Knees – not just getting old? #21 – Before MRI scan

Mon 23 Jan 2017

Since my last blog post on Fri 06 Jan, the knee has improved only slightly.  For much of the time it is still tight in the joint, and it also seems tight around the lower IT Band area when I bend it – even if bending with no weight, i.e. lifting the leg up and bending at the knee.  The rest of the time, it is a bit better than this, but still has what feels like tightness in both of those places.

Lately I have begun to think that the “tightness” in the lower IT Band is not to the ITB muscle itself, but maybe just the sciatic nerve.  Whenever I foam roll, which is 2 or 3 times a day, that lower ITB is no tighter than on the other, healthy leg.

On once occasion I tried a foam roll on the ground and  with the affected knee joint bent, to see whether the ITB would seem to be tight – but this proved to be pretty much impossible to do properly, so I did not get a definitive result from it.

Whatever is up with the ITB, it feels like borderline pain that is sharper than in the knee joint itself.  I can even feel this borderline pain in the ITB if I press on that area with my fingers while the leg is straight and the muscles are not being worked.  This is partly why I suspect it is more to do with the sciatic nerve, than the muscles in that area.  The joint mainly feels tight around the outside, as it has done for some time.

I have done John’s new recommended ankle exercises every day since my last post on 06 Jan.  I cannot tell whether there are having any effect, but am doing them anyway.  If they are working to help the joint stay loose, I think it is only by a little.

I have done no running for 2 months now.  Since my last post on 06 Jan, I have played some table tennis.  This sometimes seems to leave the joint worse off the next day (tighter), but not always – and it does not seem to be related to the length of time I play, more to whether I hold back a bit when going for shots, or take them fully committed.  Unlike the more severe troubles I was having before early December, the joint is not sore on the day after table tennis.

When I bend the knee, even without putting weight on it, it still does not “pop” as much as the other, healthy knee joint.  When it hardly pops at all, these are times when the joint is always tighter.  When I have been working at the computer and get up, I often get a small pop from bending the knee, and the joint and ITB feel a bit less tight.  On days when I am not at the computer and do not do any sitting of that sort, the joint pops less, and is a bit tighter in general.  I find this to be a strange observation, but that’s what’s going on.  Maybe it tells us something about what’s wrong with the knee.

I have been walking most days, for around 1.5 miles or so usually.  Walking down a slope no longer results in that “goofy” gait, and there is no specific pain in the knee joint now, when on a downward slope   – but overall, I am still favouring the affected knee a bit when I walk, and I can almost always feel that something in the joint is not right, as I take each step.  I would not want to do any amount of running or even jogging on it, at this time.

I still cannot use my preferred sleeping position when on my left side.  It continues to give the same pain to the knee joint as it has done since early October last year.

I am having the MRI scan this Thursday 26 Jan.  I have spoken to a technician there, and they have told me that the area the scan will cover should include about a third of the way down the lower leg from the knee joint itself, and a third of the way up the upper leg from the joint.

With the lower IT Band clearly playing some sort of a role in the current state of the knee joint – even if it is just the part of the sciatic nerve that goes across the ITB – I am wondering whether it would be a good idea to ask the technician to aim the MRI scan down a bit lower, so it still includes the whole of the knee joint itself, but also picks up more of the lower ITB.

That is a question I would like to hear from John on, before the appointment for the scan on Thursday.

Thu 26 Jan 2017

The scan took place today.  There were no issues with how the scanning process went.  They told me the results should be with my GP in about 2 weeks.

2 thoughts on “Knees – not just getting old? #21 – Before MRI scan

  1. Knee MRI positioning.
    I am not a qualified Radiographer, but my expectation is that the MRI coil frame will be centred on the joint line of your knee to achieve the best resolution images of the internal joint structures. These include the important medial and lateral meniscus, the knee ligaments and the cartilage covering the joint surfaces. In a regular MRI it is possible to see the insertion of the ITB and the sciatic/tibial nerve as its passes behind the knee.
    I don’t think its necessary to change the regular knee MRI protocol to reflect your existing symptoms.
    Hope that helps
    John Stephenson at AAA Physio

    1. Hi John. Many thanks for these details – they are very helpful, and just what I needed to know. More news later /tomorrow etc. The scan is scheduled for the end of this afternoon.

      – Nelson

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