[38M] With right knee pain and weakness post-foot fracture

Patient Description

A 38-year-old male reports experiencing pain and weakness in the right knee, particularly when walking. The pain is localized on the outside of the knee and radiates around it as it worsens. This has been occurring for a few weeks, with the pain initially noticed during squats or leg presses 6 to 12 months ago. The patient rates the pain as 5-6 out of 10 in severity. The onset of pain is sudden, occurring once or twice daily, lasting from a few minutes to several hours, and is relieved by resting. The patient has a history of a right foot fracture approximately 1.5 years ago, which required non-weight bearing for 3 months. The knee pain began shortly after resuming walking and workouts. Additionally, over 10 years ago, the patient twisted the same knee while rollerblading, resulting in an inability to walk for several weeks. This is the first time since that injury that localized pain and weakness have occurred. The patient has not tried any treatments or medications for the current knee pain and has not changed exercise routines recently. The pain and weakness cause the patient to walk slower with a limp and necessitate caution when moving around.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations for your knee pain and weakness:

  • Iliotibial Band Syndrome (ITBS): This condition occurs when the iliotibial band, a ligament that runs along the outside of the thigh from the hip to the shin, becomes tight or inflamed. It can cause pain on the outside of the knee, especially during activities like walking, running, or squatting. Treatment typically involves rest, stretching, and physical therapy to improve flexibility and strength.

  • Patellofemoral Pain Syndrome: Often referred to as "runner's knee," this condition is characterized by pain around the kneecap. It can be caused by overuse, injury, or muscle imbalances. Treatment usually includes rest, ice, compression, elevation (RICE), and exercises to strengthen the muscles around the knee.

  • Meniscus Injury: The meniscus is a piece of cartilage that provides cushioning between your thigh bone and shinbone. A tear in the meniscus can cause pain, swelling, and a feeling of weakness or instability in the knee. Treatment may involve rest, physical therapy, or in some cases, surgery.

  • Osteoarthritis: This is a degenerative joint disease that can cause pain, stiffness, and weakness in the knee. It is more common as people age or after previous injuries. Management includes lifestyle changes, physical therapy, and sometimes medications or injections.

What you can do

While it's important to consult a healthcare professional for a formal diagnosis and treatment plan, here are some steps you can take to manage your symptoms:

  1. Rest and Ice: Avoid activities that trigger your pain and apply ice to the affected area for 15-20 minutes every few hours to reduce inflammation.

  2. Compression and Elevation: Use a knee brace or wrap to provide support and elevate your leg when resting to decrease swelling.

  3. Gentle Stretching and Strengthening: Engage in exercises that focus on stretching and strengthening the muscles around your knee. A physical therapist can guide you in the right exercises.

  4. Over-the-Counter Pain Relief: Consider using nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen to help manage pain and inflammation.

  5. Symptom Tracking: Use MDandMe to journal your symptoms, track your progress, and share your notes with your healthcare provider. This can help in identifying patterns and triggers.

What you should look out for

Seek medical attention if you experience any of the following:

  • Severe pain or swelling that does not improve with rest and home care
  • Inability to bear weight on your knee
  • Noticeable deformity or instability in the knee
  • Signs of infection, such as redness, warmth, or fever

Remember, while these suggestions can help manage your symptoms, it's important to consult a healthcare professional for a comprehensive evaluation and personalized treatment plan.

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1 mo ago

People Also Ask

What is Iliotibial Band Syndrome and how is it treated?

Iliotibial Band Syndrome (ITBS) occurs when the iliotibial band, a ligament running along the outside of the thigh, becomes tight or inflamed, causing pain on the outside of the knee. Treatment typically involves rest, stretching, and physical therapy to improve flexibility and strength.

What are the common symptoms of Patellofemoral Pain Syndrome?

Patellofemoral Pain Syndrome, often called 'runner's knee,' is characterized by pain around the kneecap. It can be caused by overuse, injury, or muscle imbalances. Symptoms include pain during activities like running, squatting, or climbing stairs. Treatment usually includes rest, ice, compression, elevation (RICE), and exercises to strengthen the muscles around the knee.

How can a meniscus injury be identified and treated?

A meniscus injury can be identified by symptoms such as pain, swelling, and a feeling of weakness or instability in the knee. Diagnosis often involves a physical examination and imaging tests like an MRI. Treatment may involve rest, physical therapy, or in some cases, surgery to repair the tear.

What lifestyle changes can help manage osteoarthritis in the knee?

To manage osteoarthritis in the knee, lifestyle changes such as maintaining a healthy weight, engaging in low-impact exercises, and using supportive devices like knee braces can be helpful. Physical therapy and sometimes medications or injections are also used to manage symptoms and improve joint function.

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