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Author Topic: another knee diagnosis/rehab story/question  (Read 1193 times)

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Offline John_2007

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another knee diagnosis/rehab story/question
« on: October 04, 2007, 03:52:41 AM »
Thank you very much in advance for your help. I'll do my best to be detailed yet concise.

Me: 29 years old, 160 pounds, 10% body fat, "competition shape" before injury.

I practice Brazilian Jiu-Jitsu (a martial art) and attained a knee injury during practice. A guy landed on the outside of my knee and it dislocated outwards with a "CRACK-pop-POP!!" sound. Just before the dislocation, my knee was bent at about  a 100-110 degree angle. Needless to say I was in extreme pain and clutched my knee, which put it back in place. I immediately elevated it, applied some cold-packs with compression for about 30 min., and took 800 mg of Ibuprofen. Note: I don't have health insurance.

The next day I went to see my friend's chiropractor who is supposed to be good with sports medicine. I hobbled in to see him using a stick for support, still in excruciating pain. He listened to my story, pointed out how swollen my knee was, and did one test. He bent my lower leg out about a half inch and immediately told me that it was obviously a mcl tear and who knows what else, but that I need to see a Orthopedic Surgeon. It definitely felt unstable laterally.

Same day, I went to see a friend who is an athletic trainer at a community college. He iced me and hooked me up to an electro-stimulation machine for 15 min. Then he did a couple of tests of his own. He bent the lower leg out and said it was probably a grade 2 mcl tear or maybe even a 1.5. He said if it was a complete tear, he would be able to bend it much further, maybe even all the way out with no end if other things were damaged as well. He also did a acl test and said it was attached.

For the next 3 or 4 days, my knee was immobilized and I used crutches. The athletic trainer advised me to take only Tylenol for the first few days and switch to Ibuprofen afterwards, which I did. I recieved the electro-stimulation and applied ice everyday. 5 or 6 days out, he said we need to work on range of motion and strength. At this point I couldn't bend my knee much at all. So he had me sit on a table with my leg resting straight out on it, and using a towel try to pull my heel towards my butt. For fifteen minutes I pulled as far as I could (10-20 degrees) until I felt I couldn't take the pain, then relaxed for 10 seconds and pulled further, another 10 seconds rest, then pull, and one more time before straightening out the leg and starting over. Then he put a cylinder under my knee and I did partial range of motion lower leg raises (4 sets of 25). Another exercise was for me to lie stomach down and try to bend my knee, bringing my heel to my butt. I couldn't do this at all, it was too painful and I felt like I lacked the strength. The trainer assisted the motion, but I kept feeling jolts of sharp pain and my muscles instantly cramped up with every movement. He advised me to relax and we kept at it for a while. At most, he was able to get it as far as I was able to with the towel. Next was partial range of motion leg raises (lying both on my back and stomach - same amount of reps/sets). At night as I got into bed, I held my leg straight out and turned my foot outwards, at which point the lower leg "dropped down" or "gave" about a centimeter before I caught it and supported it.

Next day it was the same deal, electro-stimulation/ice, exercises, etc. BUT this time he "stretched" my knee manually. He had me lie face down and told me to try to bring my heel to my butt. I probably got to 20 or so degrees. He slowly forced my foot back MUCH further, maybe to about 100 degrees with me screaming and almost passing out from the pain. It felt like my knee was being destroyed.

For the next 4 or 5 days it was the same deal but without the manual stretch. He added a couple of exercises such as balancing on my bad leg 10 times for 30 seconds at a time and walking without the crutches. After that he said I should walk on it as much as possible at home and use the crutches only when going out. The "towel-pulling" exercise was continued at home as well.

Today he did the manual stretch and it was too much. I tried to take it but I ended up not being able to, I was a mess. I normally have a high pain tolerance having broken several bones and sprained every joint on my body, rarely taking medicine for pain with no problem. But this was by far way too much pain. At this point, I can bend my knee a little past 90 degrees AFTER about fifteen minutes of the towel-pulling exercise. Before that, it's the same as when I first got hurt.

I have had no mri taken nor met with an Orthopedic Surgeon. I'm working on getting insurance now.

What do you think? Does this sound routine? Any advice or insight? Thanks again very, very much.


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Re: another knee diagnosis/rehab story/question
« Reply #1 on: October 04, 2007, 06:22:17 AM »
You have messed up your knee big time and need to get to an OS now.  I don't think a trainer or chiro can help you.  I would not attempt manual stretching at all.  You could mess it up worse.  Work on getting insurance, ice, elevate and get your butt into the Dr.  Please don't' mess around with this you could make it worse.
Good Luck
Ice, Elevate and gobble tylenol

Offline Nettan

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Re: another knee diagnosis/rehab story/question
« Reply #2 on: October 04, 2007, 06:35:31 AM »
I would really advice you to check this knee out with a OS before going on with any more treatment or phys at all.
You could have damages that is hard to discover with just a physcial examination.
I hope you can get insurance going and see a OS soon.
Surgery 6 times left knee torn meniscus, RSDS,chondromalacia, nervdamage cause constant nervpain,chronic inflamm.
Spinaldamage wheeler 100%.
Right knee damaged aug-06, use brace surgery 4/9-07.LCL tear.

Offline Aff

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Re: another knee diagnosis/rehab story/question
« Reply #3 on: October 04, 2007, 09:25:22 AM »
i agree that you should get it properly checked out.  i'm in the middle of rehab right now (i do ju jutsu too, but japanese :)) and the sort of treatment you are getting to me seems to be for a latter part of rehab, when you should be getting less pain.

no doubt you'll be doing some of these exercises during your rehab but i would have thought rest, ice, compression, elevation is the only option right now and mobility exercises later.

i know how you feel, it feels like a disaster and you want to get it 'fixed' asap to get back to training.  unfortunately as i've found out, there is no quick fix, it's an unusually long process.

hope it all goes well, keep us posted.

Offline tanyap

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Re: another knee diagnosis/rehab story/question
« Reply #4 on: October 04, 2007, 10:10:42 AM »
you absolutely need to get this knee seen to by an OS - no one has looked inside it with either MRI or x-rays - more damage could be happening with all this manual stretching and exercises - you may need time to heal before starting on any exercises, and that manual stretch just sounds like torture.

A chiropracter is not a knee specialist - please please see an knee specialist - you do not want to mess it up long term by dealing with people who are not specialists without knowing the nature of the damage inside it!

I dont know what country you are in but I strongly recommend you make an appointment with an OS immediately.
1986 - recurrent dislocations of right patella began
1988 - Modified Hauser Procedure
1991 - dislocations started again
2005 to 2007 - 150 dislocations in 2 years - OUCH!!!
June 2007 - new OS, new physio
Oct 2007 - VMO woke up
Mar 2008 - big quads, still dislocating
Apr 2008 - next OS app