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Dr. Mark
Dr. Mark, Neurologist (MD)
Category: Neurology
Satisfied Customers: 1985
Experience:  Neurosurgeon - Brain, spine, and peripheral nerve surgery
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Need specialized advice in joints, osteopathy, sports

Customer Question

Need specialized advice in joints, osteopathy, sports medicine, etc.:
I started having a problem that worries me: my left knee ~5 weeks ago.
When I walk faster than at a tediously slow rate, and with very deliberate care, the joint pops and rattles - to the extent that I can even feel a small seismic shock in my spine.
I had an arthroscopic surgery on that knee 24 years ago (I’m 63).
That was occasioned by no apparent event the day after I had done considerable physical exertion, cleaning and rearranging 6 bookcases of hardcover books.
Awakening the next morning, I had intense pain and severe difficulty walking, then the surgery 10 days later.
Over months and years the discomfort and awareness did mostly subside, but a pillow between my legs makes it easier to sleep.
I think that I earlier injured a knee during my childhood and 20’s.
I recall at ~8 getting a limp while at camp. But it was gone a week later.
And I recall getting a limp for no apparent reason when I was ~11 or 12 that went away after a while.
And I twisted my knee when I was ~25, skiing in new wet snow.
I don’t recall which knee for any of the above.
Probably irrelevant aside:
My right knee is not in pristine condition either.
On 9/13/11 I twisted it while doing some plumbing.
I was advised to get an arthroscopic operation of it as well.
But being unemployed, I put it off, taking aspirin, until I eventually concluded it was unnecessary, as it was better than the one that had had the surgery.
What’s happening:
Until recently I had no significant problems; I could walk, run hike, etc.
But about 2 months ago I went about a major reorganization of a different 12x20’ room.
And yes, there were bookcases (9 this time), ~half of which held books.
Plus putting down a carpet, moving boxes & furniture, and extensive vacuuming , etc.
I explicitly remarked to myself to be wary of compromising exertions and did not notice any stress.
Soon after I completed that reorganization, I did notice that walking at a brisk or even normal pace was problematic.
I have only a middling understanding of knee anatomy and mechanics.
But it feels like the tibia/fibula move away from the joint while the leg is swinging, or rotate relative to the joint, or translate (left/right, fore/aft) relative to the joint.
Then as I plant my foot and apply my weight, there is a squush or plop as it reseats into the joint.
This ‘disconnect/reconnect’ can also happen when I extend my lower leg, e.g. while sitting, especially if done quickly.
What I’ve done:
I walk as slowly as necessary to prevent the disconnect/popping.
From my unschooled imagination, the symptoms seem consistent with either that the internals of the joint are eroded or that the tendons, etc. have become stretched.
I went to Sports Authority, intending to purchase a compression ‘sock’ for the knee that in my thinking might take the stress off the tendons, maybe preventing their additional trauma.
Near closing, I tried on a couple cheap ones of the many they had, but both of them actually seemed to slightly make the disconnect/reconnect less preventable by slow walking.
A friend said to me that I should tense the muscles around my knee, while lying in bed, as an exercise that would strengthen the knee joint.
Seems like it can’t hurt, but to no avail as yet.
While I had hoped that this issue would heal/go away, given the time, it is clear now that I need some learned advice.
My medical insurance that used to cost $200/mo 6 years ago with a $2000 deductible, now costs $504/mo with a $10k deductible.
So, I don’t want to pay hundreds to someone who will just charge me for advising me to help pay off their tomography equipment loan.
I want to understand:
Will this heal, of itself?
Can it heal with specific diet, supplements, care, exercise, avoidance of stress, bracing, or therapy, etc.?
Will surgery be the only option?
I request a conversation that might inform my thinking about the situation.
What do you think could be going on?
And what do you think I should do?
- Joel xxxx
408 241-xxx
Knowledge is knowing a tomato is a fruit.
Wisdom is not putting it in a fruit salad.
Submitted: 2 years ago.
Category: Neurology
Expert:  DrRussMd replied 2 years ago.


No comment can really be made here without knowing what the problem is with the knee

It would all be guess work.

You have not had an MRI is that correct?

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