Knee update

I've put this in a separate post, so please skip it if you are not interested in my knee.

After 10 years of chronic intermittent knee pain that I attributed (incorrectly) to my IT band, about 8 months of worsening knee pain that I thought was in the joint but was very hard to pin down, and about 3 months since I've really run at all, I got an MRI after physical therapy did not help.  The MRI showed the suggestion of a minor medial meniscus tear and some cartilage wear just under it.  So last night I saw a PM&R doc at the orthopedic center who specializes in running medicine last night, expecting to talk about whether I need surgery for this minor tear.

Instead, after a thorough (and very instructive) history and exam, he told me very convincingly that my pain, both acute and chronic, is due to poor patellofemoral tracking, with the superolateral undersurface of the patella rubbing against the bottom of the tibia.  This is near but not identical to the where the IT band attaches, and it explains almost all of the knee pain I've ever had in this leg, from my first run-stopping episode in 2001, to the very localized stiffness during the first few hundred yards of a run that I've been feeling for the last five years or so, even to the vague pain radiating from the back of the patella to the back of my knee.  The abnormal MRI findings?  Purely incidental, as no amount of directed knee grinding could actually elicit pain.  What did elicit pain?  Him putting his finger in a certain spot and having me flex my quads.  That, my friends, elicited a lot of pain, and convinced me more than anything that he had figured out the problem.

So, basically this is a case of longstanding patellofemoral pain syndrome (PFPS) or runner's knee.  The good news is that it can be treated with physical therapy, maybe a brace, maybe a joint injection, and very unlikely to require surgery.  I'm very confident that I will be back running soon enough.