Sports Medicine/knee pain and laxity


I am a 43 year old male who has been diagnosed with fibro. Recently I have had a swelling in the right knee and pain in the area of the medial retinaculum. If I cross my right leg over the left when seated with the right ankle above left knee I am fine, but when I put my foot back down something feels like its loose medial to the patella. I had a MRI without contrast and all that it showed was a slight effusion. It feels like the patella is being pulled posteriorly. Do you think this is a tear?

Hello Rick;

Your description indicates there might be a tear, but the fact that you can fully bend it so the ankle is resting on the left bent leg, tells me there is not a tear.  As you indicated with a diagnosis of "fibro" you mean "fibromyalgia"?  Normally that would be out of the indication for knee pain on one side.  You did not mention any type of injury to that knee, and the MRI was essentially normal except for effusion.....which you had indicated prior to the MRI.

Here are a couple possibilities: You stated it felt like there was something "loose medial" to the patella when you returned your foot to the floor.  Also,it felt like the patella was being pulled "posterior".  The patella sits inside the tendon that attaches the femur to the tibia.  When the patella is compromised by an incident which allows the patella to push hard against the tendon, and theoretically gets "stuck" within the tendon, it can't move properly with leg motion.  So, when you have your right leg laying on the left leg, it is relaxing the tissues.  To initiate pain, however, is to move the leg back to the ground, and the tissues spasm, thereby generating pain in the posterior aspect.

My suggestion would be to find a good Sports Medicine physician in your area, and have him check it out.  Anytime there is swelling and pain, there will be a problem with the tissues.  If I were a surgeon, I think I would have a look at it with a scope to see what is happening.  Why they didn't use contrast with the MRI, I don't know. Contrast would have shown where and what the problem is.

Thank you for writing me, and please let me know what they find when you see the physician, and if this a different doctor than the first, take a CD of the MRI with you to show the consulting doctor.  Always ask for a CD anytime you have ANY type of imaging procedure done.

Good luck to you, and I hope they come to a final conclusion with this problem.


Dr. Patricia Arthur  

Sports Medicine

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Dr. Patricia B. Arthur, DC, MRC, CST


As a 30-year practicing Chiropractic Physician, my specialty was Sports Medicine. For 8 years I had the distinct pleasure of working with the USOC, and traveled the world to care for the athletes in the Pre-Olympic venues for the Summer Games. When I wasn't traveling, I had a private practice, and a hospital practice, in Kamuela, Hawai'i. Questions I couldn't answer usually dealt with pharmeceuticals. This was not my expertise, but the simple questions pertaining to familiar drugs I was able to digress, or refer to someone that was knowledgable in that field. Most Sports Medicine field injuries were familiar to me, but I always aired on the side of caution. In my office practice, I would tend to see more patients with the weekend injuries who would try to self-treat, only making the injury worse than it should have been! Nevertheless, I never took anything for granted, and so it was my conservative approach to the "cause-and-effect" mechanisms that were vitally important to the healing process.


Following my competitive nature, I knew Sports Medicine would always be a part of my life. After graduation from Palmer University in Iowa, the old adage taught at the school dealt only with the spinal column......anything connected to the spine was outside our scope of practice. To me, this was too simplistic, because the complex body also had arms and legs! From this point, I developed specific technigues which would encorporate the body as a whole rather than haphazard segments. There is nothing traumatic that happens to a single ligament, tendon or joint that doesn't effect a secondary, or possibly a tertiary element in that area. In order for that space to heal, all the factors must be addressed. Volunteering my time teaching referrees, coaches, and interested parents about the realities of probable sports injuries was worth a thousand words!j

American Chiropractic Association; Local Emergency Response Committee; Hazardous Materials Response Team; Urban Search and Rescue Team - Operations and Planning; Federal Corps of Engineers Committee; Earthquake Advisory Board; Big Island Wildfire Committee

Papers published focusing on the importance of proper care of sports injuries; Authored medical columns for the syndicated magazine "The People's Doctor "; Published papers in professional journals on Head Injuries in Sports; Published papers on Drug Abuse in Sports.

Robert Packer Hospital - Certified Surgical Technician - CST; Palmer University - Doctor of Chiropractic - D.C.; Wright State University - Masters in Counseling/Psychology; Wright State University - Masters In Couseling of the Severely Disabled.

Awards and Honors
Selected US Olympic Physician -1988; Graduated Wright State University with a 3.75 GPA; Graduated Palmer University with a 3.5 GPA; Faculty Appointment - Palmer University Post Graduate Education; Faculty Appointment- Hawai'i/Kapiolani Community College - Skills Team Tester;

Past/Present Clients
Cincinnati Bengals Football Team pre-season training; Summer Olympic Athletes worldwide; Kona Ironman Triathletes - Finish - line physician

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