Hi Guys

I have a client (18 years old footy player) who twisted his knee 5 weeks ago.

Mechanism: lateral knee rotation on a flexed knee (twisting out on a fixed foot)

He is now much better, however he still experiences pain on kicking the ball with the inner side of the foot. He also complains on a feeling of "instability" in the knee

Facts about his current status:

- positive medial Mc'murrays & negative prone and standing Appley's compression
- no pain on medial joint line (firm) palpation
- all ligament provocation tests are OK (MCL, LCL, ACL, PCL)
- pain on passive knee flexion and extension (especially with overpressure)
- feels fine with CKC exercises (SL deadlifts, lateral squats, rotational lunge) and nordic curls
- good proprioception and knee appears stable whilst performing excursion exercises

My questions:

1.) is it possible anyhow that he has got stage III medial meniscus rupture, which contraindicates aggressive CKC strengthening? (he does not have locking, crepitations or pain during active and passive knee motion)....ROM is also near full. Does such a clinical observation rule out stage III lesion?
2.) is it more likely that deep coronary ligament is affected?
3.) is there any chance that the knee cartilage is damaged (althoug clinically appears to be fine?)

4.) And most importantly any other suggestions in terms of follow up treatment? (Continuing with CKC, Foamrolling,...)?

Thanks in advance

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