- Hi, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- And together we are the most famous
physical therapists on the internet.
- In our opinion, of course, Bob.
- Brad, today, you wanted to talk about Plica syndrome.
- Plica syndrome. Exactly.
- P
L
I
C , A
- Yep.
- Plica syndrome and the Plica tissue
is in the knee, Bob.
- Right
- Okay. And it's not a real common thing.
I've never worked within fifteen years,
someone with, was diagnosed with Plica syndrome.
- Believe it or not, I think I just had someone,
I mean, I diagnosed it or I assessed it,
so it wasn't diagnosed by a doctor,
but it seemed to fit along those lines.
- Sure. Right
- So.
- But it definitely exists.
It's out there and it's pain
and it's typically on the medial side of the.
- Show them what the medial means, Brad.
- Okay. So here's my right knee,
so it's gonna be on the inside.
- The inside of the knee.
It's usually just to the, by the patella, the kneecap
and it's right in this area typically.
- Right. So if it's on this one, it would be on the inside
of that facing this one.
- Right.
- So they're both facing each other basically.
- Right.
Okay. Now the way you can get this painful for one thing.
Um then you get a snapping sensation is one
of the typical um..
- [Both] Symptoms.
- There you go, I lost my words.
And what if you have these symptoms
that you're gonna see a doctor about it first.
- Right.
- Okay. I mean, you can do some conservative treatment.
that's not gonna hurt anything if you would like to.
- Yeah. If it starts off and you're feeling this pain
my patient, just to give you a brief history of her,
she went to Washington
and had increased her walking dramatically, you know?
Normally she'd walked, she walked normally two
two miles a day.
- Sure.
- That day she probably walked seven or eight.
- Right.
- And she began having pain in there,
could not find anything else wrong.
So that kind of pointed to the area,
and she was tender in this area, which made me
think it was Plica syndrome.
- Sure.
- Which basically is folds., isn't it kind of the.
- Yeah.
This is a, a difficult one to, if you look it
up on the computer you
can really find a good illustration of it
but they describe it as part of the uh
synovial uh tissue or..
- Capsule.
- Capsule and that is like,
if I look if you look at this, there's a fold in it.
When you get that fold in there that fold creates
a little bump and when your knee bends, it can go over that
and then you get that snapping.
- Sure.
- With associated pain
- It gets flared up.
- The three common causes of it is repetitive motion.
Just like this woman had, did a lot
of walking where she hadn't been doing before.
So a lot of repetitive motions.
- Sure
- She wasn't used to trauma.
If you fall in your knee or twist your knee
or something like that might get it going.
- Or kneeling.
- Right. Just plain kneeling on the floor.
- And so it gets fired up,
and so you're gonna wanna do the things that you
would do to calm it down.
One, you could ice it right, Brad?
- Sure.
- Two, this is the one that I recommended to her
and she did it,
even though she wasn't that old of a lady
I had her use a cane for a while and, and it calmed down.
It just, I, you know, a week later she brought the came back
and she was doing fine.
- Sure.
- Just needed to calm down.
You could take an anti-inflammatory.
- Yeah.
- Right?
- Ibuprofen or something like that.
What else Brad, do people try?
- Well, you can do some cross friction massages.
We've done a number of videos on it, we've had
good response with our patients as well
as people that watched our videos, heard good feedback.
- So you're doing massage right
across the fold basically.
- Right.
- Is what you'd be doing.
- Right.
- And, and you're doing that quite deep
and you're going, rubbing back and forth like that.
- Right.
- So that's really the, the major treatments,
isn't it, Brad?
- Right. You can also work
with strengthening for general strengthening.
We're not gonna get into that today, but you know
quadriceps in the hamstrings, the big
big muscles here that you can strengthen and stretch
if you got tight hamstrings,
you're gonna wanna stretch those out as well.
- So I would say those are more long term treatment
of it, you know?
Cause that's maybe to try to prevent it from coming back.
- Right. Right.
- But the, the initial treatments are, you wanted to
get calmed down.
So ice, take the weight off of it,
and, and, and also when I, oh, ibuprofen.
- Right
- So those are probably the three things that you wanna try.
- Worst case scenario if it doesn't get better,
and it is Plica syndrome,
they do have surgery for it, where they go orthoscopically
and remove it.
It's not a big deal,
and you know, obviously we don't want that so.
- Right.
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- That's right. I love that word.
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