Knee muscle(?) injury

[maurostsouk]

Hello,


First I'll describe how the injury happened.
Two weeks ago I was playing football (soccer) , at some point I did a tackle and intercepted a pass.The ball was stoped and my opponent was about to kick it away. I tried to stop him while being on the ground by putting my foot in front of the ball, but I had a bad body position with my leg being behind the rest of my body and thus I was unable to put a lot of strength. He kicked the ball with all his strenght which resulted in my ankle being twisted( I have a chronic problem with my ancles). Anyway I got out of the game at the 40th minute because of the pain in my ankle. During halftime I felt that the injury was not that serious, and I decided to make a few sprints to determine whether I would be able to play the second hand. Then I realized that although my ankle was fine, I had an injury just bellow the knee. When I was trying to run it felt like my leg didnt have enough strenth to hold me and it was bending. I am not sure if this was happening from the pain. Of course, I didnt play the second half and I returned home.

Location on the knee:

Searching the web, I found out that my pain is close at what is called the "lateral colateral" if I understand it correct from the figures. It is on the external side of the leg, about 3-4 cm bellow the knee at the place where the bone finishes. A friend who is a doctor but not a specialist told me that my symptoms(see bellow)
show that it is not the lateral colateral but it is probably a muscle.

Symptoms.

I could walk from the very beggining. After 2 days I could walk without any pain.
Right now I can easily jog(havent tried sprinting) without any pain. I still feel pain when I try to take off the shoe of the injured leg, by holding the shoe down with my good leg and pulling the injured leg upwards. This is the movement that hurts me more than anything else. I can also feel pain(not a strong one but I can understand that something is not normal) when I press with my fingure on the injury point(there is a bone at the point so i have to put strength to feel it). Today I went to try to play football with some friends to have an easy going check on whether
I have recovered. In the first 3 passes I made, I felt a (very light) pain and I decided to quit just in case I make it worse.

Does anybody know what may be wrong with my knee and what kind of actions I should take? If this helps I am 28 years old. I play a lot of football and basketball.
I dont go to the gym, I cannot say that I am in general very fit(although above average) but my legs where always very strong and I never had any problems with
my knees. The only problem I ever had appart from my ankles, which I twist often,
was a hamstring strain 2 years ago which has passed.

I would appreciate any help you can give me.

Cheers,

Angelos

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[Canuck Physio]

Hello

Could you update on your situation, was there any bruising in the area?

It has been several days since so it may be helpful with exact details about what causes onset of pain, what relieves it, and if there is any observable or physical changes upon touch?

Thanks

[maurostsouk]

Hello,

No, there was no bruising or anything else that you can see with the eye.
The only everyday movement that causes pain is when I try to take my shoe off
by stepping on the back of the shoe with my good foot and pulling my injured leg
upwards. No other movement causes pain, I can easily walk and run.

When I try to kick a ball it also hurts. I dont know how much because I didnt try to kick a ball with force. When I show that it hurts I stopped, being afraid of doing worst damage.

The pain is not strong(it was strong only the first two days), the only thing that worries me is that it has been three weeks now and it has not passed. There are football matches coming(starting on sunday) that I want a lot to play and I dont know whether that would be dangarouns or not.

Last week I played basketball, at the first 5 minutes it hurted, as soon as I got warmed up I did not feel it. After the game however, it got worse again (not as bad as it was the first two days, but as it was, lets say, about a week after the injury.)

There is nothing special I need to do to relieve the pain, since If I dont do sports there is no pain. If it was anything but the knee I would not worry to much.

Does the fact that It does not hurt when I warm up mean that it is just a muscle injury?

[Canuck Physio]

Hmm..

Okay here are some things I am going to ask you to do, and maybe you can try them and tell me what happens (please be careful not to induce any pain).

Firstly while in sitting:

1. Flex your calf muscles and notice the response
- Add resistance on your knees (with your hands) and repeat
Is there a difference?

2. Dorsiflex your ankle and notice the response

3. Evert the ankle (ie. your outside heel should raise from the floor)
- Is there a pain response? In any of these movements?

Finally repeat the above while in standing.

The reason I ask is because I can not quite figure out exactly where you have descibed the source of problems. The lateral collateral refers to the ligaments of the knee which can only be tested for by hands on work by a therapist. If it is truely muscle or tendon then the above should at least give some indication of which muscles are effected. The area you describe is where the ankle everters (Peroni Longus, and Brevis) attach on the Head of the Fibula. Additionally, the hamstings (biceps femoris) has an attachment on the posterio part of the Head of Fibula. If the above is pain free, then the hamstrings may be suspect and another test is necessary.

Cheers

[maurostsouk]

First of all thank you very much for taking the time to help me. I appreciate it!

The only thing that causes pain is number 3. Actually, now that I think about it, this should be the movement that caused the injury because my ankle was kicked from the inside. I can feel it more when I am standing than when I am sitted.

Cheers

[Canuck Physio]

Hello thanks for that information,

It does appear that the source of your pain is tendon/muscle attachment of your ankle evertor muscle tendon attachments at their Origin in the head of fibula.

I would be interested in knowing how your ankle flexibility is at this moment especially in the time after the injury.

However, I think this will take a little more time to heal than you have before your next game.

I suggest that you see a Physiotherapist and actually get a firm diagnosis on the problem.

However: here are some things you can do that may speed healing ( you will probably need the help of another person)
- Massage the area with something cold, either use ice or a cool (ibuprofen free) gel.
- Warm up the ankle and muscles around the lower leg by completing dynamic movements, such as plantar flexions and dorsiflexions.
- Complete isometric contractions of the evertors (do not move the ankle, but just contract the muscle slightly before the onset of pain)
- Progress to active movement of the ankle, without pain once again both invert and evert
- Stretch the ankle by inverting it while your knee is bent (slowly without pain, for 30s)

This is only a generic program that is only of use based on the information provided, but I suggest a Physiotherapist confirm that it is indeed those muscles, and then you can also receive appropriate stretches that will really target the problem, and massage and exercises that may pin point the exact source of problemes

Cheers

[maurostsouk]

Hello,


After the injury I had a twisted ankle as well and therefore It was in pain.
Now my ankle is perfectly fine, I can make any everyday move without any pain.
Even the move you asked me to do (number 3) produces only a very light pain, so I think it is getting better.

In terms of pain, I think I could even play football now, especially if I do a proper warm up. I am just a bit worried of doing more damage. I'll do your exercises and if it does not completely pass by next week I will go see a physiotherapist.

I show the english flag at your profile by the way.Are you based in London?

Thank you very much for your help.