The SPECIALIST'S OFFICE => Ligament damage => Collateral Ligaments and other non-cruciate tendons & ligaments around the knee => Topic started by: LDP2019 on April 20, 2019, 12:58:39 PM

Title: MCL and ACL high grade tear - ROM problems (canít bend knee)
Post by: LDP2019 on April 20, 2019, 12:58:39 PM
Hello, I fell over whilst skiing 6 weeks ago, and was on crutches and a knee brace for two weeks, and didnít bear any weight on the injured leg until I got back home (on hindsight I probably shouldnít have waited that long to start bearing weight). I had my MRI two weeks after the injury. MRI has confirmed itís a complete tear in MCL and ACL (meniscus intact). Doc told me to stay in the brace for another 3 weeks to give the MCL a chance to heal. Finally took off the brace last week and have been trying to walk, but Iím still walking with a limp. I have been going to physio for 4 weeks already but have not managed to regain much of my range of motion (ROM). Once I bend my knee to 95 to 100 degrees, the pain kicks in. The pain has been at a similar sort of level for the last 4 weeks, and the inner part of the knee starts hurting once knee flexion reaches 90 degrees. Itís like there is this block there that wouldnít allow me to bend it any further. This has been been very frustrating because Iíve not seen much of an improvement in my ROM despite doing all the exercises prescribed by the physio. The physio himself has said that my ROM progress has been slow compared to many patients heís worked with.

Has anyone had a similar experience where it took them a long time to achieve their ROM? I am just a little worried that because itís taken this long that Iím not going to get my full ROM back. Thanks!
Title: Re: MCL and ACL high grade tear - ROM problems (canít bend knee)
Post by: Vickster on April 20, 2019, 03:02:54 PM
Are you having surgery to reconstruct the ACL? Have you been told to get full ROM before they proceed?

It's more important to get full extension than full flexion in order to be able to walk normally and limp free, where are you at in terms of straightening?
 Is there still swelling, can block flexion.

Meniscus tears can often be missed or not show up on MRI too, when do you go back to the knee specialist / surgeon (assuming you've seen one, if not get referred asap)? For a review of the MRI and your function (meniscus tears should be diagnosable without the tear being clear on scan.

How's the flexibility in your muscles, are you getting massage to the quads, calves, glutes? As any tightness can affect ROM too.

Have you tried rehabbing in a hydrotherapy pool, a great environment for working on ROM and function? Does your physio have access to such a facility?

I think you may just need more time and patience, recovery from serious knee injuries like this is a marathon not a sprint. MCL can take months to heal and that still being damaged could explain your medial pain bending?

In my opinion, if the physio is concerned, he should send you (back) to the specialist asap.

Info here
Title: Re: MCL and ACL high grade tear - ROM problems (canít bend knee)
Post by: LDP2019 on April 24, 2019, 09:53:55 AM
Hello Vickster, thank you so much for your comments and suggestions. I really appreciate them.

I have had two appointments with my Orthopaedic doctor since the injury beginning of March. He has told me to just continue with my physiotherapy, and he said we will not talk surgery yet. My next appointment with him is on 9th May.

- My leg extension is just missing that last bit where I sit on the floor upright with my knees straight out in front, and I place my hands underneath the back of my knee. With the injured knee I am not pressing down on my hand yet. I was told to help myself train my leg by doing some passive stretching by pressing down on it.

- Muscle around the leg are quite tight. The physiotherapist spends a lot of time massaging it. And I do a fair bit of foam rolling every day to try and loosen it all up. I'm naturally an anxious person so I'm automatically tightening up my muscles when I'm walking around and find it hard for me to relax them. So I know my robotic walk is not helping the situation.

- Unfortunately we don't have access to hydrotherapy pool. I tried looking it up after you mentioned it. Unfortunately I could only find a few private hospitals that have it.

- My physiotherapist tells me to keep on working on the bending at home, but once I get to the sharp pain point I stop and scared to push myself any further. Fingers crossed hopefully with more time and with MCL healing the medial pain will eventually go away. Thank you so much!