Patellar Osteoarthritis & a Cortisone Shot

I  have been having pain in my right knee for a few months. For the past several years (or a decade?) my knee occasionally will ‘click’ when I run downhill when very fatigued, or on an occasional swim day when I am flutter kicking. The pain has been growing over the summer and fall, finally making it so painful to run downhill that I have had to stop running. 

I did not suffer a fall or impact to the knee, but increasing pain and post-run throbbing became no longer to ignore after I fell on a downstep when my knee felt like it “collapsed.” The pain is sharp, running the length of the patellar tendon from patella (knee cap) down to the tibia (shin bone). I do not feel pain when climbing stairs, running or hiking uphill.

Annoyed with myself for the fall, I made an appointment to visit an orthopedist. A few xrays and a quick physical exam and history, and the diagnosis of patellar osteoarthritis was made. Apparently, while my knees are overall healthy and in great condition, I have developed bone spurs on the right knee, making the edges of the patella sharp where they should be rounded. These spurs catch and cause inflammation within the joint, which I recognize as pain. 

While there is nothing surprising about this diagnosis, I am pretty bummed. It’s never nice to know something in your body is not operating as it could at optimal condition!  The path forward is pretty “choose your own adventure” with options from do nothing to treat with ibuprofen/etc to manage pain and swelling, to try a cortisone shot to calm down inflamation, to engaging in physical therapy (PT) to strengthen my overall core and legs, to knee replacement (strongly NOT recommended by the doctor).

I opted to take the cortisone shot and sign up for PT. The shot itself took about 10 seconds to administer, and felt like a flu shot, but in my knee joint. Following the shot, the knee was sore, stiff, and felt as though I’d just had fluid injected into it: kind of puffy. I hobbled out to my car and home, where I spent the afternoon with my leg stretched on the couch, slightly elevated. The doc recommended nonsteroidal anti-inflammatory drug (NSAID) to manage post-shot soreness, and resting from high-impact activity.

The soreness was pretty intense for that afternoon, and I even felt fairly nauseated. The joint remained sore for a couple of days. Two days after the shot I swam a couple of thousand yards, and the knee, while feeling tender, was fine. I ran four days post-shot, and while it felt great during the run, the knee was slightly swollen and tender for the rest of the day.

Right now, I’m still feeling a bit sore from my first post-shot run, but am hopeful that progress will happen over the next few weeks. Big questions remain about the long-term progress of the arthritis, what activity level I will be able to sustain, and what steps I need to take to maintain an active, strong, and confident lifestyle. This includes a trip to White Sands National Park with my kids and my sister and her family this past weekend.

I’ll keep you posted on future developments, including what PT for patellar osteoarthritis looks like. For now, I’m grateful for my overall general fitness, strong bones and “good looking” knees, and the opportunity to explore treatments for the things that bug me!

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