UKC

So - two slightly different diagnoses so far on my two very painful knees

Doc 1 says the meniscal cartilidge is either torn or swollen initial treatment is dichlofenac, and non-impact excercise to keep the joint mobilsed.. failing that, steroid injections and ulitmately if all else fails - surgery

Doc 2 (a week later as I wanted advice on more pain relief when driving) no way is the meniscal cartilidge - just damaged tendons - oh and stop taking dichlofenac, its no better than ibuprofen: take that instead and give it a good 8 weeks and all wil be well...

so aside from dodgy docs - what advice can anyone give for good excercise to help my knees?

(and I'm going back to see a 3rd doc soon to get a 3rd opionion )

In reply to Nick Ward: I'd see a decent physio mate or an Orthapedic surgeon for an opinion.

Those two diagnoses seem a bit unclear to me, for example i've notheard of swollen meniscus!? Or, if swollen tendons...which tendon and why etc!?

If you have pain I would certinly rest a while and anti-inflammatory meds for a short period shouldn't do any harm.

I'm not a doc or physio mind you...my opinion is based on numerous knee problems over the years and a fair bit of surgery!

In reply to Nick Ward:

Ive been in a similar position, buggered my knees in the army basically, Meniscus problems and unfortunately for me I was born with a condition called discoid cartlidge syndrome..One doctor basically said to me that the ball was in my court, if I worked hard to buid my quads up then I may well be able to get to some sort of level of comfort with my knees. I then had an arthoroscopy to trim down my damaged mensicus and wash out all the rubbish that had accumulated around my knee over the years.
At first, I binned the running altogether, stuck to swimming, static bike and exercises such as the leg extension machine in the gym. After the pain sort of going almost completely, I started doing squats and running however I found that the running agravated my knees yet again. I then went and got my gait assessed and having been told that I run like a complete lunatic trying to escape from somewhere I was told that I supinate when I run. I then went off with my new trainers and insoles and I am now running better than ever, I keep up the squats, burpees etc to maintain strength in my quads and I am careful about what running shoes I wear and thus far I have had no major problems, currently in training for the Liverpool Marathon in October and climbing 2-3 times per week.

In reply to abr1966: well, something like 6 weeks of dichlofenac havent really done much to help :s

trouble is - the docs seem to be of the "sit and wait" variety... so a referral at the moment is unlikely

In reply to Nick Ward:

You want to talk dodgy knees...I'll tell you about dodgy knees. Crawling about under wagons and coaches piping up and coupling rolling stock on railway ballast for thirty years has completely shot mine. What did the doctor say when I went to see him? "Oh yes, that activity certainly would cause your problem" What was his advice? NONE....dodgy doctor indeed. Rant over, thanks for listening.
Can't give you any advice re exercise, sorry.

Pete

<Walks away from computer with dificulty>

In reply to Nick Ward:

6 weeks with no improvement? Demand a referral.

In reply to Eric the Red: the highlight of the advice - when I could what I could do about the pain when I drive - was that I shouldnt be driving then!

2 days before I was due ot drive the family on holidy. To Mull. Best part of 500 miles each way with me as the only driver...

wasnt too impressed

In reply to Nick Ward:
Find yourself a good, experienced sports injury physio who specialises in knees, and get an opinion and then a referral if needed. GPs are generalists IMHO can be a solution looking for a problem.

In reply to Jim at Work: hoping for the referral first - cant afford a specialist fees lol

In reply to Nick Ward:

I went in saying I got pain in my knees after running 3 or 4 miles, every time and it was in the same place every time. The doctor reckoned that a lot of people would be happy to run that far and maybe I shouldn't run any further if it hurt.

Eventually I got a referral to an orth. surgeon and he diagnosed ITB and I got it sorted.

I went with a shoulder injury once and showed the GP the hideously contorted position that brought the pain on. (It was a particular climbing move and looked ridiculous in his room) He said 'well just don't do that with your shoulder then.'

It's not their fault but make sure you push for a referral.

In reply to Nick Ward: You can self refer to Physio, don't need a doctor for it.

In reply to Nick Ward:

Depends what you've done to the knee. If the pain followed a heavy twisting movement (tennis, squash) you may well have torn the cartilage which will need surgery (keyhole) to repair. They simply trim it down so it doesn't interfere with the jont and cause pain (I'm sat here having had this exact op on Tuesday!), it will not get better with physio, I tried for over a year until I had an NMR scan...

In reply to Red Chilli: nah - no specific injury (as far as I know)a very good friend of mine had the op (twice - and its still not fully fixed) and although my symptoms are similar to hers - they;re not exactly the same, and tbh, I really dont think I've torn the cartilidge... I'm hoping for just swollen

In reply to Sonya Mc: really? how does that work then?

In reply to Nick Ward:

Find one, phone 'em up and go. You'd have to pay for it though.

I can only echo what's been said above, most GPs are as much use as Anne Frank's drum kit when it comes to sports injuries, or injuries to people who do sports. Get yourself to a specialist if at all possible.

In reply to George Ormerod:

And a large percentage of Physios aren't really any better, too many physios look at the injury rather than the actual root causes

In reply to George Ormerod: No you don't. I'm not talking about private Physio, I'm talking about self referring on the NHS.

To OP - go into your Doc's surgery and ask the receptionist for a self referal form for Physiotherapy. You have to fill out a form with your personal details, a description of your injury (where it is and how it came about etc.) Give the form back to receptionist, they will send it to your local NHS Physio. department and you will be put on the waiting list.

You still have to wait, but it's no longer than the wait you would have if your GP referred you, quicker in fact as you don't have to go via your GP.

In reply to Nick Ward: PS - I'm not an amazing fan of Physio, finding it utterly useless for my spinal problems. But it was great for my knee (wear and tear to meniscus) Physio had me do certain things, determined it was cartlidge, said usually the deal is to get folk to strengthen their quads to support the knee but that my quads were so strong that nothing they could do would help. Referred me straight away to Orthopaedics who offered surgery. (which I didn't go for in the end)

In reply to Sonya Mc: Seconded. I got a self referral form to print off and fill in from the local hospital web site last time I needed to self refer.

To the OP - there was a lot of discussion on here several years ago about 'brittle knees' ;p)

In reply to Sonya Mc:

so - apparently, not all pct's go in for the self-referral thing.. and guess what? Mine doesnt...

Back to the GP I go lol

thanks anyways

In reply to Nick Ward: It might be worth trying to get opinions of local sports physios and going for a private session. Every time I've used a private physio it's cost between £30-40 per session and on the initial session they'll evaluate the problem and tell you what they think it is. You could then take this information back to your GP and try and persuade them to refer you to the appropriate specialist. You may have more luck doing this if you go in with a physio's opinion rather than just trying to second guess the doctor. Also the physio should give you some exercises, etc. to do in the mean time to try and improve the situation, especially if they're good and you explain that you can't afford many sessions but are trying to get information to persuade your GP to refer.

In reply to Nick Ward:
Hello Nick,

Your pain while driving thing caught my eye - does it feel like someone is trying to prise your kneecaps off after youve been sat for a bit? If so, I suffered from that and like lots of people say here its often down to weak quads/badly tracking kneecaps. Painkillers didnt help me at all.

Excecises the physio got me to do were standing sideways to the stairs, with one foot on a step and the other danglying over the edge. then doing little dips, making sure not to extend my "uphill" knee in front of my foot and not letting it waggle about all over the show. I imagine it was ten reps three sets, assuming no loss of quality. As I was shortly to go on a snowboarding holiday, he was also able to show me how to tape it so it wouldnt get aggravated whilst away.

Once the pain had gone, I find that running stops it returning. Hope some of that helps? Hope your knees feel better soon!

In reply to Nick Ward: Whats the first thing a Doctor asks you.. : Now then whats wrong with you !!!!! my knee problems have been with me for years and I still dont realy know what the problem is,seen 3 phsyios and all said different things ..

In reply to goosebump: hard to decribe - but kinda bit like that... I also get pain going up /down stairs and climbing :s

In reply to Nick Ward:
There is a syndrome that's given the name cinema or movie goers knee which is exactly where I experienced some knee pain, also felt when driving long distance and recently after a longish day on the hills. I'm hoping it is temporary but should really go and get it looked at as I've recently had a sore hip joint and I'm thinking perhaps my gait lies behind it and needs looking at. Self treatment so far has consisted of using walking poles on the hills, wearing a knee bandage and taking Nurofen - a combination of which has helped a bit.

Is this the physical decline I haven't concerned myself a jot about?