Knee Report – Doctor Visit

Knee showing the pes anserine bursa

The pes anserine bursa under the hamstring tendons and right below harvest scar.



Pes anserine bursitis, to be specific. At least, that’s what the doctor thinks.

The theory is that scar tissure around the harvest area is irritating the pes anserine bursa and causing my pain.  In many ways, this makes sense. It’s a common enough ailment among healthy knees, and any one of the things associated with the surgery could haved caused it in my case. 

For treatment, the doctor suggested a shot of cortisone.  And  when he administered it, he had trouble getting the needle in and then injecting the cortisone in and around the bursa.   A pretty clear sign of some tough scar tissue.

At the very least, the cortisone will reduce the pain in the short run and likely reduce the internal scarring as well. But there are no guarantees. I don’t think we’ll know for sure for another couple of months. More suspense.

For good measure

I also got another cortisone shot in the shoulder. This was my second since my ill-fated attempt to try swimming as a way to stay in shape. The first shot seemed to do wonders, and I had no troubles with my shoulder until I got the flu a couple of weeks ago.  It got into my joints, which all began to ache, and I guess the area around my rotator cuff got irritated enough to stay angry beyond the illness.  Oh, joy. 

Starting over

My next karate class is just a couple of days before I hit a full 4 weeks off from exercise.  If the knee feels better, I’ll go.  But I’m thinking that this time I really need to slow down and kind of start over.   Go through the basic katas and movements only as a way to recondition my legs.  

At my school, blue belts are often called “black and blue belts” for their penchant for finally hitting targets with good power, but less than stellar control.    They also tend to have knee pain, which I believe is because,  at this point in the training, your body is working to keep up with all the stuff it’s being asked to do.  The knees are bearing the brunt of this, and I think they’re adjusting and even reworking themselves.   

This was echoed by another doctor for a follow-up of a study of ACL injuries I’ve participted in.   He said that my body is likely still “learning” the new knee — the one with new scars and fewer tendonous material.  He seemed to think that it will ultimately make the necessary adjustments, but that it could take awhile.  

I hope he’s right.


11 Responses

  1. Cortisone shots suck. I so hated when I got mine. I hope you’re icing and elevating plenty. Regarding scar tissue, I had a bunch removed from my one incision area and feel like a new woman. Now if I could just stop worrying about my other knee. . .

    It’s neverending, isn’t it?

    Relax and feel better. Martial arts will always be there for you when you’re ready to return.

  2. Thanks, BBM. It has seemed never ending recently. For a long while I kept getting better and better and then I just didn’t. Very frustrating.

    I’m keeping my fingers crossed the cortisone works and exercises work. And just today, I’ve started seeing signs that they might. Not sure yet and still taking it fairly easy.

  3. Hey, just wanted to let you know I started a toplist for ACL bloggers. If you’d like to join, just go here and click “join.”

    Hope you’re feeling better!

  4. Hi BBBlues: How is your knee?

  5. Michele,

    Thanks for asking. I’m going to try to put a report today, but the short answer is that’s it’s doing better than it has for awhile. Now if I could only get my shoulder back in shape, I’d be good to go.

  6. […] so many people wearing these days.  It’s not ideal, but with the wrap on I hardly feel that bursitis that dogged me for so long, even when I practice […]

  7. Thanks much for sharing this! I am a high-altitude mountaineer who tore her ACL 12 months ago (snowshoeing of all things!) and am still struggling with pain and nowhere near fully recovered. I had the cadaver graft, followed all PT and recommendations religiously, and am still having trouble regaining my gait, let alone returning to climbing big mountains with heavy packs for days on end. The latest theory is that the medial pain interfering with my gait is caused by pes ansurine bursitis. Seeing a new doctor this week for a second opinion as my surgeon has blown me off as a problem case. I’m sorry you had to go through such a protracted recovery, but it’s somehow comforting for me. Thanks again for sharing.

    • Emilie,

      Sorry to take so long to respond. How’s your knee?

      • No worries! I’ll share my update in case it helps anyone else. I’m doing wonderfully now – in fact I am writing from Nepal where I just guided an all women’s trekking trip ( The second opinion was very helpful – the guy was a retired surgeon so there was no risk of getting a surgical recommendation unless it was really needed. He said in all his years, he had seen a few situations like mine where people just have a ton of pain, swelling, scar tissue, and overall a really delayed healing response. He recommended being patient (which of course I didn’t like but it was better than being blown off!) and switching my focus to pain and inflammation management (which you do earlier in recovery but was still my main issue nearly 12 months out). He recommended buying a Laser Touch One (laser and stem unit in one that is supposed to promote healing faster than laster or stem on its own) and avoiding activities that caused the pain and limping.
        So I stopped trying to jog or hike and minimized walking as much as possible as all my pain and limping was associated with my gait. I also stopped the weights routine. Quite contrary to the typical ACL recovery regime. I let pain be my guide and ONLY did things that did not hurt at all – yoga, indoor rock climbing, and slowly got back to outdoor cycling. I also did the Laser Touch One religiously and did ice massages on the pain points (rather than icing the entire knee).
        The doc said I was in a state of chronic inflammation so he couldn’t predict if it would take 2 weeks or 2 months. It took around 3 months, but I am doing so great now. I have been hiking and climbing easy mouuntains. I also guided a backpacking trip and although I can feel I don’t have all my quad strenght back, I am no longer crippled by pain.
        Generally I found that acupuncture and massage also gave me relief in addition to the Laser Touch One, but the real turning point was when I began to avoid all activity that caused pain, even though those activities are part of the “normal” ACL recovery process.
        One final note is that I went on a journey to find out why this is the second surgery recovery that has gone so poorly. I am still young (30s), fit, compliant but have these epic recoveries. The one thing a naturopath found was that I am gluten intolerant and that could also have caused systemic inflammation and immune system depression that could have impeded my healing. It was around the time that I stopped eating wheat that my pain abated. So it’s tough to say exactly what had the most impact, but sharing it all in case it helps anyone else that is struggling. Thanks!!!

  8. Thank you so much for writing this entire blog. I am 41 and have just had it confirmed that I snapped my acl in my ‘cho dan no’ grading in Tang Soo Do, the last grading before my 1st dan grading.

    • So sorry, Matt! I was 41 when I tore mine, too. It’s a terrible moment when it happens and then again when you confirm. Your martial arts will help you immensely, especially being so close to your blackbelt exam. I was a couple of belts away when I tore mine, and the understanding of your body and balance that you get by the point are far beyond that of most people.

      I’m glad this helps, and I would encourage you to start your own blog if you are at all inclined. The surgical techniques and post surgical therapy have changed and every experience is different. Plus, you’ll likely make contact with others going through the same experience right now. That was very helpful to me back then. Good luck with your surgery and rehab!

      BTW, I tore my other ACL in February and am still a couple of months away from getting back to sport. It’s been easier this time for me physically, but I didn’t just didn’t have in me to write about it again.

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