100 lb. Club - Who Should I See About My Knees?

Should I go to a physical therapist or to an orthopedic surgeon? I know the PT can probably make my knee feel better, but I'd really like to know what is going on inside the knee. Looking back over the last few years, I can see problems with my knees for a long time. Now, its just much worse. Can a PT determine the cause? Can I see an orthopedic surgeon if surgery is not yet an option?

Rhonda, I went to an orthopedic surgeon to find out what was wrong with my knees. Matter of fact, I got the doctor's name from my PT, who I was seeing at the time for rotator cuff rehab. She said that she couldn't diagnose knee issues (or any other kind) when I asked her what she thought was wrong.

I'm not sure how your health insurance works, but I can only see a PT with a doctor's referral. So I'd start with a doctor if I were you, find out what's going on, and figure out the best way to treat it. :)

In my case, all it took was a set of Xrays to diagnose my issue.

I say see an orthopod, they can at least order the x-rays/MRIs or whatever you need....just because they're also surgeons doesn't mean you necessarily need surgery...I saw my orthopaedist for my ankle and he got me the right pain medication, the boot I needed, and even a referral to the PT. So I vote for Ortho to start! It doesn't hurt to know a good ortho guy "just in case"!

PTs don't diagnose, you should see the orthopedic for that. The orthopedic should be able to diagnose you and tell you whether he thinks PT or surgery is the better option for you. If you tell them you don't want surgery and would rather do PT, then they usually accept that unless they think the surgery is necessary. I've gone through this whole thing before with my back AND my hip. PT both times and no surgery. Good luck to you!

I can also only see a PT with a doctor referral. Go to the orthopedist, get a diagnosis, and ask for a referral to PT. The PT can then work with the diagnosis and "prescription" from your doctor to develop a plan that will fix your problem (for example, my diagnosis was post-arthroscopic surgery and patellar malalignment, and my doctor wrote me a prescription that said "increase range of motion, improve IT band flexibility and leg muscle strength", which were the things that would help me resolve the problem). The PT's job isn't to diagnose, it is to strengthen/improve function based on the prescription from the doctors.

Thanks everyone! I'm starting my search for a great orthopedist today.

Good luck, it is a tough road. I agree, see an ortho. He had dx and send you to a PT. My insurance is ridiculous. They cover NO PT unless I have a knee replacement! Hello, I am trying to AVOID a knee replacement! So I got some books and am doing my own PT until I am ready for surgery. You probably need xrays and perhaps an MRI, which is what I had, to dx my severe degenerative arthritis and torn meniscus and bone spurs in my knees. And I am only 38...

Lyn
TWENTY SIX pounds gone!
My Blog:
www.escapefromobesity.blogspot.com

I was referred to an Ortho by my PCP when I severly sprained my knee in the fall of 2005. I will say that I did do PT and followed the surgeon's instructions to a "T" and I have had *no problems* <quickly knocks wood> since then.

Good luck!

I really have nothing to add since your question has been well answered already. I just wanted to say that I hope you find a great doctor, perhaps a recommendation from a friend, and that you find some good answers and some relief. Good luck. Let us know what they come up with.

If you have a family doc, you could get a referral from him or her to the orthopedic surgeon they recommend. Usually they will refer you to the best one they know, and you don't have to search in the phone book wondering if you're getting a good one or not. :)

Good luck, it is a tough road.


Yeah, it is tough. I've always wanted my own treadmill. Now, I finally have one and was really getting into walking on it everyday...only to start having big problems with one of my knees. Both hurt, but one is much much worse than the other....and, I'm only 43.

Yeah, it is tough. I've always wanted my own treadmill. Now, I finally have one and was really getting into walking on it everyday...only to start having big problems with one of my knees. Both hurt, but one is much much worse than the other....and, I'm only 43.

We are the same age so literally I feel your pain!! I have a friend who works for an ortho in another state...and I got an earful about not going to the doc for a few weeks. I was afraid he would tell me I needed surgery. I quite literally could not walk down stairs or inclines. Not good. Flat areas I was *fine* unless I overdid (and at that weight I hardly "overdid" exercise ever).

Who knows? It could be as simple as needing better sneakers or requiring inserts, etc. I know it is worrisome, but hang in there until you get a diagnosis.

I have been to an orthopaedic surgeon twice regarding the condition of my knees. I have also ended being refered to their physical therapy department as well for leg muscle strengthening exercises to do at home. I have also been refered to a prosthetic expert who made a custom-made ($1100) flexible brace for me to wear while walking. All of them work as a team. The doctor can diagnose the condition of your joints and where you are at in terms of a time line.

I was told in 2003 that I could have surgery immediately for a total knee replacement on my right knee. I asked what was the outside limit of how long I could wait and he told me 5 years. I did not have it then because we were planning on moving from Minnesota to Georgia and I didn't want to take off time from work. Now, I wish I would have. Now, I don't have health insurance and I have had several years of increased pain and lack of mobility.

If you have health insurance, it doesn't hurt to have a consultation. Knee damage is progressive and it only gets worse before it gets taken care of.

Good luck

bad knees suck! i feel your pain too, i'm 41 and my knees sound like rice krispies when i go up/down stairs hahaha

i asked my doc about it, what could be the problem, and he said (he's a REALLY nice guy, not mean at all) "I think it's the extra PERSON you're carrying around" hahahah it was kinda funny!

i'm down 40-ish lbs., and i do feel better - but i'll keep an eye on it...i want those knees workin' til the end!

PTs can't diagnose, although we are petitioning the AMA for diagnostic rights. If we are granted that, then you can go straight to a PT. Until then, you can go to any doctor (even your GP) and if THEY refer you over, you can come to us. BUT if you go to your GP and he says "I dunno, go see a PT" and the PT thinks something specific is going on that changes the doctor's orders in any way, then you'll have to be sent back for more specific tests and another referral order will have to be written. We can't order tests. We can and do generally have a good idea what's going on, but we can't order MRIs or X-rays or anything like that. An orthopedist will be able to order all the tests right off the bat, and with those test results can write you a referral to a PT. Then we can help you much better. :)

As for doing the exercises--DO THE EXERCISES! Trust us. The exercises aren't meant to strengthen your body in a global, noticable way. Many of the exercises you'll be given are for small, secondary muscles. A HUGE issue in PT is noncompliance, ie not doing your exercises. I promise you you'll get better, faster, if you do! :)

Rhonda--Good luck w/ your search! All I can do is echo what everyone else has said....start w/ an ortho who may recommend pt. I learned SO much from my pt!!!!!!!!

I would go to your PCP first. I had back issues and I went to my Dr and then he told me to get an MRI and then he sent me to an Orthopeadic Surgeon... And I didnt have surgery until it was the last option.... we tired other stuff first... so just because you go to a surgeon doesnt mean that you will have to definately have surgery

Rhonda - I had awful pain in my knees (which is one of the reasons I decided I better loose this weight) I rarely have issues now, thank g-d. I also make sure to wear very good shoes (I wear Ecco)

Rhonda - I had awful pain in my knees (which is one of the reasons I decided I better loose this weight) I rarely have issues now, thank g-d. I also make sure to wear very good shoes (I wear Ecco)

Thanks, Mrs Quadcrew! I know that you walk everyday, so that is encouraging. Hubby and I are going to the running store this weekend to have our gaits analyzed and get fitted for good shoes. I'm hoping that I can get walking again soon. I was really getting into the new muscle definition I was seeing in the calves and the tighter thighs.:)....not to mention, the quicker downward movement on the scales!