Do you feel a strange pain or tightness when you walk up a flight of stairs, get up after sitting for a while, or bend and straighten your knee? Do you sometimes feel a 'click' or 'click' sound coming from the inside of your knee? Many people don't pay much attention to this, thinking it's just a common knee or joint pain. But perhaps the cause of this is a condition you haven't heard of, but is very common, called 'Plica Syndrome.' Don't worry, today we'll talk about this simply and in a way that you can understand.
Simply put, what is Plica Syndrome?
Okay, let's start from the beginning. Our knee joint is a very complex structure. Inside this joint, there is a membrane to protect it and help it function smoothly. This membrane has a series of naturally occurring folds. In medicine, we call those folds 'plica'. Normally, everyone has about four such folds in their knees.
Having these is not a problem. However, sometimes, especially the medial plica, which is located in the middle of the knee, gets injured and starts to swell due to frequent rubbing or some accident. The pain and other discomfort that comes with that swelling is what we call Plica Syndrome . To be precise, this is a natural part of the knee that starts to bother us.
How is this different from a Torn Meniscus?
This is a question that many people have. Because when they experience knee pain, many people think that the cartilage in the knee called the 'Meniscus' has torn. The reason for this is that the symptoms of both conditions are very similar. However, there is a clear difference between the two.
The main difference is where the pain is felt. In a torn meniscus, the pain comes from the middle of the knee joint, just above the joint line. In Plica Syndrome, the pain is usually felt a little above that.
Your doctor will try to distinguish between these two conditions when examining your knee. However, an MRI is often recommended to help differentiate between the two conditions and to make sure there are no other problems. So if you have knee pain, it's best to see a doctor rather than guessing on your own.
Who is more likely to develop this condition?
Although this condition can occur in anyone, some people are at higher risk.
- Athletes: This is especially common in those who engage in sports that involve constant bending and unbending of the knee, such as running and cycling, because the plica membrane is constantly being rubbed during those activities.
- Accident victims: This condition can also occur after a sudden accident, such as hitting the knee on the dashboard in a car accident, or hitting the knee hard in a fall.
- Working posture: Some jobs require people to work with their knees bent all day (e.g., tilers), and they are also at risk.
Just think, someone who climbs and descends the stairs in the office several times a day, or someone who rides a bike regularly, could get this kind of injury. So this is not something limited to athletes.
What are the main symptoms of Plica Syndrome?
If you suspect you have this condition, pay attention to the symptoms below. These are the most common symptoms of Plica Syndrome.
| Symptom | Description |
|---|---|
| Knee pain | A dull, aching pain in the front or middle of the knee. This pain may be worse when climbing stairs, kneeling, or bending. |
| 'Tock' or 'click' sound | Hearing or feeling a 'clicking' sound from the inside of the knee when bending or extending the knee. Sometimes this sound is accompanied by pain. |
| Catching Sensation | A feeling of tightness in the knee when you stand up after sitting for a while. As if something is caught inside. |
| Swelling | You may notice a little swelling around the knee, especially where the pain is. |
| Instability | Feeling like you have no control over your knees and are about to slip when going down stairs or on a slope. |
| Difficulty sitting for long periods of time | Pain that worsens when sitting in the same position for a long time, especially with the knees bent. |
How does a doctor recognize and treat this?
When you go to see a doctor with these symptoms, he or she will first ask you about your symptoms, how they started, and when the pain gets worse. Then they will examine your knee. If there is a swollen plica, you may be able to feel it when you press on the kneecap.
Then, as mentioned before, they will order an X-ray or MRI scan to make sure there are no other knee problems (such as tendinitis or meniscus tear).
When it comes to treatment, the good news is that most of the time, it doesn't require major surgery . It can be managed with simple treatments.
| Treatment method | What are you doing? |
|---|---|
| Non-Surgical Treatments | |
| Rest | Temporarily stopping the activity that caused the pain (such as running, climbing stairs). |
| Ice melting | Apply ice to the area of pain and swelling for about 15 minutes at a time, several times a day. |
| Painkillers | Your doctor may prescribe medications (NSAIDs) to reduce swelling and pain. |
| Steroid injections | If the pain and swelling are severe, the doctor may administer a corticosteroid injection directly into the joint. |
| Physiotherapy | This is very important. Exercises that strengthen and stretch the muscles in the front of the thigh (Quadriceps) and back of the thigh (Hamstrings) can reduce the pressure on the knees. |
When is surgery necessary?
In most cases, the above-mentioned things can help control the condition within a few months. However, if there is no improvement despite these measures, and the pain continues to interfere with daily activities, your doctor may recommend surgery.
The surgery for this is called an 'arthroscopic resection'. Don't worry, this is not a major surgery where you completely cut out the knee. What is done here is that a small incision is made, a camera is inserted, and then another small incision is made, and fine instruments are inserted to cut out and remove the problematic, swollen Plica. After this surgery, you can usually return to normal in about 6 weeks.
How can you avoid this situation?
While this cannot be completely prevented, there are several things we can do to reduce the risk.
- Avoid putting too much strain on your knees. Avoid doing the same activity continuously without rest.
- When starting a new exercise routine, start slowly. Don't put too much weight on your knees all at once. Give your body time to adjust.
- Keep your leg muscles strong. Exercises that strengthen your thigh muscles (quadriceps and hamstrings) will increase the support provided to your knee joint.
- Wear the right shoes. Wearing a good pair of shoes that are appropriate for your activity is also good for your knees.
When should I see a doctor?
If you have persistent pain, swelling, or stiffness in your knee, please don't ignore it. Definitely see a doctor.
Thinking that this is just a sore joint will only make things worse. If you find the exact cause and get the right treatment and advice, you will be able to get rid of this pain and go about your daily activities as usual, without any hindrances.
Take-Home Message
- Plica Syndrome is a common condition in which a natural fold of tissue inside the knee becomes swollen and painful.
- The main symptoms are pain when climbing stairs, a 'click' sound when bending the knee, and stiffness.
- Although these symptoms are similar to a meniscus tear, they can vary depending on the location of the pain. An MRI can be used to confirm the diagnosis.
- Simple treatments such as rest, ice, and physical therapy exercises can often completely cure this condition.
- If you have persistent pain or discomfort in your knee, do not ignore it and definitely seek medical advice.
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