annual knee injury!

[sheepiegirl]

Hi

Hoping some nice person will read this and hopefully be able to offer me some advice!

Ok am aware this is a long post so am going to try and put a brief summary in here: hypermobile, over pronating 21 yr female with right knee pain issues(knee gives out). No sign of ligament or bone damage. Has recieved physio treatment (quad strenghtening).

New to this so not too sure what info about myself is displayed so here's a brief summary: 21yo female who likes to keep fit and active through a combination of cycling, skiing, kayaking, gym sessions and swimming. Currently wears customized orthotics to correct over pronation. I know I shouldn't but I do lock my joints out which I put down to being hypermobile. Also have an inwards rotation of my hips.

As can be seen from the title am having the problem with my knee. First occurred almost a year ago whilst playing basketball, twisted to get the ball but my knee gave out under me accompanied by a popping sound. Followed RICE procedure and not surprisingly had significant swelling afterwards (hopefully pic is attached) but as I was working at an activity camp in the countryside didn't get it checked out for 3days after the injury. Hosp x-rayed and told me to rest up for a few days as it was probably a partially torn medial ligament? (always getting lateral and medial wrong way around the one on the inside anyway!) as this was where the pain was. X rays were clear.

After 6 weeks or so decided to see physio 1 as although most of the swelling and pain had gone down (was still taking ibuprofen) but having problems bending and fully extending my knee and my knee giving out on me whilst going downhills etc. Physio after the 'usual' manipulating thought it was more likely that I had overstretched the ligaments so set about giving me exercises to loosen the ligaments.

Physio 2 wasn't too sure what the problem was (maybe a small meniscal tear) but wanted to restore the extension in my leg and strengthen the quads. This sessions lasted about 3 months and all was going great until I reintroduced 'heavy' weight bearing exercise (e.g. running) this then caused the knee to start giving out again and what I can only describe as like a golf ball of fluid moving from the base of the knee joint round to the top via the medial ligament. Afterwards activities such as walking for more than 1 hour a day also caused the above symptoms. Physio 2 recommended going to GP to get a referral to a specialist. Didn't get around to this until about 6-8 wks after as was overseas. eventually did and was told had to go throught NHS physio first.

Physio 3 then set me back on quad strengthening exercises which helped to a certain extent (think anything to help support the knee joint would though) but during in that time didn't try 'heavy' weight bearing exercise and ended up being referred onto an OA knee group! Physio 4 at the OA knee group was as confused as I was as to why I was their as exercises were too basic and couldn't understand why I hadn't recieved an orthopaedic ref.

Few weeks later (coincidentally almost exactly a year after first time) and I'm turning to step up a step (much the same movement as did when playing basketball) and the knee gives out again. Should add the pain was much worse this time (9/10 compared to 8/10 first time). Carted myself off to A+E immediately this time and ended up with my leg in a splint for 3days and still about a week later on crutches. X ray did show a mark on the bone (wasnt told which one) but Doc not sure if this was from birth or as a result of injury unfortunately xrays from a year ago hadn't been put on my records so couldn't be compared.

Currently can weight bear on the 'bad' leg but walking is a problem as can't fully bend the leg upwards (i.e heel to bum) very well or straighten out fully (still slight bend in the knee) also still quite painful if I do too much shuffling around without the aid of crutches.

If you've reached this far, well done and look forward to hearing any ideas you may have

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[physiofixme]

What you have described has all the hallmarks of a ruptured anterior cruciate ligament. This would be the thing i would look to rule out first and foremost. Get some treatment and get on the list to see an orthopedic specialist who can properly diagnose your condition.

A physio who has experience in sports injuries and dealing with this type of injury should be able to diagnose you and manage your condition approprately. See if you can seek out a good sports physio while you wait for an orthopedic specialist appointment. Meanwhile google ACL rupture and see if you think your symptoms are similar.

Good luck

[sheepiegirl]

Hi

Thanks for the reply. Yep do seem to have a lot of the symptoms but have no pain when the ACL is stressed. Just heard today that I'm now getting to go to a sports injury clinic so hopefully they will have some new ideas.

Thanks again and will be pushing for that orthopaedic ref.

[physiofixme]

Unfortunately once the ACL is ruptured you often don't get pain when stressing it (especially if it happened a while ago) but what you do get is a feeling of laxity (looseness).

[sheepiegirl]

okay dokes, good to know. Will let you know how everything goes in a week's time at the sport's injury clinic. Thanks again for your advice

[owenybhoy]

hi there, i have just read this thread and i am not a physio but i have had several injuries to my knee( including acl rupture). the symptoms you are describing sounds like an acl rupture. it sounds very much like my problem 7 years ago where my gp thought i had just twisted my knee and it ended up being acl rupture and a buckethandle tear of my meniscus. make sure you see a surgeon and like in an earlier post a good physio.

[sheepiegirl]

Hi everyone. Thanks for the posts and pm's guys. have finally managed to persuade my gp to refer me onto a consultant after being at the sports injury clinic where they agree with the majority here that its a ruptured acl. Thanks for the advice guys hoping the appointment will come through soon.

[sheepiegirl]

Just thought I would give an update as know how annoying it is when your researching your knee problems and don't find out what treatment occurs!

So got my MRI results back and thankfully all ligaments are intake but have damage to my articular cartilage and menisci with a blunting of the femur causing problems with patellar tracking. So physio (to build up hams and quads even more) for another 3 months then a reassessment! Still suffering from knee giving out and problems with bending, fully extending it/locking out having kept up physio fully for last 6months (previous year bit off and on depending on pain/ROM) so not too sure that I can train the proprioceptive system much more but not seeing any other options other than to keep going with the physio. Would patellar taping help me get back into weight bearing exercise as currently can't manage this?

Also been finding lately that when teaching breaststroke after only 2 leg kicks then struggling to walk properly for the next few days. along with sometimes I will just be walking along then struggle to lock out knee/bend properly and end up 'dragging' my leg along as it feels like something is catching and stopping the full ROM.

Any advice or ideas would be much appreciated

[sheepiegirl]

Ok another update!

Seem to have made more progress this time visiting the consultant.

Physio has agreed that more physio will not help the problem and still having issues which if anything are getting worse! So surgery is the next option. There are 2 options open to me:a medial patellofemoral ligament recon or trochleoplasty. Going to try the Mpfl recon first and fingers crossed it will work although have been told I have a very shallow trochlear groove so may need a trochleoplasty.

Thanks to everyone who responded privately or publicly to me I hope that's me now on a more stable (pardon the pun!) recovery path now