Diagnose my injury

[fluidmosaic]

So I was snowboarding last night and i landed a jump with my front leg locked, the landing felt fine then a few seconds later my knee began to hurt and started to buckle. I stopped, laid down, and it stopped hurting. When i got up i couldnt put weight on it and it hurt pretty bad, so i slid on my butt down the mountain. When i got to the bottom i walked with ski poles for several meters and my knee although kind of painful, started to hold my weight relatively well. It is still quite weak and i walk gingerly on it. It isnt really swelling noticably, and only hurts if i walk on it roughly. I do have a history of acl injury, it was replaced about 7 years ago but i rehabbed it. The pain location is from the middle to the outside of the knee. What do ppl think? I think it is a minor acl sprain. Do you agree? Suggested treatment and rehab? And dont say go to a doctor because I have no health insurance (live in USA).

[blackbeltgirl]

It's against the law to practice medicine if you're not a doctor, so no one can "diagnose your injury" in that regard.

You should probably spend 2 weeks following the RICE protocol, and see where you are then.  Rest, Ice, Compression, Elevation.  Even if you don't see swelling, ice the knee regularly.  COnsider using an ace bandage or a simple brace you can buy at the drug store.  Keep the knee up when you can.  And stay away from any uncesseary activity.  If it's a minor sprain, it will start to heal by the end of 2 weeks, but only if you really rest it.  Don't go to the gym, or go snowboarding, or anything.  If you think it will help, you can also try using NSAIDs for a while.  Ibuprofen and Naproxen are the standards in the US.  I don't know the numbers for naproxen, but for ibuprofen the minimum dose to be effective as an anti-inflammatory is 600mg, 3x daily.  And you need to take it for 7-10 days, regularly, to get this benefit, not just a couple of days.

IF, at the end of 2 weeks you're not seeing any improvement, you should a) have a better idea of what activities make it hurt worse, how it responds to a Saturday on the couch vs. a Monday at work, etc.; and b) be able to decide if it's worth your money to schedule a doctor's visit.

Good luck-
Jess

[fluidmosaic]

Thanks, I'm definitely going to do the RICE thing and see what happens. I'll repost if I have something interesting to say about it.

[kittent1211]

I would add Aspirin to that suggestion.  My doctor woudn't even look at my knee until I had been on  Aspirin for two weeks first.  That way, if you need to see a doctory you can tell him that you've already tried Aspirin and it didn't help.

Teresa

[Leentje]

Don't take Aspirine just like that! Call your Dr and see if he's ok with that!!


Helena

[fluidmosaic]

lol, I have no doctor because Ihave no health insurance and no money so i think i will hit up the aspirin. Btw is there any special kind of aspirin? Will tylenol or advil work or what?

[blackbeltgirl]

You want an NSAID - non-steroidal anti-inflammatory.  Ibuprofen or naproxen are best.  Not tylenol (no anti-inflammatory benefits) and no aspirin.  Advil or Aleve.  For advil, you need at least 600mg 3x daily.  For aleve, I'm not sure what the prescription level is, vs. OTC.  But you need to take it regularly for 10 days to see the most benefit.  Be sure you read the bottles carefully, and are aware of the potential side effects and danger signs.  ANd if you're taking advil, aspirin, or aleve regularly, and get a headahce or something, don't take more of that drug, or any other of the same class.  All 3 are based on aspirin, so if you're already taking aleve, and you take advil for a headache you're risking an overdose.  It is ok to take tylenol as an "Extra" while taking any of those NSAIDS. 

If it's working, and your knee starts hurting again more, or swells again, when you stop taking it, you will need to consider finding the money to see an orthopedist.  If you don't need x-rays or mri, a consult with a good OS is probably about $200. 

Good luck-
Jessica

[harry78]

Hello there,

I would agree with most that NSAID's are the way to go to getting rid of the initial pain (not asprin!) and ice most importantly (was for me anyway). Then do organise a date with your doctor depending on whether the injury is still not improving (I don't know about your situation in the US). That could have been a slight stretch of the knee capsule but I certainly think you would'nt have been able to walk afterwards if it had been an ACL injury even with the graft.

Harry

[fluidmosaic]

the advil i have is 200mg ibuprofren each. it says not to take more than six capsules or 1200mg ibuprofren a day. Blackbelt says to take
1800milligrams a day. That would exceed the recommended dosage on the advil box. what do you think?

[doublea21]

What jess said is the prescription level of advil for the anti-imflammatory benefits.  I take 3 Advil 3X a day.  When you take the higher dose you really want to make sure that you take it with food and watch for any of the side effects on the box because the higher dose can bother some peoples stomachs.

Amy

[blackbeltgirl]

Amy is right.  Prescription strength is 600 or 800 mg, 3x daily.  The OTC doses on the box will not do much, if anything, for swelling.  Those doses or for headahces.  But again, you do want to pay attention to your body's responde, because you are basically self-medicating at prescription strength.  I do it all the time, but not everyone does. 

Let us know how it goes.  How is resting and icing working for you so far?
Jess

[fluidmosaic]

it feels less weak but still weak, i think the ice and rest is helping. i will repost soon. Again, thx for the info

[fluidmosaic]

So I have been taking lots of advil 600mg 3 times a day. Resting when not at the office, and ice pretty much all evening after work.
My knee seems to have become less swolen and more stable but feels very unstable while walking down stairs, or down hill. I am almost afraid to bend my knee going down stairs for fear of it giving out or reinjuring or something. But except for thatt it seems to be doing very well. I dont know ifthat means anyhting.

[blackbeltgirl]

If it seems to be getting better with what you're doing, then keep it up.  If I recall, you said you don't have health insurance.  Even minor sprains can take a couple of months to heal.  Keep up with the ice and ibuprofen until the swelling seems to be gone.  Although if, after a month, you still have swelling and are not confident on the steps, it may be time to give in and pay for a doctor's visit.  YOu may also want to do the most basic physical therapy at home.  It will work on gaining some strength in the critical muscles.  Straight leg raises are done on all 4 muscles groups around the knee.  Start on your back, and with your leg out straight, first tighten the quad, then lift the leg about 6 -10 inches off the floor, hold for 5 seconds, and release.  Do this for a couple sets of 15-20.  The roll onto your side, do the same thing.  Onto your stomach, where you'll be tightening the hamstring, but same thing.  Then the other side and repeat.  Start out with no weights at all.  If you can easily do 2 sets of 20, go to a sporting goods store and buy an adjustable ankle weight.  They have them in 1 pound and half pound increments.  Start with around 2 pounds.  WHen you can easily do 8-10 pounds you should be good to go.

As long as you continue to see improvements, don't worry too much.

Good luck-
Jess

[fluidmosaic]

thanks for the advice. I started doing the straight leg raises on my back yesterday. I will do them on all sides now.