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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 31326
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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I have a sharp stabbing pain in my right knee. It is under

Resolved Question:

I have a sharp stabbing pain in my right knee. It is under and to the outside of my kneecap. I first experienced this pain in Novemeber 2008 when I was doing walking/running intervals. After 6 weeks of no walking/running and then 6 weeks of only walking I began to my walking/running intervals again. After two weeks the pain is back just like before. It especially hurts when I walk downhill or down stairs. Up is ok, but down is killer. I thought I had a stress fracture and did everthing the doctor told me to do, but I am not better. What could this be?
Submitted: 7 years ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 7 years ago.



The symptoms you are describing seems to be manifestation of Runner's disease or chondromalacia patellae or patellofemoral pain syndrome. The investigations done are knee radiographs; these should include weight-bearing anterior and posterior views, a lateral view with the knee in 45 degrees of flexion, and tangential and skyline views of the patella and Magnetic resonance for evaluation of meniscal injury. Treatment is by deep electrotherapy and physical therapy, which is the mainstay of treatment. You may like to read this resource for the details;


Please feel free for your follow up questions.


Dr. Arun

Customer: replied 7 years ago.
There were many views of xrays done back in Nov. Nothing showed up on the xrays. Is this a condition that can be 100% diagnosed thru xrays? Or will there still be some question of what may really be going on? Is this what I have heard referred to as runner's knee?
Expert:  Dr. Arun Phophalia replied 7 years ago.



Usually x-rays of the knee are able to give quite a good evidence of the disease (for runner's knee or runner's disease). The diagnosis is solely not based on the x-rays. It is collectively based on the symptoms, signs, clinical examination findings and x-rays. An associated osteoarthritis needs to be considered. Following is the comprehensive plan of treatment;


1) Knee care in the activities of daily living. Few simple self-care measures can be remarkably effective in ending pain cycle.

a) Avoid prolonged standing or walking or sitting with joint in a single position.

b) whenever you sit, keep the knee stretched and fold them intermittently.

c) Squatting, sitting cross legged should not be done.

d) Avoid climbing stairs.

e) Avoid sitting legs unsupported or hanging.


2) Rest: Taking a break from your normal activities reduces repetitive strain on your knee, gives the time to heal and helps prevent further damage.


3) Anti-inflammatory medications.


4) Physical therapy; the goal of physical therapy is to strengthen the muscles around your knee and help you regain knee stability. Ideal is supervised physical therapy. Stretching exercises are also part of the physical therapy regime.


5) Orthotics and bracing.


6) Glucosamine and chondroitin orally for about 1-2 years, if there is an associated osteoarthritis.


7) Hyaluronic acid injections in knee.


8) Local sprays and ointments to your skin may help relieve the pain and stiffness.


9) Deep Electrotherapy by physical therapist.


Please feel free for your follow up questions.


Dr. Arun

Customer: replied 7 years ago.

How long before I should be able to run.?


I forgot to say that I have been on an anti-imflamatory since I went to the doctor, about 3 months.


Should I go back to the orto dr I saw before so he can do comparison xrays. I just really thought 14 weeks would be long enough for this to be better. Why is it not?



Expert:  Dr. Arun Phophalia replied 7 years ago.



Yes, I agree, that 14 weeks are quite a good duration. If a god physical therapy regime is followed it should heal in next 12 weeks. When you intend to start running, it would be started by walking, then jogging and if both are painless, then running. Going to your previous orthopedist would be prudent. Another specialists involved are MD in physical medicine and rehabilitation or a sports medicine specialist.


I hope this was helpful to you. If it was, please remember to ACCEPT the answer so I can get compensated for my work. if you have any more questions, please feel free to ask. I am truly privileged to help you, and I want to make sure that you are satisfied with the answer. Good luck!


Dr. Arun

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