Pierre Joubert/Physiotherapist/Physio on Ross
What is a Plica?
A plica is commonly found on the anteromedial aspect of the knee, it is a fold of synovial membrane/ tissue. Plicae are only present in about 50% of the population and are thought to be the fragments of embryonic connective tissue that never fully resorb during your fetal development. We may potentially have four plicae, but in most cases plicae are asymptomatic.
The medial plica, however is mostly symptomatic and runs parallel to your medial patella and inserts into your fat pad. Plica Syndrome then is essentially an inflamed plica. Your plica can become irritated during activities such as repetitive knee straightening and bending, blunt trauma or knee twisting, fat pad irritation, altered knee motion or internal knee derangements such as meniscal tears. Plica syndrome often does not always occur in isolation, but concurrently with other knee conditions.
How is Plica Syndrome Diagnosed?
Your physiotherapist will be able to clinically diagnose plica syndrome. It is more important that you have your knee thoroughly assessed by a physiotherapist or sports doctor to exclude other knee pathologies, in particular meniscal injuries.
X-ray may be useful to rule out other associated pathologies but will not identify a plica. MRIs can identify plica inflammation. However, MRI is more useful for diagnosing other pathologies that may be related to the plica irritation.
Plica Syndrome Treatment
Studies show that about 60% of patients with plica syndrome will settle successfully with conservative physiotherapy treatment within 6 to 8 weeks.
- Improve patellofemoral (knee cap) alignment via taping, bracing and exercises.
- Normalise your muscle lengths.
- Strengthen your knee quadriceps muscles (especially VMO)
- Strengthen your hip and lower limb muscles.
- Address foot biomechanics issues.
- Improve your proprioception, agility and balance.
- Improve your lower limb function and quality of movement when walking, running, squatting, lunging etc.
Should your symptoms persist beyond 3 to 6 months, arthroscopic knee surgery for a plica syndrome may be considered. The most successful surgery involves the removal of the plicae.
If you want to know more about how to self-manage the condition through strapping, bracing or exercises please feel free to come in and see one of our Physiotherapists. It would be recommended that a full assessment and a course of conservative treatment be administered by a Physiotherapist if you suspect that you might suffer from Plica Syndrome. If you have any further questions, feel free to make an appointment with our friendly team at Physio on Ross (07) 4728 2116.