Just some background about me. I am 35 years old, in excellent shape, and was previously a high school and a little bit of college cross country and track athlete. In 2011, I had arthroscopic surgery on my left hip to repair a labrum tear/bone spur. I have had no issues with pain in that hip since. No other major injuries of note. However, I did decide to give up running afterwards and switched to doing P90x, and it's variants, which I've done almost continuously since 2011. The last time I ran was for a work fitness test, 1.5 miles in 8:57 last year, so despite not running, the P90x style programs have kept me in great shape, though looking back, the plyometric aspects of those programs landed (pun intended) me here.
In August, I noticed that my left knee would hurt a bit (medial side just below knee cap) upon assuming a catcher's position and when going into Child's Pose. I thought nothing of it other than my knee must not like to bend that way and continued to train... By mid-August, the pain went from mild to moderate and starting to get unbearable, even at rest. I went to the first Ortho who did X-Rays, which were normal. He also performed an MRI in mid-September that showed the following issues:
1. "Focal small area of mild chondromalacia junction of midline and lateral aspect femoral trochlea."
2. "Chronic grade 1 sprain/no tear with thickening MCL at femoral insertion."
3. Small patella femoral joint effusion and medial synovial plica."
4. Mild Deep infrapatellar bursitis
Everything else was normal on the MRI.
He told me to modify activities and rest. I took 6 weeks off and did absolutely no working out, and took Aleve. The pain did seem to not get better. Referral to PT who did two sessions with me said I was already strong and that it wouldn't help me going forward...
I thought that was ridiculous, so got a second ortho opinion in October, who has been much better. He referred me to 8 weeks of PT, which focused on hip/leg strengthening exercises 3x a week for an hour or so per session as well as a bout of Meloxicam for a month straight. There was noticeable discrepancy in strength between my left and right hips at initial evaluation. It is my left knee with the above issues, so that makes sense. At 8 weeks, the strength discrepancy was essentially gone upon re-examination in late December. I noticed an improvement in pain, but the pain never really went away (always a dull ache, a 2-3 on pain scale or so most times). The pain would semi-subside during activity but slowly come back post-activity. I also went back to the gym during this time doing a weight training program called Athlean-X, while eliminating anything that had high impact or irritating knee flexion moves.
In early January, I decided to do an experiment and not go the gym and only focus on my PT exercises 3 x per week and foam roll/stretch the other days. After 5 or so weeks only doing the PT exercises (numerous band hip exercises, straight leg raises, etc.), I still have the dull, aching pain mostly medial side below knee cap with occasional stiffness and just not feeling right. I thought maybe just focusing on PT moves and not going to the gym on my own on top of it would help, but it seems to not have made much of a difference either way. In summary, I have done 3 months of PT with 2 months of it being in conjunction with supplemental program at gym, and one month without the gym part.
Last week, I finally had it after 6 months of dealing with this, and opted for a cortisone shot. I turned this treatment down the first couple of times it was suggested, but decided to try a one and done approach to see if it would help with the pain. So far, over a week later, no real improvement, if anything it is slightly worse. They are now suggesting Hyaluronic Acid injections if no improvement within next month. I refuse to go down the road of injections and am still wondering if we are missing something here. The ortho is sure the pain is caused by my chondromalacia and not the other issues seen on the MRI, but could it be something else?! Experiences and thoughts please. Thank you!