There may be many different reasons why you have knee pain. One type of syndrome that is normally overlooked is called Plica syndrome. This can start to cause a dull achy pain due to an injury or overuse.

What is a Plica?



The Plica is a fold in the lining of the knee joint.  A good way to think of this is pretend that the inner lining of the knee joint is like a sleeve of tissue.  Synovial tissue makes up this sleeve of tissue. Within this sleeve of tissue, there are folds that allow the bones and joints to move without restriction. There are four  different Plica folds that are found in the knee. Out of all three of the folds, there is only one fold that always seems to be a trouble maker. The trouble maker fold out of them is called the medial plica. The attachment point for the medial plica is the lower end of the patella. It runs sideways medially and attaches to the lower end of the femur.


Why is the Plica causing pain?

When the plica is irritated, pain may arise. This is called plica syndrome. Repetitive motions that repeatedly bend and straighten the knee can irritate the medial plica. Some of these activities include but are not limited to arising from a chair after sitting for an extended period of time, squatting and bending, running, biking or using the stair climbing machine. Other causes that would irritate the medial plica is if you strike your knee against something. Many times patients have Plica syndrome for hitting their knees on the dashboard during a car crash.  Injury to the plica may cause scarring and thickening which may cause problems later on.

What does Plica Syndrome feel like?

You will have pain along the inside of the knee . There are many different other causes of knee pain so it is important to get checked out by a medical professional. You may experience a snapping sensation along the inside of the knee as the knee is bent due to the rubbing of the plica that has been thickened due to injury. Sometimes the plica will catch over the medial aspect of the medial femoral condyle. The plica may be tender to the touch if this is the case.





How do I know if it is plica syndrome or something else going on with my knee?

MRI is one of the ways to differentiate the common causes of knee pain.


How can Dr. Goldstein help you?

First thing you want to do is modify your workouts that you think is irritating the knee.

Stretching and strengthening exercises will help with your injury. Ultrasound, friction massage and other therapies may be use to help decrease the irritation in the plica.

It is important to build up strength in the quads because the plica is is dynamically controlled by the quadriceps muscles. These exercises can include quadriceps sets ,straight leg raises , leg presses , and mini-squats.  The hamstrings should be stretched out as well because tight hamstrings can increase the force needed to extend the knee which can be a source for irritation to the plica.