The WAITING ROOM => GENERAL KNEE QUESTIONS and comments (good for new threads) => Topic started by: hanjabanja on November 03, 2008, 01:15:26 PM

Title: I don't really know what is going on
Post by: hanjabanja on November 03, 2008, 01:15:26 PM
Hello everyone,

I sustained an injury in my left knee six weeks ago, by squatting down to pick leaves up at work. I'm not sure where exactly it started hurting right then as it seemed like it was the whole knee. I stayed at work for a week but it got too much so I've been pretty much immobile for five weeks, supported by a crutch around the house and taking co-codamol 8/500mg (although I try to keep that to a minimum as I know people get hooked on the stuff). By the end of the day I'm still in a lot of pain, and if I try to do anything in addition it's unbearable. It got better quite rapidly from the obscene pain right at the beginning, but hasn't got much better for the past three weeks. I was wearing a tubigrip and then a bike support for a little while but I was getting a lot of pain around what looks like the top of the lateral collateral ligament so mostly haven't been wearing a support.

The last doctor I went to poked and prodded and apparently it seems like the left knee's freer in movement than the right and I've probably torn the medial collateral ligament. This doesn't make me happy as most of the pain I've been experiencing has been from the outside of the knee to the bottom of the kneecap. There is also some popping in the knee when I straighten the leg or bend it to tie my shoelaces etc.

I am currently waiting for a physiotherapy appointment on the 10th of November but they still don't know what the problem actually is. Should I expect the physiotherapist to make the diagnosis or is there some other step that should be taken? It seems like a scan might be a good idea but are there restrictions for when they can do this on the NHS? Does it even help? An orthopaedist appointment has also been made in case physiotherapy doesn't help, but god knows when the referral will come through.

For background, I have had problems with the left foot before, in that the arch has been fallen and swollen for about ten years, so the foot is slightly angled. I do wear supports for this.

Additionally, my contract at work finished on Friday so now I'm unemployed, but not remotely able to get to work, so if anyone has any advice about benefits it would be gratefully received.

So yeah, if anyone has any advice as to what steps should be taken for diagnosis or if it sounds familiar, I would really appreciate anything you've got.

Many thanks,

Title: Re: I don't really know what is going on
Post by: Clarkey on November 03, 2008, 03:56:16 PM
Hi Hanja,

What Job did you use to do, a manual worker? I work full time as a Greenkeeper, so on my feet most of the day and does involve lots of heavy lifting at times.

I found the NHS system shambles as I sustained my injury back in October 2007 and the PT finally decided I need to see an OS. I think you need to see a OS as well and could well be sent for an MRI scan at the hospital. I live In Birmingham and found the MRI service very fast I had a MRI scan done within 5 weeks and got the results back 3 weeks lator.

Make sure the admin Staff dont lose or misplace your appointment as they did with my 1st PT appointment. After waiting 3 months for the appointment only to find out they never got my referral letter from my GP.

When you see a PT they should have some idea what could be wrong with the knee and if you need to see an OS straight away or not. Just by looking at your kneecap will know if you have maltracking problems as they did with me. Its easy for a PT to spot a knee cap not alligned properly.

Good luck with your PT appointment.

Nick :) {2008} :)

Title: Re: I don't really know what is going on
Post by: luckygrandma6 on November 05, 2008, 12:50:54 PM
Unfortuanately some doctors think PT is the answer to everything. I've wasted so much time at PT for this reason before every surgery I had, but still ended up having surgery. If something is seriously wrong PT can't fix it. I went to PT for almost three years after my TKR and finally PT said to me "whatever is wrong with this knee we can't fix it" This is what every doctor does before surgery, but if it is too painful or PT doesn't feel PT will work, they will be a referral for the doctor as the doctors tend to listen to them. I got a referral from my GP to see a Knee Specialist as i was getting so frustrated with the OS who did the surgery. My present OS wanted to do an arthrodesis for the overextention, but as it turns out the new OS said "No! you are no where's near that drastic of surgery" He looked at the x-ray and pointed out many things wrong with the knee that could be fixed, but it would take a very long difficult surgery. He said if I was in my 70's or 80"s he wouldn't even offer this surgery to me. The last OS botched up my knee as he got into an area he wasn'tr experienced in, revision from PKR to TKR. He doesn't even perform PKR so how could he know how to take one out. Listen carefully also and see if you are comfortable with what the OS is saying to you, if not seek another and another opinion until you get a doctor who will listen.
Title: Re: I don't really know what is going on
Post by: hanjabanja on November 07, 2008, 01:20:42 PM
Thank you so much for the replies.

I was working as a Ranger at a Botanic Garden, so very active (walking around 5 hours a day).

I had an orthopaedic assessment today (someone cancelled their appointment so I was bumped forward), but I am unimpressed and discouraged.

Good things: I now have a second crutch and know how to use them properly, have been told that using painkillers more regularly should help, and been given a couple of exercises to do before physiotherapy on Monday.

Bad things: After explaining to the doctor that most of the pain is on either side of the patella, she pretty much ignored that and just poked around the top and bottom of the kneecap, although she did move the leg around a bit. Discovering that it hurts above and below the kneecap but that it's not excruciating (but it *did* hurt like hell, should I be screaming more or something? I am annoyed with doctors telling me how much I hurt) she decided I sprained my quadriceps and am mostly just sore because I haven't been using my crutch right. Then while getting a second crutch from another room she was very loudly telling a colleague that I wasn't using it right and sometimes she just doesn't know what to do with people so she sends them to physiotherapy. And it cost about 20quid in taxi fare to get there and back.

So I am not especially convinced, and am now in quite a lot of pain and grumpy as all hell, but I have physiotherapy on Monday and will do whatever both of them say, and hopefully it will work.
Title: Re: I don't really know what is going on
Post by: hanjabanja on November 13, 2008, 11:54:40 AM
Had physiotherapy appointment on Monday. It was good, I was given a load of exercises to do and told I probably need to up my painkillers, and that I need to ice the knee regularly to get the swelling down so they can actually make a diagnosis. The GP had apparently diagnosed ACL tear, but when he was examining me and decided I'd torn a ligament it was the MCL he was pointing to, and the orthopaedic assessor decided it was just a sprained quad muscle, which is frankly ridiculous.

The physiotherapist has told me that, because I've been staying immobile like my GPs have been telling me to, I've now got quad inhibition which is making the pain *worse*, and because there's still swelling she can't really tell what's going on with the ligaments, although I seem to have patellar tendinitis. So I need to be more mobile, ice, and probably take stronger painkillers.

I've also been aware of circulation problems (my left leg is usually considerably colder than the right, there is swelling in my left foot and leg), and last night I noticed that my toes are kind of falling apart. I'll make a separate post for this as I'm quite concerned.
Title: Re: I don't really know what is going on
Post by: Silkncardcrafts on November 13, 2008, 12:02:07 PM
Hi there,

I've often heard stories like this through the NHS. I lived in London for a couple of years and went privately to see a sports physician and private physio.

If I was you I'd see an OS privately. It would definitely be worth the money. If you are in London I would contact Pure Sports Medicine about seeing one of their sports doctors. I was a patient there when I lived in London and were very helpful.

Good luck !!!
Title: Re: I don't really know what is going on
Post by: bavage on November 13, 2008, 12:30:05 PM
You might wrap an ice pak around your knee with an ACE bandage & elevating the knee above the heart 30 minutes B/4 PT. This reduces the swelling and allows greater flexibility. You should also be taking anti-inflammatories. Be religious about the exercises they give you. Good luck.