Ruptured acl, torn mcl and lcl, damaged meniscus both sides and refused surgery

[Wee chris]

Hi, I am new to this forum so I will introduce myself. I'm 24 living in the Uk so all treatment is under the nhs. I compete and have compete for several years in weightlifting or more specifically powerlifting. About 12 weeks ago in training, my training partner passed out whilst squatting over 400kg, he fell backwards and landed on me, the safety bars caught the weight, but my leg was twisted really badly.
After an MRI scan I was told I have
Ruptured the acl
Torn mcl to unknown degree, but it feels noticeably lax
Torn lcl same as above
Torn meniscus both sides, again not informed to the degree or type of tear, but do get pain from certain movements, and it has had episodes where placing weight on the leg causes incredible pain, but only lasts for 20 minutes at a time and only happens maybe once every 2 weeks so far.
I was also told I have damage to the posterolateral corner.

My surgeon is very keen on the fact I'm a competitive weightlifter and is confident aggressive physio will have me competing again in several months.
My intuition disagrees, in competition I can be expected to squat no less than 300 kg. I can only imagine any weakness in the knee and it will show with max weights on the squat.

Can any experienced physics advise or anybody who has been in this situation before please comment.
I feel that his advice is lining me up for a much worse injury, but don't want to stop competing, I currently hold several national records.
P's. Physio starts tomorrow
Bst regards
Chris.

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[Emanuele]

Hello Chris,

I am not an expert physio, but the presentation you gave us seems to be pretty serious.
Would be interesting to know the exact degree of lesion on the structures you mentioned, but my personal understanding of the injury you had sounds quite nasty.
If the ACL is fully ruptured then you need a surgical operation, and same applies to a 2/3 degree sprain of the MCL and ACL. If your menisci were to be removed than you would lose a great biomechanical advantage on your knee for what concern joint congruity and weight dissipation. (without menisci our the force passing through the tibial plateau is 5 times greater, so you can understand that putting even more weight on your knee is not the best thing to do)
I am puzzled that your surgeon suggested that, but it is true as well that surely he/she may have lot of experience and surely a better understanding of the your case.

Wish you all the best

[Wee chris]

Hi, thanks for the reply,
I'm just back from physio, they seemed confused by the fact that I had not been offered surgery.
On tests I have nearly full range of motion, but have problems straitening the leg with toes pulled back but not pointed.
Can perform single leg press with above expected weight for a person to be discharged so leg strength is not an issue.
In terms of injuries, lateral meniscal tear on horn ?
Grade 2 tear in lcl and mcl, though the mcl seems to have healed fairly well and presents fairly well in tests, the lcl opens a fair bit but the physio has said it is far from the worst she has seen.
My concern isn't so much if I can get by without surgery, the OS has informed me I should be fine to return to competitive weight lifting, where I would squat normally around 300 plus. I can't see that happening safely without surgery.
I'm confused as to what to do. Can I book an appointment to see the surgeon again and try to push for surgery. Dsperately seeking advice. .

[Emanuele]

See what the surgeon says, to me this is not a knee that can so lightheartedly go back to sustain such heavy weights. But I may be completely wrong.

all the best! let us know how your coping!

[Wee chris]

I spoke to the head physio he has indicated that he cannot understand why I have not been offered surgery when my knee is so unstable and the dangerous position that places me in my sport.
He has said he will speak to th surgeon and see if he will offer me surgery. I am not so sure if this will be the matt resolved, but the physio has told me he holds quota bit of weight as he is a specialist in complete knee dislocations which I had.
I can only hope tha this will at least get the ball rolling again when it comes to surgery.
I just can't understand why the surgeon would suggest this approach to me.
On the plus side I had horrible, violent shaking in my knee when tying to straighten my leg, which completely slides the physio but happened to see my osteopath after and he took around 30 seconds to find the problem and a corrected it immediately, a lot easier than I thought.

[Emanuele]

As I said before, it sounded too strange to me that you could get on just with rehabilitation for such an injury... quite curious to know what your osteopath diagnosed and did on your knee, if you don't mind to share, as I'm an "osteopath-to-be" and that has caught my attention

all the best

[Wee chris]

I don't mind sharing at all, Brian my osteo had lay me on my back, pushed my leg bent to the side applied pressure on thin side of thhip and groin area and asked me to straighten my leg, that did the trick. I didn't get a full explanation off him I was just happy I could move the leg properly, what I did gather was that it was something to do with where the nerve crossed th hip at the front of the leg and groin area, it was not allowing the muscles of the leg to fire, but only when the toes were pulled back, with throes pointed I could extend th eg fine. Very strange one indeed, but Brian is very good.

[Emanuele]

cool stuff, maybe he did a manouver to free the femoral nerve up... well done and thanks for sharing