KNEEtalk

The WAITING ROOM => GENERAL KNEE QUESTIONS and comments (good for new threads) => Topic started by: julius on October 04, 2012, 05:34:40 PM

Title: PCL injury - developed into ITB syndrome
Post by: julius on October 04, 2012, 05:34:40 PM
Hello everyone!

Like most of us here, I've been struggling with a knee injury and I must say it's been a rather depressing time. The injury happened in July when I crashed downhill skateboarding. I landed on my left knee while it was in a 90 degree angle with the foot extended (I believe this is a common way to injure the PCL) while going around 50km/h. With the impact I felt immediate pain at the lateral side of the knee, mostly below the joint line. Also the patella was rather sore for a month or so. I proceeded with RICE for the following 2 days and then went to see the doc. After 2 days I was already able to bear weight on the knee and walk by limping and the doctor said it's probably nothing serious.

Well time passed and I still had guite a lot of pain so I got an MRI 3 weeks later. It showed that the PCL had a rupture, which fortunately was not complete. Meniscus, ACL and the collateral ligaments seemed intact. So the doctor, who was an orthopedic specialized in sports injuries, told me that I could now do just about anything with the knee. At this time I was not aware of how serious a PCL injury can be, so I went riding downhill. Of course I had to fall again, this time it was a lateral blow to the injured knee. Usually this kind of a crash would have been nothing, but I felt severe pain at the lateral area and was unable to bear weight for 10 minutes. But then the pain faded and I walked without problems.

At this time I started researching PCL injuries and found out that it's a rather big deal to have incompetent PCL. So I asked my physiotherapist friend for some exercises and started training my quads to be able to skate again. These exercises include ball wall squats, swiss ball squats and contracting the quads with a water bottle under the knee. I've also been doing heel slides to gain back the range of motions, which at this time is already a bit better. However, it is still hard to bring my feet near the buttocks, as if something is resisting the motion without pain.

But what really worries me at this point is how my left VMO has shrunk about 50% and that I am unable to fully contract my left quadriceps. Everytime I try to fully extend my leg and contract the whole thigh muscle, I feel a sharp pain below the kneecap and at the lateral side of the knee, below the joint line. Also while squatting really low or kneeling I get a sharp pain at the lateral side below joint line. This area also aches especially when I wake up, but also when I walk for a long time. I'm suspecting that this pain could be caused by the femur and the tibia rubbing together, but it could also be a broken meniscus since the range of motion is restricted. When the muscles are relaxed, the tibia sits a bit lower than in the other leg and pushing the tibia forward and back I can feel a bit of lax there.
The most recent symptom is snapping sound and a popping sensation at beneath the patella, when moving through 90 degrees of knee bend. This does not hurt, but in the state I'm in dealing with the injury it obviously alerts me.

I feel like my biggest problem right now is the inability to fully work on my quads. I know that strong quads are one of the most imporant things in conservative treatment of PCL injuries, but despite exercises mine have been only getting weaker.
Has anyone else had similar problems with PCL or any other knee injury? I feel like I'm running in circles here and any advise will be appreciated.

- julius
Title: Re: 2,5 months after PCL injury - cannot fully contract my quadriceps
Post by: ArtByCassie on October 13, 2012, 04:41:52 AM
I have not had the same injury.. However I have had the quad issue.. I found a fabulous PT that they hook you to electrodes and stimulate the quad while you do leg lifts. It seriously helped me!  After my last knee surgery I literally had no ability to flex my quads. They simply did not work. Onmy last appointment I had full range of motion and my quad mucsle had grown.. So it certainly worked for me.. But the stimulation was the key!!Good luck. I hope you can get those quads working the way they should!
Title: Re: 2,5 months after PCL injury - cannot fully contract my quadriceps
Post by: julius on December 19, 2012, 05:01:24 PM
Thanks for the reply Cassie!

It's now been over four and a half months since the accident and my pain level has gone down pretty good. Now it's mainly minor aches but they are still almost daily. I can now contract my thigh and it hurts only a little occationaly.
Recently I went to see the doctor again and he said I had also developed ITB syndrome. I haven't ran at all since the accident, but a lot of walking though.
One thing bothering me daily is the laxity in my knee. The tibia moves guite a bit when my thigh is relaxed, but it doesn't really hurt. Then, at the anterior end of the motion range, it's as if my tibia hits something that stops it. I can feel a knock in there, and it's definitely disturbing. In many ways the knee just doesn't feel like it is supposed to and I'm afraid this is something I have to get used to from now on.
I know that getting the knee better requires a lot exercise. Unfortunately I can't afford a PT and insurance won't cover so I just got to work this out on my own. Wish me luck :)
Title: Re: PCL injury - developed into ITB syndrome
Post by: GIMPocalypse on December 24, 2012, 07:23:29 AM
Hey Julius,

I also have a partial PCL tear.  Before I had my MRI my OS had me in PT for 7 weeks--my quads were in great shape before my injury and moderate shape at the end of 7 weeks--I was removed from PT once my OS read my MRI--partial PCL, partial patellar tendon tear, partial quad tendon tear -- and now I'm in a similar situation.  My quad is visibly smaller, in my mind, significantly.  I am headed back to the OS the second week in January to see what is going on and/or what can be done. 

Flexing my quad, I have the same symptoms you mentioned and also right below my kneecap hurts--as though my tibia is wedging itself in the wrong place.  I, too, feel pain on the lateral side of my knee when bending my knee.  I also cannot walk normally if I have been laying/sitting for a slight period of time, it is as if I can't fully feel everything or that my brain cannot get that part of me to move correctly. 

Right now I am in a custom PCL brace--somehow I still get those moments of popping and clicking, which I tend to feel on the medial side of my knee for some reason.  My understanding is that my brace shouldn't really allow for joint movement in the manner that it is happening so now I am concerned that my quads and calf have atrophied to the point that I already have to resize my knee brace after only having it for like 3.5 weeks.

Bottom line is: I completely relate to a lot of what you said...
I injured myself September 12 of this year, so not quite as long ago as you but I definitely understand what you're going through. 
I've been to two OS--and I'm thinking about going to 1-2 more now that I have an MRI and results...

GOOD LUCK!