Bone bruising of femural lateral condyle

[roco42]

Hi,
In january of this year while on the beach in the canary islands i landed awkwardly on a sandy beach while playing "foot volleyball". After this i felt a weakness in my knee while ascending and descending stairs. sometimes my knee would give way.I thought the injury would clear up as i was not training for the next two months. The odd time i did take part in sport my knee would become sore and weak.The pain would be most severe when trying to straighten my leg in a sitting position or raising my leg when lying in bed.
When i did try to resume training two months ago the knee deteriorated further. I eventually got an MRI scan and the radiologist concluded that the medial, lateral, ac and pc ligamets were fine. He found a slight wearing of the cartilage but nothing serious.He did note however, extensive bruising of the lateral femural condyle with swelling beneath the patella and a tiny effusion within the knee. I was recommended to rest the knee and ice it to bring down the swelling and bruising. I did this for two weeks and resumed training only for the knee to swell up and become sore again.
Was it that i did not give the knee enough rest?
Considering the large amount of time since the damage to the knee and the treatment underwent, could there be anything else causing the knee pain?
What treatment and time would you allow for the knee to heal?
Any help would be greatly appreciated!!

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[charlize29]

Hi roco42,

What you are having right now is chondromalacia patella or Patellofemoral Pain Syndrome. Try to avoid activities that increases the load on your knee such as:running, volleyball, basketball and substitute it with low-impact activity like swimming. Strengthening of the quadriceps muscle,SLR( straight leg raises),hamstring and stretching are important.

Regards,

Charlize29

[roco42]

Thanks for the quick reply,
The radiologist was told to look out for signs of chondromalacia and found there was no signs of it. All my symtoms do point to patellofemural pain. I'm resting and icing the injury at the moment and doing some non impact training like swimming and cycling. I'm going to start a stretching regime now too. Is there anything more i can do? Any idea how long it will take for me to get back playing football?

[charlize29]

Hi roco42,

some people will take at least 6 weeks or more eps. for those who have re-injured the site then that's not so good either. Be patient. You have to check out the range of motion and the strength of your quadriceps and make sure you do a lot of stretching. A good re-assessment done by your physio will let you know how you progress with your knee.

Take care!!!

Regards,
charlize29

[jwilso]

sounds like a chondral defect on the femoral condyle. i would rest until symptoms abbolish. maintain ROM and quads power with simple exercises(non weight bearing). recommence sport etc when painfree. if symptoms persist may require further investigation.

[junior_physiotherapist]

Hallo All

First wish to u a fast and full recovery.
In case of chondromalacia x-ray 'll be normal,depends more on clinical findings as Q-angle,...
Any way u've to strengthen ur quadriecps muscles in terminal extension so there is minimal stress to patellofemoral joint,high repetion with low resistance to the point of fatigue is less traumatic to joint than opposite!!,u've to focuse more on sensation of vastus medialis muscle contracting to emphasize it's medial pulling on patella,Stretch iliotibial band ,
Avoid stairs climbing and descending until muscles strength return back,don't make ur's knees flexed excessivly at sitting for prolonged periods,...

[jwilso]

he probably doesnt have chondromalacia. he has a history of trauma and so you probably wouldnt need to look at the biomechanical issues as if he had a patellofemoral maltracking problem he would have had pain prior to the accident. i feel that physios are sometimes a bit quick in prescribing VMO exercises and stretches of the lateral structures. its virtually impossible to lengthen the ITB in an adult anyway. why do we do it????