Bad Knees, Need Help

[Strykervet]

So I have bad knees, they've sounded like rice crispies in my 20's and when I got out of the army a doctor told me I had the "knees of a 70yo man". That was 15 years ago. They went along cracking while my back and feet gave me issues the most.

Then one day I hear something crack or snap and my knee hurt like hell and I could put weight on it or extend it or flex it. It even locked up for a moment, which was scary. Had to lay down and massage it around until it came free. I used ice packs and started using my knee brace. I have really nice ones the VA gave me years ago. I'm having trouble finding shoes or boots that'll fit because of failed foot surgeries that left me with a big toe where the knuckle rubs on everything and anything. Been using sandals for the several months, waiting on custom inserts and new shoes the VA ordered, but I just got done getting these boots and inserts they ordered and they still take the skin off my toe. So it's back to the damn sandals, even though I'm pretty sure whatever is going on with my knee is due to the sandals.

I got an MRI and knee xray and the MRI showed "tricompartmental arthrosis preferentially involving the patellofemoral component with moderate chondral wear. Small focal areas of moderate to high grade chondreal wear of the medial and lateral femoral condlytes are also seen. The trochlear sulcus is shallow and there is a mildly laterally positioned patella". That's a helluva lot more verbage than the last MRI.

After a few weeks of dealing with it, it went away about as fast as it happened. Then last week I went to get up out of bed and had my left leg bent and right leg off the bed. When I went to extend the left leg to stand, it just locked up and it hurt like a motherfucker. I couldn't move it in either direction but especially to extend. Hurt so bad I felt I'd break it or pass out if I tried to force it. I massaged it and played with it until it would extend. Finally it did; I was getting ready to call my buddy to go to the hospital if it didn't.

Now here's a key clue: both times this happened, something on the inside of my knee next to or behind the top middle of the kneecap will "pop out" and rise to about the center inside of my kneecap. Feels like pea sized something under the skin, it hurts pretty bad to touch, feels strange when walking and only feels normal again if I carefully slide it back up and behind the kneecap. If I were to try and attempt to over extend my knee, it would hurt but almost feel like it would be possible if you pushed hard enough. It feels weak and like it could lock up at any time, the lump coming and going, coming and going.

WTF is going on? Begged the goddamn VA for an ortho consult, they say go to physical therapy and get cortisone shots. Having the VA stick a needle in my knee scares the hell out of me (they've nailed my sciatic nerve at least 3 times, I do my own T injections now, and hit an artery (!) for a flu vaccine, blew out veins with improper IV pump setups, etc.) and I screwed up and my insurance this year won't pay for my pain doctor visits, so I'm paying those in cash. Can't have them do it until next year. I'm going to PT even though I know everything they'll say, at least I should be able to get a pool pass or possibly they'll see something. My new VA PC doctor is about as useful as a dildo. He just stares at the computer while telling me everything he can't do, regulation this, rule that, on and on and he insists he can't put in an ortho consult, which is bullshit. I know better but he wants to play the game, seen it before. My last doctor was really good and trusted me enough to take my word on what I needed or to give me advice if I was wrong.

This one won't tell me what's wrong, won't send me to ortho, I'm gonna do the PT in hopes of finding something out from someone who wasn't staring at goddamn computer screen with his dick in his hand during anatomy 101. I've looked at the anatomy drawings and I can't figure out what it is unless it's a snapped tendon that's pulled up.

I'm sure it has something to do with feet ever since another doctor crippled me. But I'm doing all I can. I put the 30lbs.+ I lost right back on because I can't go reload or do a damn thing really but lay around like a tub of shit. I know that's bad for my knees, feet, everything, but if I could at least walk around and stand without fucking something up, believe me, the weight would just fall off. So now I'm waiting on it to unfuckup again and I'll buy new shitty sandals and go back to doing. I'm not a fat ass, not naturally, and I'm not THAT old, I realize that all this would make it seem like I'm 5' and 400lbs. I'm normally 210ish and 6' when I can do shit, but not right now.

I'm just trying to find out if anyone has any idea what this? Ever happen to you? What you'd do, what's the solution, what's the outcome? I know all these are questions for my doctor but he's a useless and where I normally can figure it out on my own, this time I can't.

Sorry I'm so longwinded, I just wanted to be as accurate as possible so there wouldn't be much for questions. If one of you is an ortho, fucking jackpot! Just wanna know what's going on so I can fix it. Gonna start glucosamine/chondroitin soon, probably should've been on it all along.

 

[Bandit31]

My left knee blew out about five years ago i my early twenties. For me it was a super terrible experience because I've been cycling my whole life and I had just gotten back on a bike after never thinking I'd ride again from an injury from overseas. Luckily, I didn't have to have surgery from the VA and had my knee repaired by a doctor who primarily deals with sports injuries, and had already put back together other body parts that I've snapped or shattered.

After the surgery which was about five years ago, I never fully recovered, couldn't run, cycle, squat as much, etc. Got diagnosed with osteoarthritis and started the countdown clock since all my other major ligaments were primarily scar tissue.

For five years I couldn't run down the end of my street without pain or cycle more than a mile without it feeling like someone was trying to pull my knee apart. Now I can run several miles and generally put 20-30 miles or more down on the bike each week.

Things that helped me, may help you. If you go to the gym, stop squating with weight. When I stopped squatting with weight, it made a huge improvement in my overall knee functions.

Focus on strengthening muscles that help stabilize your knee. Cycling is easy to do so as long as you can tolerate it and get a bike that fits you. Also stretch your leg muscles. There's several muscles ( I can't recall which) that when strained will cause knee pain when you try to move. Minimalist shoes are also said to benefit those with knee pain as well.

Some may think it's snake oil but I stopped taking pain killers to save my liver and kidneys and tried tumeric and ginger capsules and some CBD salve and felt alot of improvement, especially with swelling and pain management. I also have some TBI's under my belt and get killer headaches several days out of the week and they have decreased as well.

 

[StealthOwl]

Do you stretch much? It can really change your life if you have chronic pain from tightness or imbalance..

 

[Seymour Fish]

So I have bad knees, they've sounded like rice crispies in my 20's and when I got out of the army a doctor told me I had the "knees of a 70yo man". That was 15 years ago. They went along cracking while my back and feet gave me issues the most.

Then one day I hear something crack or snap and my knee hurt like hell and I could put weight on it or extend it or flex it. It even locked up for a moment, which was scary. Had to lay down and massage it around until it came free. I used ice packs and started using my knee brace. I have really nice ones the VA gave me years ago. I'm having trouble finding shoes or boots that'll fit because of failed foot surgeries that left me with a big toe where the knuckle rubs on everything and anything. Been using sandals for the several months, waiting on custom inserts and new shoes the VA ordered, but I just got done getting these boots and inserts they ordered and they still take the skin off my toe. So it's back to the damn sandals, even though I'm pretty sure whatever is going on with my knee is due to the sandals.

I got an MRI and knee xray and the MRI showed "tricompartmental arthrosis preferentially involving the patellofemoral component with moderate chondral wear. Small focal areas of moderate to high grade chondreal wear of the medial and lateral femoral condlytes are also seen. The trochlear sulcus is shallow and there is a mildly laterally positioned patella". That's a helluva lot more verbage than the last MRI.

After a few weeks of dealing with it, it went away about as fast as it happened. Then last week I went to get up out of bed and had my left leg bent and right leg off the bed. When I went to extend the left leg to stand, it just locked up and it hurt like a motherfucker. I couldn't move it in either direction but especially to extend. Hurt so bad I felt I'd break it or pass out if I tried to force it. I massaged it and played with it until it would extend. Finally it did; I was getting ready to call my buddy to go to the hospital if it didn't.

Now here's a key clue: both times this happened, something on the inside of my knee next to or behind the top middle of the kneecap will "pop out" and rise to about the center inside of my kneecap. Feels like pea sized something under the skin, it hurts pretty bad to touch, feels strange when walking and only feels normal again if I carefully slide it back up and behind the kneecap. If I were to try and attempt to over extend my knee, it would hurt but almost feel like it would be possible if you pushed hard enough. It feels weak and like it could lock up at any time, the lump coming and going, coming and going.

WTF is going on? Begged the goddamn VA for an ortho consult, they say go to physical therapy and get cortisone shots. Having the VA stick a needle in my knee scares the hell out of me (they've nailed my sciatic nerve at least 3 times, I do my own T injections now, and hit an artery (!) for a flu vaccine, blew out veins with improper IV pump setups, etc.) and I screwed up and my insurance this year won't pay for my pain doctor visits, so I'm paying those in cash. Can't have them do it until next year. I'm going to PT even though I know everything they'll say, at least I should be able to get a pool pass or possibly they'll see something. My new VA PC doctor is about as useful as a dildo. He just stares at the computer while telling me everything he can't do, regulation this, rule that, on and on and he insists he can't put in an ortho consult, which is bullshit. I know better but he wants to play the game, seen it before. My last doctor was really good and trusted me enough to take my word on what I needed or to give me advice if I was wrong.

This one won't tell me what's wrong, won't send me to ortho, I'm gonna do the PT in hopes of finding something out from someone who wasn't staring at goddamn computer screen with his dick in his hand during anatomy 101. I've looked at the anatomy drawings and I can't figure out what it is unless it's a snapped tendon that's pulled up.

I'm sure it has something to do with feet ever since another doctor crippled me. But I'm doing all I can. I put the 30lbs.+ I lost right back on because I can't go reload or do a damn thing really but lay around like a tub of shit. I know that's bad for my knees, feet, everything, but if I could at least walk around and stand without fucking something up, believe me, the weight would just fall off. So now I'm waiting on it to unfuckup again and I'll buy new shitty sandals and go back to doing. I'm not a fat ass, not naturally, and I'm not THAT old, I realize that all this would make it seem like I'm 5' and 400lbs. I'm normally 210ish and 6' when I can do shit, but not right now.

I'm just trying to find out if anyone has any idea what this? Ever happen to you? What you'd do, what's the solution, what's the outcome? I know all these are questions for my doctor but he's a useless and where I normally can figure it out on my own, this time I can't.

Sorry I'm so longwinded, I just wanted to be as accurate as possible so there wouldn't be much for questions. If one of you is an ortho, fucking jackpot! Just wanna know what's going on so I can fix it. Gonna start glucosamine/chondroitin soon, probably should've been on it all along.

The groove your kneecap rides in is shallow, and the kneecap is riding a bit off the centerline. There is degenerative arthritis in this system which can be very painful. Locking up mechanically is usually from a torn flap of meniscus or a loose body ie a torn-off piece of cartilage floating around in the joint, neither one of which your mri summary mentions (competent vs incompetent, who knows). Locking up from pain alone could be back to the kneecap. You are at higher risk of it “coming out of place”, dislocating. A pea sized lump can be a neuroma, synovial cyst, etc. you need a Competent ortho guy on board, who can read an mri. If no surgery indicated, the best rehab imho is swimming with flippers, as strengthens the Vastus Medialis muscle and pulls the kneecap into alignment.

 

[Strykervet]

The groove your kneecap rides in is shallow, and the kneecap is riding a bit off the centerline. There is degenerative arthritis in this system which can be very painful. Locking up mechanically is usually from a torn flap of meniscus or a loose body ie a torn-off piece of cartilage floating around in the joint, neither one of which your mri summary mentions (competent vs incompetent, who knows). Locking up from pain alone could be back to the kneecap. You are at higher risk of it “coming out of place”, dislocating. A pea sized lump can be a neuroma, synovial cyst, etc. you need a Competent ortho guy on board, who can read an mri. If no surgery indicated, the best rehab imho is swimming with flippers, as strengthens the Vastus Medialis muscle and pulls the kneecap into alignment.

Yeah, this has been my problem. The VA apparently says I'm not "bad enough" to warrant an ortho consult!? I just feel backed in a corner with this. It's not healing up, I've been trying to so some things but nothing seems to help. I did start glucosamine this week.

That lump that comes out of place and has to be pushed back up does feel sorta like a piece of cartilage maybe, I can't tell. Another problem with the MRI is that it took three months to get, so by the time I went my knee had for the most part stopped being as much of an issue. But now it's out again and it's been out for a while this time. They did give me a rheumatology appt. and I'm gonna go to the PT appt., more in hopes I can get an ortho consult out of them just so I'll have a competent doctor to talk to.

I can go get the MRI images and xrays myself and it wouldn't be the first time whoever interpreted it missed half of what's going on.

 

[Ravenworks]

If I were you I would go find an orthopedic surgeon and get something accomplished.
Sitting around hoping the VA is going to do something for you is a bad way to go.
Are you on disability?
There are programs that enable you to find a civilian doctor of your choosing.
I feel for you,but YOU NEED TO TAKE CARE OF YOU before it's too late.
I had a good friend of mine cut several fingers off on a table saw,the wait time with the VA doctor's ruined him for life.
I begged him to take it upon himself to find a doctor, he is regretting it now.

 

[Seymour Fish]

Yeah, this has been my problem. The VA apparently says I'm not "bad enough" to warrant an ortho consult!? I just feel backed in a corner with this. It's not healing up, I've been trying to so some things but nothing seems to help. I did start glucosamine this week.

That lump that comes out of place and has to be pushed back up does feel sorta like a piece of cartilage maybe, I can't tell. Another problem with the MRI is that it took three months to get, so by the time I went my knee had for the most part stopped being as much of an issue. But now it's out again and it's been out for a while this time. They did give me a rheumatology appt. and I'm gonna go to the PT appt., more in hopes I can get an ortho consult out of them just so I'll have a competent doctor to talk to.

I can go get the MRI images and xrays myself and it wouldn't be the first time whoever interpreted it missed half of what's going on.

A rheumatologist “might” refer you to an Ortho guy, eventually. Might be able to diagnose a Mechanical Derangement, which is the buzzword you need to use. Likely is coerced to follow some bullshit “guidelines”; step by step walk you through various anti inflammatories which are no better than aspirin. A stalling tactic. Phys therapy, while useful in the proper context, could just as easily worsen things, and would be remarkable if it led to a back door ortho referral. Take the bull by the horns. Find a vet-friendly Ortho guy, take all xrays/ MRI films, pay cash for an initial visit if you have to, and get a solid diagnosis. Many ways to work it from there.

 

[Squibbler]

Sounds like patellofemoral tracking disorder that's being exacerbated by arthritic condition and positional stresses...., i.e. your patella is subluxing. Most likely predisposed due to genu valgum, hallux valgus, and/or pes planus/ankle inversion. Just a suggestion as you search for answers and a Dx from your doctor.

 

[OLD308]

Please don’t over look muscular atrophy that is exasperating your noted issue. YouTube, banded leg press and other forms of using bands to safely and effectively engaging your proper muscular recruitment. Many a person (me included) avoided doctor suggested surgery by strengthening the area. Really odd what the body does when proper motor patterns are not adhered too. Not medical advise, just sharing my experience.

 

[Seymour Fish]

Please don’t over look muscular atrophy that is exasperating your noted issue. YouTube, banded leg press and other forms of using bands to safely and effectively engaging your proper muscular recruitment. Many a person (me included) avoided doctor suggested surgery by strengthening the area. Really odd what the body does when proper motor patterns are not adhered too. Not medical advise, just sharing my experience.

Old, maintaining muscle mass and strength is the Key for long-term care of a fucked up knee. The catch-22 is that acute pain limits ability to exercise, and quad strength decreases up to 50% in a week of immobility. Presuming the acute injury or the exacerbation of the chronic problem resolves, it is an uphill fight to regain strength, especially the vast us medialis , which is both critical for proper patellar tracking and typically de conditioned in the general population even when injury-free. Tight hamstrings typically coexist. Your experience is heartening and instructive

 

[northshorelumber]

I realize you can't be active and therefore have gained back that 30# but losing just 10% of your body weight can have a profound affect on bad knees and pain. Even if you can't be active calorie restriction alone will allow for weight loss. Granted easier said than done but it it a treatment that is free and doesn't rely on a doctor. Good luck from a fart with a trashed knee.

 

[Strykervet]

Thanks for the advice here, I figure I have an update.

I FINALLY, as in just last Monday, got a cortisone shot. Luckily VA was too fucked up so I was able to go to a civilian doctor instead of a government agent for my healthcare. While I was there, the doctor pulled off 30cc of fluid which tested positive for (for some reason "irritant" keeps coming to mind but that obviously isn't the word) but negative for gout. He also looked at the MRI disc and it was the first time I got to go through the images myself. How in the fuck does a radiologist miss THREE floating bone fragments? I have images from xray and MRI from several different dates and it's obvious the fragments are moving around.

So he INSISTED they send me to ortho --now for an arthroscopic surgery and a "knee scrape" (I apologize for the language, I'm tired, that shot has robbed me of sleep for nearly a week now) in order to prompt healing.

What pisses me off is I was right AGAIN, and they didn't listen, AGAIN. Finally getting the foot surgery I needed over a year ago later this month.

There wasn't anything I could do really.... It's a little better now but still janky and it can still lock up when a fragment winds up between the joints. So that makes a broken knee and a broken toe I've been walking around on for the last year. This shit is getting old.

Fuck it. Next time the doc ignores me I'm just gonna make a deal with him. If he's right, I'll pay him $1000. If he's wrong and I disagree, I'm taking $1000 out of his ass after work. If that's more than he can handle he's welcome to pass me onto someone who will listen. It only sounds fair if he's gonna deny me treatment for what I know I need and make me wait for a year for no goddamn reason. So far I haven't been wrong and I'm getting sick of these fucking VA doctors, I mean govt. agents masquerading as doctors.

I needed this ortho consult last year. At this point, I'll be lucky to get that surgery done this year at all.

 

[Squibbler]

Thanks for the advice here, I figure I have an update.

I FINALLY, as in just last Monday, got a cortisone shot. Luckily VA was too fucked up so I was able to go to a civilian doctor instead of a government agent for my healthcare. While I was there, the doctor pulled off 30cc of fluid which tested positive for (for some reason "irritant" keeps coming to mind but that obviously isn't the word) but negative for gout. He also looked at the MRI disc and it was the first time I got to go through the images myself. How in the fuck does a radiologist miss THREE floating bone fragments? I have images from xray and MRI from several different dates and it's obvious the fragments are moving around.

So he INSISTED they send me to ortho --now for an arthroscopic surgery and a "knee scrape" (I apologize for the language, I'm tired, that shot has robbed me of sleep for nearly a week now) in order to prompt healing.

What pisses me off is I was right AGAIN, and they didn't listen, AGAIN. Finally getting the foot surgery I needed over a year ago later this month.

There wasn't anything I could do really.... It's a little better now but still janky and it can still lock up when a fragment winds up between the joints. So that makes a broken knee and a broken toe I've been walking around on for the last year. This shit is getting old.

Fuck it. Next time the doc ignores me I'm just gonna make a deal with him. If he's right, I'll pay him $1000. If he's wrong and I disagree, I'm taking $1000 out of his ass after work. If that's more than he can handle he's welcome to pass me onto someone who will listen. It only sounds fair if he's gonna deny me treatment for what I know I need and make me wait for a year for no goddamn reason. So far I haven't been wrong and I'm getting sick of these fucking VA doctors, I mean govt. agents masquerading as doctors.

I needed this ortho consult last year. At this point, I'll be lucky to get that surgery done this year at all.

Sounds like things are at least headed in the right direction... Hope things all work out for you

 

[MarineWinger]

I understand this sounds like a stupid hippy thing, but try it. I drink Ginger tea everyday. I have two jacked knees, a bad back, post Navy surgery screw ups, and i can still get out for runs and hit the gym. I also stretch, and stay with a healthy diet and away from sugar.
Ginger Tea is an anti-inflamitory. Supper cheap, and still tastes good.