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Sports Medicine

Pain behind knee

11/06/2006

Question:

I am a twenty year old who has had pain behind the knee for about eight weeks. I don`t know how I hurt my knee. The pain is located behind my right knee on the outside to the middle of the back of the knee. I woke up with it hurting and I hadn`t done anything other than muscle failure in the upper body two days before this. My knee is not swelled and it wasn`t swelled when it started hurting. When it first started hurting I was having muscle spasms behind my knee. My knee was also locking and then buckling on me and I couldn`t straighten my knee out. Now it hurts worse than it normally did if I walk at a fast pace, run, and move around at a faster pace and at weird angles. I also can not straighten after walking at a fast pace or after running. When I went to the doctor after this first happened they stated that I had runner`s knee then changed it to a pulled muscle. The doctor stated that my knee cap was stable but the doctor only did tests to see if my knee cap was stable. When it first happened I went three weeks in which I would just walk slowly everywhere then I increased the pace even though it was still hurting and I could bearly unbend it all the way. Now I run and everything but it hurts to do so and if I walk at a fast pace for a little while or run I can not unbend my knee. Now all I have to do is put weight on it for about three hours without rest for it to really start hurting and sometimes it will just start hurting worse for no reason. Also two days ago when walking my knee was hurting and as I stepped down on my right leg I heard and felt a pop and my leg felt better for about five minutes then it started to hurt worse than before. The pain is still in the same place as before but now it is more distinct. The pain doesn`t travel up and down my leg and it doesn`t really move from the original area that it started to hurt in.

Answer:

At your age, your knee symptoms could be due to such conditions as "a discoid lateral meniscus" or "osteochondritis dissecans" among other possible causes of the "mechanical" knee symptoms that you've experienced: locking and buckling, difficulty straightening your knee, and feeling/hearing a "pop" in your knee.

Imaging studies - to at least include X-rays, but to possibly also include an MRI scan - of your knee may be necessary to determine a definitive diagnosis and treatment plan. Your doctor may also consider referring you to an orthopedic surgeon. Until then, continued impact activities such as running would not be advisable. You should let your knee symptoms guide you; they may or may not allow you to engage in such non-impact activities as cycling or swimming.

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Response by:

Brian L Bowyer, MD Brian L Bowyer, MD
Clinical Associate Professor
Physical Medicine & Rehabilitation
College of Medicine
The Ohio State University