until your ortho exam.  The cool thing about the exam is that with all the twisting, turning, pushing and pulling, a good sports ortho can definitely rule out certain problems and either give you an immediate diagnosis or require more imaging to focus in on something he/she suspects could be the problem.  No telling which way this can go.

Before my TKR in '16 at age 68, I had four knee scopes in my 50's for four separate problems...two each knee.  In ALL cases, the x-rays and MRIs were ALL inconclusive, hence the scopes.  One meniscus on each side, one femoral condyle cartilage on each side.  This was after decades of playing hockey.  Had my hip replaced in '09 and my playing days were terminated at 45 years total.  Damn...  I could be in an over 70 league right now...ain't gonna happen.

Save the inquisitiveness for another time.  Only your ortho can tell you what's wrong. 

3

Thanks for your reply. I recently relocated and I saw a new ortho in March. He did a physical exam and told me that everything was fine. He asked if I had been doing anything differently, etc. I told him I stopped taking Glucosamine for about 6 mos. He replied, "Sometimes you don't know if something's working until you stop taking it..." He ordered my PT and said to continue the glucosamine supplementation. I'm going to travel and see my old ortho who is also an avid tennis player.. I'm hoping he hasn't retired yet...

4

I'm hoping they don't find something that will force you to give up the game you love.  I had to do that with hockey.  It was a no-brainer decision (hip would last 3 or 25 years) but it's very difficult to give up an activity that has become part of your life.  Just put your worries aside...sounds like you'll be OK...

5

Three days complete rest, ice and massage.

6

Maybe you can find a sport that has to be played while using a walker. I've been working on it myself but so far putting away an ice cold pint or 2 is about the only thing I've come up with. Until I figure out the game I can't even begin to come up with rules. Is the ice off the lake down your way yet?

7

Ok. Thanks all. Just got the diagnosis from the Kerlan Jobe Ortho: Fat pad Impingement. Two orhtopedists I saw said I tent to overextend my left leg. This is what I forgot to tell the docs and it may be an important issue:

In early 2000, in PT for similar discomfort, I was advised to purchase & wear a small (10mm) lift in my right shoe due to LLD (leg length discrepancy). My chiropractor, whom I've known for decades said he saw no LLD, but stated that my hips were out of alignment.......I stopped using the lift for years, then began using it again after my left plantar fascia tear (12/2015).

As previously stated, the two orhtopedists I saw most recently have said I tend to hyperextend my left leg. 

Could it be that my hyperextension is actually being caused by (unessessarily) wearing the lift on my right side? 

In other words, --- my left leg is trying to compensate for the right side being longer DUE to the (perhaps unnecessary) lift???