Welcome to Momentum Health's patient resource about Plica Syndrome.
Plica syndrome is an interesting problem that occurs when an otherwise normal structure in the knee becomes a source of knee pain due to injury or overuse. The diagnosis can sometimes be difficult, but if this is the source of your knee pain, it can be easily treated.
This article will help you better understand:
what a plica is
how plica syndrome can cause problems
what doctors can do to treat the condition
Hear from some of our patients who we treated for Knee Pain
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Still going to momentum health and still love it! Jason is the physiotherapist/ owner and he is absolutely amazing. I dislocated my knee a couple months back and he helped me tremendously! ”
“ Still going to momentum health and still love it! Jason is the physiotherapist/ owner and he is absolutely amazing. I dislocated my knee a couple months back and he helped me tremendously! ”
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The folks at Momentum have been excellent supporting me through my knee surgery recovery. They always listen and respond to my symptoms and encourage my progress. In addition they are helping get... ”
“ The folks at Momentum have been excellent supporting me through my knee surgery recovery. They always listen and respond to my symptoms and encourage my progress. In addition they are helping get ready for my next knee surgery. From reception to all the folks in the back, they are friendly and welcoming! I feel like the old show cheers ' ... where everyone knows your name.' Keep up the great work -- I am a good reference -- my wife is going to come by for some physio. ”
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I recently attended a GLA:D program for education and exercise for osteoarthritis at Momentum Health in Seton in Calgary, Alberta. I was under the care of Dr. Teac Engen 2 times a week for 7 weeks of... ”
“ I recently attended a GLA:D program for education and exercise for osteoarthritis at Momentum Health in Seton in Calgary, Alberta. I was under the care of Dr. Teac Engen 2 times a week for 7 weeks of education exercises for the hips and knees. During that time, I learned valuable resistance training to help build up the areas around the hip and knee joints. The sessions were professionally carried out and I was treated with kindness and understanding. Dr. Engen created an environment for me to excel. He communicated through word and action. He lead by example and allowed me to discuss my feelings openly. He seeks input and involvement from others. He recognizes the contributions of others. I am comfortable going back to the program in the future if I need additional help. Sincerely Linda Rogers ”
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Russ, Mark and Safia were extremely knowledgeable and helpful in helping me with the GLAD program. Anybody with arthritis in the knees, or the hips should go to Monument health at Deerfoot City and... ”
“ Russ, Mark and Safia were extremely knowledgeable and helpful in helping me with the GLAD program. Anybody with arthritis in the knees, or the hips should go to Monument health at Deerfoot City and check out the GLAD program. ”
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Mark and his team were amazing. I came to their office with an uncomfortable sensation on my right knee that it was solved prior to my race last May. ”
“ Mark and his team were amazing. I came to their office with an uncomfortable sensation on my right knee that it was solved prior to my race last May. ”
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I would highly recommend Mark and Safia at Momentum Health for physiotherapy. I received treatment over 6 months for a WCB claim involving wrists, elbows and knees. They took the stress out of the WCB... ”
“ I would highly recommend Mark and Safia at Momentum Health for physiotherapy. I received treatment over 6 months for a WCB claim involving wrists, elbows and knees. They took the stress out of the WCB claim process and continued with thorough reviews to make sure treatment was complete and did not end prematurely. They assessed my condition, developed a treatment plan, and then patiently helped me carry it out. They selected and taught me exercises appropriate to my level of recovery and gave feedback through all the stages. I also received in clinic treatment including muscle release, heat and dry needling. To top it off, the atmosphere in the clinic was always friendly and happy, so treatment became the highlights in my week. They seemed to care for the whole person not just the physical condition in need. Thank you Mark and Safia! ”
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Just had to share my experience with my chiropractic care here at Momentum. Last week my back went out and I was suffering with terrible sharp, excruciating nerve pain. I had been to Momentum for... ”
“ Just had to share my experience with my chiropractic care here at Momentum. Last week my back went out and I was suffering with terrible sharp, excruciating nerve pain. I had been to Momentum for physio and the knee Glad program, but not for chiropractic care. So I called them up and told them about my back pain and they felt I needed an adjustment by one of their chiropractors. I went in and met with Dr. Denis Simons and had my first adjustment. I found him to be an ultimate professional and he quickly found out what needed to be done. After my second adjustment I was completely rid of the extreme nerve pain! I couldn’t believe it! I did the dance of joy! I will continue to see Dr. Denis for any chiro needs I may have in the future. Highly recommend him! ”
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Participated in GLA:D hip knee clinic. Excellent program and well supervised exercise routines and instruction. Suggest anyone with hip-knee issues to look at program earlier rather than later. ”
“ Participated in GLA:D hip knee clinic. Excellent program and well supervised exercise routines and instruction. Suggest anyone with hip-knee issues to look at program earlier rather than later. ”
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The staff here are fantastic! From the ladies at the front all the way to the physiotherapists. I had the pleasure of working with Leah as I navigated my recovery from ACL surgery. She was super kind... ”
“ The staff here are fantastic! From the ladies at the front all the way to the physiotherapists. I had the pleasure of working with Leah as I navigated my recovery from ACL surgery. She was super kind and supportive and every time I came in she had new exercises for me to try and really worked with understanding how I functioned and what would benefit me. Not just giving me the standard exercises. I appreciate the time she took to recognize when an exercise worked for me and when it didn’t. This even meant researching in between appointments to find new studies or techniques to try. I highly recommend the clinic, especially Leah. ”
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I have been enrolled in the GLA:D Knee/Hip program since April 19th and have been delighted with the progress. I have bone on bone on the lateral portion of my right knee and have found over the weeks... ”
“ I have been enrolled in the GLA:D Knee/Hip program since April 19th and have been delighted with the progress. I have bone on bone on the lateral portion of my right knee and have found over the weeks that I am getting stronger and definitely have less crepitus. I was able to hike Grassy Lakes; the more challenging side too. Today Dr. Carpino has started to work on other areas. He is competent, very knowledgeable, and a truly kind, caring Chiropractor. ”
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I am very appreciative that I joined the Gla:d program, it taught me what I needed to know regarding my knee pain. The classes were educational, interactive, and fun & challenging at the same time.... ”
“ I am very appreciative that I joined the Gla:d program, it taught me what I needed to know regarding my knee pain. The classes were educational, interactive, and fun & challenging at the same time. Giancarlo Carpino is an excellent instructor, very kind and patient, very likeable and knowledgeable. You know this is his passion, and that he cares deeply about a person's well being. Worth the time and money spent to attend. ”
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Moustafa Korayem, Physiotherapist I had a wonderful experience under your care. Your treatments have made a difference and tremendous amounts of relief from my chronic knee pain. Thank you ”
“ Moustafa Korayem, Physiotherapist I had a wonderful experience under your care. Your treatments have made a difference and tremendous amounts of relief from my chronic knee pain. Thank you ”
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I can't even begin to say how thankful I am to the team of Momentum Health. I wasn't able to get more than 4hours of sleep per night for a couple of years, I finally went to see Dr. Denis Simmons and... ”
“ I can't even begin to say how thankful I am to the team of Momentum Health. I wasn't able to get more than 4hours of sleep per night for a couple of years, I finally went to see Dr. Denis Simmons and he took a complete different approach than any other chiropractor I have seen before, my mid and upper spinal section wasn't moving they way it should i guess which caused my lower back to hurt, so he focused on a different section of my spine than previous chiropractors. it made a huge change, all of a sudden i was able to get a full nights of sleep. Then i started physio with Nathan Albinati, even no where near of sporting grey hair, he has a ton of knowledge which made me gain more strength in my core. i also had previously very painful experience with dry needling but he sure knows what he is doing. we switched over working on my repaired ACL now and i feel even his assessment is way more thorough than i have had before. Laura at the reception is always kind and welcoming. If you haven't tried this place, you have to! ”
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I cannot say enough good things about Dr. Carpino. He is courteous, inspiring, and committed. He is a consummate professional who gently leads his patience to do their best to exceed their goals. I... ”
“ I cannot say enough good things about Dr. Carpino. He is courteous, inspiring, and committed. He is a consummate professional who gently leads his patience to do their best to exceed their goals. I had the good fortune to benefit from his stewardship in the GLA:D programme. My knees are now better than they have been in years as is my mobility. Kudos and thanks to Dr. Carpino. Andrew Frank Johnson ”
Plica is a term used to describe a fold in the lining of the knee joint. Imagine the inner lining of the knee joint as nothing more than a sleeve of tissue. This sleeve of tissue is made up of synovial tissue, a thin, slippery material that lines all joints. Just as a tailor leaves extra folds of material at the back of sleeves on a shirt to allow for unrestricted motion of the arms, the synovial sleeve of tissue has folds of material that allow movement of the bones of the joint without restriction.
Four plica synovial folds are found in the knee, but only one seems to cause trouble. This structure is called the medial plica. The medial plica attaches to the lower end of the patella (kneecap) and runs sideways to attach to the lower end of the thighbone at the side of the knee joint closest to the other knee. Most of us (50 to 70 percent) have a medial plica, and it doesn't cause any problems.
A plica causes problems when it is irritated. This can occur over a long period of time, such as when the plica is irritated by certain exercises, repetitive motions, or kneeling.
Activities that repeatedly bend and straighten the knee, such as running, biking, or use of a stair-climbing machine, can irritate the medial plica and cause plica syndrome.
Injury to the plica can also happen suddenly, such as when the knee is struck in the area around the medial plica.
This can occur from a fall or even from hitting the knee on the dashboard during an automobile accident.
This injury to the knee can cause the plica, and the synovial tissue around the plica, to swell and become painful.
The initial injury may lead to scarring and thickening of the plica tissue later.
The thickened, scarred plica fold may be more likely to cause problems later.
Symptoms
What does plica syndrome feel like?
The primary symptom caused by plica syndrome is pain. There may also be a snapping sensation along the inside of the knee as the knee is bent. This is due to the rubbing of the thickened plica over the round edge of the thighbone where it enters the joint. This usually causes the plica to be tender to the touch. In thin people, the tissue that forms the plica may be actually be felt as a tender band underneath the skin. In rare cases where the plica has become severely irritated, the knee may become swollen.
Snapping Sensation
Diagnosis
When you visit Momentum Health, we will begin your diagnosis with a history and physical exam. The examination is used to try and determine where the pain is located and whether or not the band of tissue can be felt.
Some patients may be referred to a doctor for further diagnosis. Once your diagnostic examination is complete, the physiotherapists at Momentum Health have treatment options that will help speed your recovery, so that you can more quickly return to your active lifestyle.
Our Treatment
What can be done for plica syndrome?
The majority of people with plica syndrome will get better without surgery. The primary goal when treating the plica is to reduce the inflammation. This may require limiting activities like running, biking, or using a stair-climbing machine.
Non-surgical Rehabilitation
When you begin physiotherapy at Momentum Health, we may first suggest anti-inflammatory medications such as ibuprofen or aspirin to reduce the inflammation. Our physiotherapist may also use ice packs or ice massage to help reduce the inflammation and swelling in the area of the plica. Ice massage is easy and effective. Simply freeze water in a paper cup. When needed, tear off the top inch, exposing the ice. Rub three to five minutes around the sore area until it feels numb.
Additionally, we may apply treatments such as ultrasound and friction massage to calm inflammation in the plica. Our therapy sessions sometimes include iontophoresis, which uses a mild electrical current to push anti-inflammatory medicine to the sore area. This treatment is especially helpful for patients who can't tolerate injections.
Once the inflammation is reduced, our physiotherapist will begin treatments involving stretching and strengthening exercises for the leg.
Although the time required for recovery varies, if your treatment is nonsurgical, you should be able to return to normal activity within four to six weeks.
Post-surgical Rehabilitation
When you begin post-surgical physiotherapy, our first few rehabilitation sessions will be designed to ease pain and swelling and help you begin gentle knee motion and thigh tightening exercises. Patients rarely need to use crutches after this kind of surgery.
As our program evolves, our therapist will choose more challenging exercises. Patients do closed chain exercises by keeping their foot on a surface while working the knee joint. These exercises mimic familiar activities like squatting down, lunging forward, and going up or down steps. These exercises help keep pressure off the kneecap while getting a challenging workout for the leg muscles. Our physiotherapist will work with you to make sure you are not having extra pain in your knee during the exercises. We may also have you do stretches for the soft tissues along the edge of the kneecap as well as flexibility exercises for the hamstrings, quadriceps, and calf muscles.
At Momentum Health, our goal is to help you keep your pain under control, increase the strength of your quadriceps muscles, and maximize the range of motion in your knee. When your recovery is well under way, regular visits to our office will end. Although we will continue to be a resource, you will be in charge of doing your exercises as part of an ongoing home program.
Momentum Health provides services for physiotherapy in Calgary.
Surgery
If all nonsurgical attempts to reduce your symptoms fail, surgery may be suggested. Usually, an arthroscope (mentioned earlier) is used to remove the plica. The small TV camera is inserted into the knee joint through one-quarter inch incisions. Once the plica is located with the arthroscope, small instruments are inserted through another one-quarter inch incision to cut away the plica tissue and remove the structure. The area where the plica is removed heals back with scar tissue. There are no known problems associated with not having a plica, so you won't miss it.
A plica causes problems when it is irritated. This can occur over a long period of time, such as when the plica is irritated by certain exercises, repetitive motions, or kneeling.
