Ask Dr. Geier – Plica Syndrome

I’m back!

Yes, after being away from the blog and social media almost completely for the last four weeks, I am excited to be back. I have always said that I really enjoy writing, communicating, and interacting about sports medicine, so my absence hasn’t been for lack of desire. I’ve been moving, which is never fun or easy. Plus, after writing 25 posts in 20 days in late March and early April, I honestly needed a break. But I have a huge number of topics and questions that have been building up, and I am eager to get them on the blog.

There are also, some exciting opportunities coming. As you might have seen, I am writing a regular column for the Charleston Battery site that will run in The Post and Courier as well. These posts will be similar to those written for the Family Circle Cup, which were widely read and shared. I have been writing for the STOP Sports Injuries blog, the Be Active Your Way blog, The Post and Courier, and Cover 2 Cover Magazine. If any readers out there are interested in sharing my posts with your local newspapers, magazines, or sports blogs, please touch base with me. I am asked frequently to write about specific topics, so I am sure that I can adapt content for almost any publication interested in sports injury topics.

Lastly, I want to thank a group you wouldn’t expect me to acknowledge – Philadelphia Phillies fans. In a two-day period my blog had over 500 unique visits from Philadelphia looking for information on flexor-pronator strains of the elbow. Why? Phillies pitcher Jose Contreras suffered that injury and was placed on the disabled list. Fans wanting more information on that uncommon injury searched for more information and found that the number one Google listing was my blog.

Why do I mention it? One of the reasons that I started the blog was to provide a forum to discuss injuries suffered by famous athletes. And it has worked all along, as the Famous Athletes category has provided a huge percentage of the incoming traffic to the blog. But I want to do more in this regard, so I want to encourage more sports fans to send questions or post more comments on famous athletes with injuries. I’m also thinking of using Twitter more in this regard. I encourage people who want to know more about an injured athlete to tweet the question and mention me (@drdavidgeier) or include a specific hashtag (#askdrgeier). There might even be more opportunities coming for these questions…

Now to this week’s Ask Dr. Geier column. It discusses a diagnosis that really had fallen out of favor in recent years but occasionally returns. As always, please refer to my disclaimer about me discussing specific medical information online or by email.

Thanks for sticking around!


Shawn in Plano, Texas asks:

What has been your experience with recovery after surgery to treat plica syndrome in terms of the patient getting back into playing shape? Especially in volleyball players?

There are two main points that I think are worth mentioning about plica syndrome to answer this question. First, surgery specifically to treat a painful plica is fairly unusual. It used to be done very frequently as a reason to perform arthroscopic surgery on the knees of athletic people, but sports medicine surgeons started to realize that these plicae were rarely the source of an athlete’s pain.

Do you have knee pain, or have you suffered a knee injury? Watch this video series on knee injuries in sports and exercise!

A plica is a band or fold of tissue within the knee. As embryos or fetuses, plicae of the knee are fairly common, and as humans age, they often go away. A significant percentage of people, however, do have plicae that remain within the knee. The problem is that the vast majority of people with plicae rarely have problems from them. Surgery to scope the knee and remove them would result in a huge number of unnecessary surgeries.

Often people with plicae that actually are symptomatic can still be treated without surgery. Rest, icing the knee, anti-inflammatory medications, and occasionally injection of small amounts of a steroid such as cortisone into the plica itself can relieve the symptoms. Occasionally athletes do not get better with these treatments. If the patient’s history, physical exam, and radiographic studies (such as an MRI) suggest the presence of a plica, particularly if it is swollen on the imaging, surgery can be attempted.

What is the one question you should ask yourself to decide if you need to see a doctor?

Fortunately, surgery to excise a painful or symptomatic plica, such as one that causes a clicking sensation on the inside of the knee, can be very successful. The surgery involves looking in the knee arthroscopically and using a shaver to remove this band of tissue. Usually it is a fairly quick recovery. The surgery takes 15 to 20 minutes, and the athlete is allowed to bear weight almost immediately. The first 10 to 14 days involve efforts to decrease swelling and regain range of motion and strength. Usually an athletic individual returns to exercise within days or one to two weeks. Usually return to full sports takes only three to six weeks, although full recovery often takes several months. The success rate for returning to sports at the same or higher level is usually very good, again assuming that the plica was the source of the pain.

Do you have any injury questions that I can discuss? Go to the Contact section and send me your questions!

81 Responses to Ask Dr. Geier – Plica Syndrome

  1. Doctor Geier,
    I have recently been diagnosed w/ a plica band injury after playing volleyball. I’m a marathon runner as well. My orthopedic dr. said that I can continue to run during rehab. I have read mixed things about this. Just curious what your thoughts would be.
    Thank you for your time.

    • I think there isn’t an absolutely correct answer. If a patient starts running early, he or she might get back to 100% running condition faster, but the risk is that the knee could swell, delaying full recovery. Running will not cause harm to the knee, per se, so I think it depends on the patient and symptoms.

  2. Dr. Geier,

    My son is a baseball player that had surgery in June 2012 to remove plica and two small bone spurs in his elbow, he started throwing in august as a freshman on his college baseball team, he has has had pain on and off throughout the season it tend to bother him as the throwing routine increases, we’ve been told he has some tendinitis and it seems to continue to flare up. what can we do to fully recover, he is now red shirting but i’m concerned that this is becoming chronic

    • I can’y say in his case without seeing him. But generally when young pitchers rehab from injury, we emphasize strengthening of not just the elbow, but also the shoulder, upper and lower back, core, and legs as well as work to correct mechanics flaws. Often problems in these areas lead to increased stress on the elbow.

  3. Dr. Geier,

    In 2007 I had surgery to remove a plica. I had multiple intense traumas to the knee in quick succession, and that night my knee had swelled tremendously and I couldn’t bend it past 90 degrees. The next few months consisted of physical therapy, steroid injections, and eventually surgery, which fixed the problem. However, when doing the surgery, the doctor found that the plica had actually gotten wedged in my knee joint, and eroded away some of the cartilage.

    It’s almost six years later, and I’m starting to get pain and popping in the same place, the front inner part of my right knee. I haven’t increased my exercise regimen any…it begins to hurt just from being on my feet for a few hours.

    Do you know if plica syndrome has a tendency to re-surface, or do you think it’s more likely that the new pain and popping sensations are related to the fact that my knee is missing some cartilage?

    • Lisa, I can’t say specifically in your case. I have not had issues with recurrence of plicae, but i rarely have found many patients to need surgical removal. The ones that were truly symptomatic did get relief with removal, and the plica did not return. Articular cartilage damage in the medial (inside) of the knee can present similar symptoms as well, so it can always be difficult to know exactly what the cause of pain, clicking, popping, etc. is for a patient.

  4. Hello Dr. Geier,

    I have had bilateral knee pain for 1.5 year which started with tightness around my knees with no apparent swelling or pain when i touch any part of my knee. The tightness started at a point where I was very inactive since i was stuyding for boards, i had no direct injury or anything. Now the tightness is still present, worse when im sitting. When i bend my knee to about 25 degrees or squat I get a sharp pain on the superior border of my patella. And there is a tender point in the femur on the patellar surface that i can only touch in bending my knee all the way. Thats the tender point or what i believe the cause of my pain. My knee also clicks/pops when I extend it only. The MRI is normal.

    I’ve been told that it might be suprapatellar plica, but i have read many unsuccesful plica surgery stories, not sure if i should have the surgery! do you think my symptoms are from plica?

    • I really cannot give you a specific answer to your question, as I haven’t seen you as a patient or examined you or seen any radiographic studies. Generally a plica can cause pain and a snapping sensation just medial (inside) the patella. Unfortunately there are many causes of medial and anterior knee pain.

  5. Dr. Geier,

    I was diagnosed with a patella tracking injury from a thickened plica on my left knee. I experience pain in the medial section of the knee (this has been a source of pain for over 1 year now, and I became more serious looking into it over time because it was really becoming uncomfortable).

    Initially my orthapedic thought nothing of the MRI. The MRI showed a contusion on the medial side. I went to a physical medicine doctor and he told me it’s likely the thickened plica is causing a traction injury, and the constant traction issue is causing that contusion.

    To take care of it he had me on an anti-inflammatory for 6 weeks to reduce the swelling in the knee. He also had me go to PT 2-3 times a week where I received electric ice/stim and ultrasound treatment and worked on a variety of exercises to strengthen my vastus medialis. The physical medicine doctor told me that strengthening the vastus medialis will help pull the patella back into a more appropriate anatomical position.

    The problem is, I’m off the anti-inflammatory medication now, I’ve advanced quite a bit in my strengthening of my vastus medialis, but it doesn’t seem to get much better. Initially, in the opening few weeks, it felt better, but at the 2-3 month mark of treatment, it’s plateaued.

    Normally I wouldn’t be too concerned, but I’m a 25 year old male in pretty good shape. I’m a physical education teacher and lead an active lifestyle. I also coach track in the Spring where I run with my students. I’ll have plenty of time off until then, but what should my next course of action be?

    My physical medicine doctor seemed hesitant to use a cortisone shot, but said it would be an option. Will a cortisone shot alleviate the pain? Because I’m still not comfortable in a lot of different exercises. And, when would I seek out advice on seeking an operation?

    The problem I come across with that, at least, is that my physical medicine/rehab doctor told me that most orthopedics don’t look at the plica as a source of pain. They often glance over it in the MRI and think nothing of it (which is what my orthopedic did). Would orthopedics even be willing to consider such an operation and would it be worth it for someone physically active like myself?

    • Adam, thanks for the question. I cannot answer it specifically in your case, as I explain in the post. Generally I haven’t found many patients to have plicae that are actually the cause of their symptoms. If one is, then trying a cortisone shot directly into the plica or arthroscopic excision of the plica might be reasonable options. I probably have performed only two or three arthroscopies and plica excisions in my career, as nonoperative treatment of the patient’s pain or other symptoms usually alleviates it (and shows that the plica wasn’t the problem). The ones I have had to debride were usually very swollen and thickened and actually were causing a very painful snapping with knee motion. Other sports medicine surgeons might disagree, but I don’t know many that perform isolated plica excisions often.

  6. I had a partial medial Meniscectomy in Dec 2012 and the medial plica was removed as it was inflamed and interfering with the knee. We are over 4 months post op the meniscus part is fine, but the plica still gives me pain when swim, bike, or walk. Had another MRI and there is a small amount of scar tissue that grew in place of the plica. Anyway my doctor tome me no exercise for 2 months and no PT (never completed PT anyway he told me to stop) He said it hasnt benn given time to heal because I bike, walk, and do elliptical. I am at my whits end here. Maybe I should go to another doctor.

    • Paul, I really cannot give you a specific answer to your question, as I am not involved in your care. Usually removal of a plica isn’t a problem from a pain standpoint, but I have seen people swell more after surgery. The amount of meniscus removed and status of the articular cartilage often play a role in time to return to full activities as well. It is important for patients to get rid of all swelling and get full motion and strength back as quickly as they can, but that can take time and work with a physical therapist.

    • I had plica surgery six months ago. My knee is swollen again, the is an extreme amount of pain walking. And I live on third floor of my apartment complex. I don’t understand why!

  7. Hello, I just had a plica excision due to medial & anterior knee pain x yrs. worsening on flexion & extension. I didn’t have an injury before surgery.I’m three weeks out of arthroscopy and since surgery I have had bruising in the lateral & lateral posterior knee with a snapping sensation when bending knee. It is very painfull. What could this be.Thanks!

    • I can’t say specifically in your case, since I didn’t perform the surgery. Generally a patient’s knee is swollen for weeks after surgery. That extra fluid can cause the patella to track differently and cause a popping or snapping sensation. Plus the quad weakness can add to that issue. Generally as patients get more motion and strength, their complaints resolve.

  8. Can an inflamed plica cause pain on the outside of the knee? The inside of my knee has never hurt but during my exam the Dr. pushed on it and it was tender. He said that it was plica syndrome and when inflamed it was causing the pain on the outside of my knee. I have tried researching more about Plica Syndrome and have never seen anything about lateral knee pain, so it made me curious. He said my MRI looked amazing. Even after resting for 2 months and doing several stretches/strengthening exercises, my lateral knee pain still returns after I walk about a mile and a half or run about a half mile. If I stop immediately it doesn’t bother me, but will return every time I walk or run.

    • I can’t say in your case specifically, but I don’t think I’ve seen a plica cause lateral pain personally.

  9. I have had discomfort in my right elbow for about a year and a half now. It started pretty much as soon as I graduated college and started working full time. I am fairly certain that the discomfort and pain has to do with the long hours I spend at the computer. I have tried countless remedies including oral steroids, cortizone injections, over the counter pain meds, physical therapy, tens unit, massage, etc. and nothing works.
    Among my most prevelant symptoms is that I feel the urge to “pop” my elbow many many times a day. When I straighten out my elbow I feel a small popping sensation almost like some tissue is gliding in and out of the joint. Popping my elbow only provides temporary relief and then it goes back to bothering me almost instantaneously.
    I have been diagnosed by my orthapedist as having a plica in my elbow and am scheduled to get the plica removed via a synovectamy of the elbow in december.
    Have you encountered any patients with similar symptoms before? Is this characteristic of an elbow plica? Any thoughts on the surgery, recovery time, likelihood that my discomfort will be cured?

    • As a side note I’ve tried taking a week off from work to rest the elbow and I’ve also tried splinting the elbow to keep it straight while I sleep. Neither worked.

    • I’ve had patients with painful popping of the elbow. Most of them did well with nonoperative measures, like short-term activity modification and physical therapy.

  10. Hi just wondering if I would be able to play football again I had plica surgery around 7 weeks ago and I was hoping to get back in to soccer please advise how long I should wait before playing again

    • I can’t say specifically in your case. Generally the goal is to get athletes back to sports. Plica removal surgery usually requires 4-12 weeks for return, in my experience.

  11. Ive done knee plica removal on 22/8/13, about two months ago. Ive suffered pain, swelling and clicking sound for the past 1.5 years. Is it normal for it to click now even after surgery? I still have minor pain but alot of clickings I would say.

    On the other note, during my arthroscopy, my surgeons found whitish tissue in my synovium which diagnosed as early stage synovial chondromatosis. I was told to be on constant glucosamine & omega 3 supplements as prevention of it flaring up. No other cure or treatment to it. As I understand, there should not be pain from this unless my knee gets inflammed again, which can be years yo come.

    My concern is, if clicking is normal during the recovery time of my arthoscope…if it is, will it still persist?

    • I can’t say specifically in your case. If a knee is still swollen, the patella might track slightly abnormally and cause some clicking that eventually goes away. That is probably a question better directed to you orthopaedic surgeon.

  12. I’m having surgery to remove a plica in my knee, but i also have a partially torn lateral meniscus that my doctor said he isn’t going to do anything about. I’m a basketball player and I just want to do what’s best to get back on the court. What should I do?

    • Garrett, I can’t really say without being involved in your care. You might consider asking him about the meniscus tear and the risks and benefits of leaving a tear alone.

  13. Dr,
    I went to four doctors and was diagnosed with osteoarthritis of the patella. A fifth doctor said he thinks the source of the pain is my plica. My understanding you can only determine this by athroscopy. I also had an MRI. Is it possible the plica is the problem or is it the arthritis causing the pain? I am researching this extensively before going through surgery. I am not meeting with the doctor for one month since he is so booked up. The pain only prevents running otherwise I can run, ski, bike, swim etc. day after day pain free.

    • Unfortunately only the surgeon examining you or looking at your studies can give you an idea of the source of the pain in your case.

  14. I appreciate this site! Thank you, it is a great resource. I recently had plica surgery on both knees. I am confident I needed it on at least my left, but had similar problems starting with the right and didn’t want the same thing to occur. I had both medial plicae excised arthroscopically within a month, the surgeon said they looked identical during surgery. The first one was worse and still hurts a lot at certain times (similar localized sharp pain.) I find that a day or two following exercise (3 hours downhill skiing or just 15 min. on elliptical) I have sometimes excruciating pain (but little swelling), so have been resisting more frequent exercise. I also have a lot of pain with 90 degree wall-sits but can do 45 degrees for as long as I want. Squats are very painful. I do PT 3x/week. I was very fit prior to plica problems about a year ago. My Dr. feels the pain is normal as it’s only been 4 months and recovery can take 6(?) Does this seem correct? I realize it’s hard to recommend without seeing me, but I remove all of your responsibility for any advice – would you tend to favor an aggressive rebound strategy despite the pain or do you feel like that could potentially make things worse? Many thanks!

    • Plica surgeries can be more difficult in terms of recovery than patients think. Generally working aggressively to regain motion, strength, and function with a physical therapist can get patients back to prior levels. Since I am not involved with you, it is hard to say if aggressive rehab is what you need. Hope it gets better!

  15. I just had a medial plica removed from my righz knee this morning. I have had a meniscal tear in my left knee about 2 years ago. I was able to bear full weight on it just hours after surgery. Now today with my plica removal I am in a lot more pain anf unable to put full weight on my leg. Is this any cause for concern?

    • I can’t say specifically in your case, but plica surgeries can be painful and have swelling, even more than people expect.

  16. I had plica removal surgery just over a year ago and still have pain. My range of motion is good, but the knee feels very tight and I have pain above a below the knee that just won’t go away. The post op MRI showed inflammation and scar tissue that don’t seem to be going away. I haven’t been able to run and cut back and forth because of the pain and the knee doesn’t feel stable.
    Any advice would be greatly appreciated.

    • You probably would be better off asking you orthopaedic surgeon. Often, though, a surgeon can arthroscopically clean out scar tissue to help with pain and range of motion. Your surgeon can direct you to treatments appropriate in your specific case.

  17. I had a synovectomy and plica removal of my left knee this past January for medial pain. Cortisone injections only gave very temporary relief. Post surgery rehab has been difficult. An MRI reveals inflammation. Keeping the knee flexed for 5 plus minutes results in pain upon extension of the knee and takes about 1 to 2 minutes before the knee is fully functioning. A big problem is a “clunking” sound and noticeable movement between the upper and lower leg when I flex the knee – walking, exercising, or on my back simply flexing the knee. I can hear the clunk and see the clunk of the lower leg slightly moving either out or in alignment of the upper leg – not sure what direction. Walking is not a problem after a couple of minutes. Any activity that requires impact and/or movement makes my knee feel slightly unstable.

  18. Hi Doc
    I had my medial plica surgery, done 3 weeks ago.
    My leg is stll very stiff and painful, I cannot bend down, going up and down stairs is very painful.
    I don’t have full range of motion. I have been doing the exercises at home and pysio 2x a week.
    I am limping with slight pain, tightness and swelling.
    Is all this normal in the healing process?

    I’m very stressed about this, when I speak to my OS about this, his answer is that he does not know.
    Please help with any advise on healing.

    Kind Regards

    • Plica surgery can be harder than most patients think to overcome. Often there is quite a bit of stiffness and swelling. You are correct that you’re orthopaedic surgeon can give you more specific advice than I can, unfortunately.

  19. Hi doctor

    I have a bit of a medical mystery. I get intermittent swelling in my left knee and have been since the age of 10. There is not that much pain mostly swelling. I have had the whole rheum work up and have seen many rheumatologist and it is always negative. Once the swelling starts nothing can get it under control unless I get a synovectomy. I have had three thus far. Pathology on synovial tissue is always non specific. The rest of the knee is completely healthy.

    I know from my own experience that it is something bio mechanical that is causing irritation and causing the synovitis. As every time it’s swelled something has changed I.e getting new pair of orthotics. My orthopaedic surgeon does not know what to think and has never seen anything like this. This past time however he removed a large plica. He also realized that the past surgery he missed it has we saw it on an old MRI. Is it possible that the plica could be causing the synovitis?

    • I have seen a plica cause localized pain, irritation, swelling and snapping, although I have never seen one cause generalized swelling or synovitis. Having said that, I can’t really tell what could be going on in your case without examining you and looking at your studies. I hope it goes well!

  20. Dr. Geier,

    I have been diagnosed with likely Plica syndrome bilaterally. My symptoms seem to fit clinically. I was playing sports with my nephews (I am 43 and not in shape for what I did- soccer, basketball, batting cages). I have begun physical therapy for my symptoms this week. You have said most people get good results with conservative treatment without surgery. How long (on average) does it take to typically see a response from PT.

    Thanks so much for your time.


    • Every patient is different, and it is often difficult to tell if the place is a patient’s clear source for pain. Having said that, I usually see pain resolve over 4-6 weeks, although it can take longer,

      • I have also just been diagnosed with a thickened medial plica, the background is a blunt twisting injury which produced pseudolocking, visually apparent kneecap dislocation (~0.5 cm?), pain on activity for the last 2 months. My inclination following my diagnosis (yesterday) is to avoid surgery and try to resolve the tissue problems with friction massage to eliminate scar tissue & RICE treatment. Does a presentation like this typically resolve non-surgically?

        • Both place syndrome and patellar dislocations can be treated without surgery effectively in many patients. Physical therapy can be helpful to help people return to activities.

  21. I had bilateral scopes yesterday and both plica were removed. I was told to use crutches as needed, but I haven’t used them much. In 5 days I am supposed to go to a big event at my school, should I use the crutches there for extra protection?

    • I would defer to whatever instructions your surgeon gave you. Generally weight bearing is not restricted after surgery to debride a plica.

      • THanks for the response. Can crutches help even if I am able to fully weight bear. Since the surgery I have been walking small amounts but with a limp, and I am pretty unstable. Would the crutches be useful or not worth it at the event which entails a lot of walking and standing?

  22. Dr. Geier,

    I have a possible plica syndrome and MCL sprain (MRI showed enlarged plica band and fluid around my knee). I am in my 5th week of PT and not getting any better. ROM is slightly better but pain is still very bad. Doctor wants to give me a cortisone shot and if that doesn’t work, then do exploratory surgery to possibly remove my plica band. Does this sound logical to you? I need to get rid of this pain. I am a very active person and would love to get back to sports soon!

    • Callie, it can be hard for orthopaedic surgeons to know for sure if a patient’s pain is coming from a place, because many people have them and have no symptoms. PT, injections into the plica, and activity modifications are usually reasonable efforts before surgery.

  23. Dr. Geier,

    I am about 5 weeks post op from a plica removal. I have been out of PT for about 2.5 weeks now, because I went away to school. I just got back full ROM in both knees, and most of the swelling is down. There are times when the muscles will misfire, and my knees will catch. I am defietly lacking quad strength. I tried jogging, but couldn’t make it more than about 20 feet. How long does it take to get back to running? What about getting back to playing contact sports? Any insights you have would be great! I am away at school, and can’t see a doctor or physical therapist.

    • Everyone is different, but it can take active people longer than they expect to regain full strength and get rid of all knee swelling after removal of a place. Generally I have seen patients return to full activities and sports within 6-8 weeks, but all patients are different.

  24. Hi
    I know this article on the knee, but I was told my daughter has plica in her elbow. She is 9 and is a competitive gymnast and cheerleader and is EXTREMELY flexible. she has been working for weeks on her double back handspring going into a tuck. From what I understand, plica can happen due to over use, which makes sense because she haa really been working on this skill which puts a lot of impact on her elbows when done incorrectly. Can you recommend any good websites/information to read up on plica of the elbow. I’m looking for treatment, recovery, good PT to do at home, how we can prevent this from happening again? Thank you!

    • I don’t know that I have any good websites to recommend. Generally many patients have plicae, but they can become symptomatic in people as a result of overuse. I usually have patients see a physical therapist for strengthening and to decrease pain and inflammation, and then they can transition to a home exercise program. Hope that helps!

  25. Hi! I am 3.5 months after a plica removal and the PT has discharged me and told me to try running again. (I tried at about 5 weeks post op but started feeling pain after 2 minutes; and I tried the treadmill and 3 months post op and it still hurt)I play rugby and lacrosse and really want to get back as soon as possible. How will I know when I am strong enough to get back to contact sports and the side to side/ changing directions involved in playing sports? I want to get back to it, but I also am afraid of injuring myself if I am too weak… I am in college and can not ask my regular ortho, so any information would be great.

    • I don’t know that there is an easy or correct answer. Generally I recommend that my patients go out and gradually work in to activities slowly and see how the knee does. Doing motions and drills that are involved in the sport by himself or herself can help build confidence and determine if the athlete is getting close to being ready to play.

  26. Dr. Geier,
    I might have to have plica surgery on both of my knees. I play high-impact sports like basketball and tennis. I have heard of a lot of cases where they can never run the same as how they did before the got the surgery, but then again they only had one of their legs operated on. Will I ever be able to get back on the court?

    • Generally surgery for a place is rarely needed, but patients usually do return to sports and exercise at the prior level after it.

  27. 5 years after being diagnoes with bilateral PFPS coming from collapsing arches in my feet, hip allignment, (and I think small knee caps). I was set to have exploratory arthroscopy bout 4 months ago in which they removed both plica (enlarged and the dr said they were probably causing sig. amount of pain). My knees feel better, and are mostly back up to strength. However, every once in a while on stairs or something I will feel slight pain that goes away quickly. I can work out on the elliptical and run for short periods of time, but I am still afraid to go back to contact sports. Am i incorrect in the thinking that my knees are prone to injury?

    • I cannot say specifically in your case. People with patellofemoral pain or place syndrome and no other structural damage in the knee usually are not at inherent risk for injury.

  28. I was injured at work in January.
    I had an inflamed Plica “debrided lightly” 4 months ago. I have seen small improvement, however I still have insatiability, pain on my medial side, and under my kneecap, and swelling.I have had these symptoms since the operation. While it has improved somewhat, I still cannot walk without pain.
    I also have grad three arthritis that was found during the arthroscopy. I was completely fine prior to my injury in January.
    The Plica was found whilst the surgeorgon was looking for a torn meniscus. My meniscus is intact.
    He feels it should be healed by now.
    Could this be scar tissue?
    Could my Plica have regrown?
    Do I need more healing time?
    I am doing physio to strengthen my quad.
    Thank you.

    • I really can’t know without examining you and performing your surgery. Patients who undergo plica removal often take several months to return to normal. Physical therapy can be very helpful restoring motion and strength. Arthritis can certainly slow a patient’s recovery.

  29. Hi I had this surgery a few months back and was unable to walk for like two weeks without crutches. Is that normal? My foot also turned purple and my knee was very red and VERY painful.

    • I can’t say that the symptoms sound normal after arthroscopic knee surgery, but I also cannot know exactly in your case specifically without being involved in your care.

  30. Dr Geier,

    I had a menisectomy surgery 7 weeks ago and my knee is still swollen and is sore. I had a meniscus tear but my orthopedic doc also found plica, chondromalacia and a lot of scar tissue. I don’t understand why my recovery is taking forever. Do you think probably cause i am on it a lot? I just don’t feel like I’m back to normal. I don’t have my full motion back yet. Im just worried for the most part and its been a very hard road for me. Especially since I’m a very active person. Things aren’t as they were before surgery and my left knee is starting to hurt me but it may be due it compensating for the right knee. Currently PA is having me take 600mg of ibuprofen 3 times per day. Hopefully it helps me.

    • A plica and scar tissue can extend the length of recovery in arthroscopic knee surgeries. I don’t know if that is the explanation in your case, so I think it’s worth asking your surgeon. Good luck!

  31. I was diagnosed with PFPS almsot six years ago, and about 8 months ago I ended up having arthroscopic surgery in which they removed my plicae in both knees. I was told the PFPS came from/ was aggravated by collapsing arches in my feet, my Q angle, as well as having small knee caps. Do these things make me prone to knee injury? I also have gotten bad shin splints the last 4 years during soccer season. During PT after my plica surgery the therapist told me my knee caps were small and tended to move inwards and I should be careful. What doe that mean exactly? I am looking at playing rugby, but I REALLY don’t want to hurt my knee again. Any help would be great as I am away at school and can’t contact my orthopedist.

    • I can’t say in your case without being involved. Those are all problems that often improve with physical therapy or at least working on home exercises.

      • Thank you very much for your response! I have done physical therapy 3 separate times, and continued doing home exercise programs. However, they were all unsuccessful, so far the plica surgery was the most helpful. Does that help at all? Does it make sense for me to be careful, or am I being paranoid?

  32. Dear Dr
    May I Ask You Please whats Should Be a Plica Pain ?
    and each kind diversity of Symptoms can make plica Syndrome dificult to know wxactly what is ?
    Thanks so Much
    have a pleasent day
    andre Japan

  33. Dr Geier,

    my 15 years son is an active competitive tennis player and has gone under 4 surgeries (2 on each knee) for plica and this weekend he had to whitdraw from a tournament due to a pain in his right knee.As much as I don’t want to belive that the plica has returned he told me that the pain is same as prior to his surgeries.
    Any advise so we don’t end up with 5th surgery and prevention?
    Thank you,

    • I can’t say that I have seen plicae return, so I might be little able to help. It can be a good idea to find out what is the cause of his pain.

  34. I went to my doctor and they told me that i had plica syndrome and this has been going on for three years. My doctor has suggested that i have the surgery. Do they put you to sleep during this surgery??

  35. I was recently diagnosed with inflamed plica on my left knee. 32 years ago (I am am 52) I had a complete ACL tear and partial MCL tear on the same knee. I now have a modest sized bone spur on the medial side of the knee and early stages of OA as well.

    This spring, after a short bike ride I developed patella femoral syndrome which resolved, and I have been in PT building back muscle. But the more I walk the more pain I’m in. I am no longer able to tolerate the PT excercises. I can barely walk 10 minutes without flaring up in pain. I had a cortisone injection 2 weeks ago and it didn’t help.

    I am about to start looking for a surgeon. What do you think is going on? Could a simple plica removal help or Is my situation more complicated due to the bone spur and old ACL tear?

  36. My 14 year old daughter is having her knee scoped for a plica removal. She plays volleyball and has been having knee pain since August and was originally diagnosed with patellofemoral syndrome, but the 3rd doctor said it was a plica. The steroid shot did not help and the pain keeps getting worse. Is there any chance that it could be a torn meniscus or something else?

  37. I hurt my knee 8 months ago while squatting down to do laundry. There was a very painful snap that knocked me on the floor and then quite bad pain over night. I was able to walk the next few days and went on a trip I had previously planned. While walking the pain became overwhelming and my leg started to give out or collapse. When I returned home I went to see a physiotherapist who believed it was a meniscus. I have had 2 MRI’s over the past 8 months that are both negative for any visible issues. I have been wearing a brace due to the pain. My knee aches constantly as well as shooting pains, walking downstairs is painful. I cannot squat down it feels like something is tearing (like. Thin film) is the front of my knee. I have been doing exercises as part of physio and the knee starts to ache badly after doing leg raises or leg extensions. Both MRI’s do not mention anything about the plica. I’ve read and researched quite a bit about it and in viewing my MRI it looks like this could be an issue even though it was not mentioned. Will cortisone shots help? Should I be using a cane it crutches? It seems my doctor is not taking it seriously as my MRI, X Ray and ultrasound have all been negative. It is very painful, even when sleeping or sitting my knee aches, is this consistent with plica?

  38. When I was a freshman in high school, I had my plica band removed from my knee along with lots of cartilage. I was told that my knee looked like an 80 year olds from all the damage. I was very active in cheer, track, basketball and rodeo. I am now a senior in high school, and I still have a harsh pain. I stopped playing basketball and running track my sophomore year, and I am now back in cheer as a senior and I still rodeo. We had cheer practice today and my knee is pretty swollen and is killing me. Any case what the issue is?

  39. My left knee has been swollen and sometimes painful for one year. My doctor said it was a plica and MRI showed a grade I-II chondropathia in both of my knees. I have an unusual feeling in both my knees,sometimes pain. It started with my left knee in which the doctor saw the plica. He thinks all my problem was caused by plica and it wasn’t because of the chonropathia. He said that the chondropathia is not serious in my knees but having these symptoms in my knee he suggested to me a plica surgery in my knee. I am afraid of it and I also read that you think that most plica surgery are unnecessary. And the other thing I m afraid of is that my knee will hurt more after the surgery than now.because now I only feel my knees uncomfortable when I ride a bike or run or doing activities like these but I don’t really feel pain just sometimes. So I would like to know what you think of it, should i get my knee operated because it has been bothering me for a year or is the surgery unnecessary if my doctor would only do it because of the plica? Thanks.

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david-headshot I am an orthopaedic surgeon and sports medicine specialist in Charleston, South Carolina.

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