Hurt my knee - Bone Bruise

[tensters]

I wonder if it could be related to the back - spinal nerves - sciatica or something. Weeks before the injury event with a/c, I did experience a bizarre weakness in right quad for a day or two. It was sort of funny. No pain, no knee pain, the quad would just give in. It then totally disappeared overnight and leg was totally fine. I wonder if there is a  connection. I think I'll stay off chair to lessen spinal compression. I do think there is an actual knee injury, but I think it is being made worse by possible quad weakness issue.

[tensters]

I tried some heel slides, leg raises etc and I could do them - and I have full range of motion - maybe not totally full on flexion but close, but man did it irritate the injury. The pain woke me up at night. I'm almost certain its an MCL sprain cause it hurts right in that area. It doesn't feel like a meniscus tear - though i  suppose it could feel different depending on location.

Then I think I made a mistake- i took a hot epsom salt bath - which i thought might soothed tight muscles. This made my whole leg feel like it was full of shrapnel. This was two days ago - its now starting to subside and getting better. I was unable to go to ortho appt today cause i couldn't put any weight on it without pain and i didn't want to risk injuring good knee with the limping gymnastics. I rescheduled for next week.

I've decided to skip all exercises and rest it - walk a little around the house and see if it goes in  better direction. I think i'm also going to try and always wear stability sneakers too.. i've been wearing flip flops and they have no support which might not be good for the mcl.

I'm still finding it hard to find a sleep position that does not annoy the left side of my right knee. Hoping if it heals up a little i can get away with pillow between knees.

If this is an mcl sprain - man does it suck.

[lovycrop]

Interesting

[tensters]

Okay it seems to be doing slightly better. I've been alternating ice and occasional warm/hot baths (with no epsom salts) and this seems to help a little. I've been mixing walking barefoot with flip flops since putting sneakers on and off with socks is a huge drag. Walking barefoot seems to help a little bit.

I bought a cane thinking it would help by taking a little weight off the injured leg and giving me some better balance but it seems to make things a little worse cause i think i put too much weight on the cane so I've put that on the side for now.

I'm thinking maybe there is an mcl sprain but i feel it mostly in the bone so maybe its a bone bruise. I still don't feel any instability and i don't feel any catching and I can extend my leg with no problem. So it seems like its not a major ligament issue or meniscus tear though I guess it could still be. Its just hurts when I put pressure on the bone which the quad then protects and I limp.

Looking forward to seeing the ortho this thursday. I imagine even in the best case scenario, there is some pt in my future.


I'm hoping he can tell from his knee move around tests what the issue is and we can proceed conservatively.

[tensters]

I finally saw the orthopedist today and he checked my xrays from the earlier doctor and moved my knee around and examined it.

So he says I don't have any fractures and nothing about the ligaments stick out. He doesn't seem to think there is a ligament injury. I mentioned that it feel like the bone hurts ... like a bone bruise and how it is described online. After testing my leg in various positions, and wow did some of that hurt, he thinks that its the meniscus that is the issue and that a bone bruise would have done enough healing to allow walking around by now (6 weeks). I still can't really bear weight on the leg/knee for more than 15 steps before I need to limp.

So I have a "standing" MRI scheduled for Tuesday and we'll see what's what then. He said that sometimes when you tear the menisucs a piece can hang off and cause pain etc and difficulty with walking. It if is that, he said a 15 minute arthroscope procedure would be performed and then you're walking in a few days and then some PT and he says its not a big deal.

As I mentioned earlier, I injured the meniscus in my other leg (left) 15 years ago and had an arthosopic procedure and it turned out well. This injury in my right knee feels totally different from that one. I could walk no problem with the other meniscus injury. Anyways I ordered crutches  because the cane is not enough really and I guess I should get used to them since if we go the arthoscopic route I will need them for a little while.

[vickster]

Sounds positive.  However, do not rush into meniscus surgery if you can avoid it. Removing the meniscus will likely lead to some degree of arthritis developing (depending on where, how much, how your knee reacts etc).  It is a minor surgery for most but with potential consequences (which the surgeon won't be living with). 

I had 3 weeks off work with my lateral menisectomy, unavoidable in the end after 5 months of a locked knee that started to buckle, rather than pain alone, knee not in a great state now (6 years on)

Seeing if it heals with some physio is always a wise first step

There's a really good meniscus primer and video in the Learning hub ^^

Good luck

[tensters]

Thank you Vickster.

I am definitely taking your advice and I'm going to read and view what you suggest.

I'm thinking if he shows me a small piece of meniscus that is interfering with the joints operation (via that MRI) and that is why I'm limping 6 + weeks after the injury and he intends to only remove that - basically a partial mensicectomy - and leave enough meniscus to act as shock absorber for the knee than I think that is something to consider right? Because I don't think any PT could fix that right - a meniscus interfering with walking?

One thing I don't get, and I"m no expert, but if it is the meniscus, shouldn't there be leg extension issues?  I have pretty much full extension and flexion. If the meniscus is causing a mechanical issue with the joint, shouldn't it show with extension? I still feel there is a quadicep weakness issue - maybe its the knee injury triggering it.

I guess no matter what he finds including the above I can always try some PT first right?
I'd love to solve this with PT.

[tensters]

I had 3 weeks off work with my lateral menisectomy, unavoidable in the end after 5 months of a locked knee that started to buckle, rather than pain alone, knee not in a great state now (6 years on)

Seeing if it heals with some physio is always a wise first step

There's a really good meniscus primer and video in the Learning hub ^^

Good luck

Sorry to hear that about your knee. When I had my first partial meniscectomy on the other knee, I had a discoid meniscus so he only had to remove from the center and he was able to leave a good strip all around. He told me then that this is what you want to do and that removing the meniscus can lead to issues long term.  It's been pretty well behaved since. The knee does seem a little lax in the pcl though, but no instability, I just prefer when I lay down to put a small pillow or sheet under it with it layed out to avoid any feeling of it slightly hyperextending. But the knee is okay other wise. Doc told me that is I worked the leg out and built up the quads it would not hyperextend... 

I also have a grade 1 mild spondylolisthesis... which normally doesn't bother me if I don't bother it.. any exercise that causing extension in the back bothers it... so like leg raises...so when I go to PT i have to explain/argue with them so they can give me an alternative exercise... can be a drag

[tensters]

Can a torn meniscus cause serious problems walking and weight bearing? For weeks? Can it get better?

 Like I mentioned, I can walk a few feet before I'm limping bad enough that I have to be careful not to injure my other leg or my back and now have a cane and soon crutches.

I feel a little scared and nervous about this. Its not acting like other injuries including knee injuries I've had.

[vickster]

Mine caused my knee to lock for 5 months, then I had surgery to remove the torn bit from the joint. I tried physio, at no time did I need crutches, but I did limp because I couldn't straighten my leg, I used a neoprene sports support. Ice, occasional painkiller

I have two further tears (at least, the MRI was nearly 3 years ago) in that knee which cause me little to no bother

It depends very much on where the tears are and whether they are interfering with the mechanics of the joint. For me, pain alone would not be cause for surgery given the potential issues from surgery and beyond. Locking and buckling are indications for surgery as the tissue being trapped can make the tears worse

Have you read the info in the learning hub about the types of tears?

[tensters]

Yes I just read through that about the tears. I don't seem to have any locking or buckling and my knee extends and flexes okay unless its very sore from bearing weight then flexion goes but it comes back. The problem is the pain - when i bear weight on it is enough to make my knee bend to take weight of it and then I limp but its not a good limp. Its stressful. When it really hurts and i've pushed it standing on it (doesn't take much) then I feel like the knee has no strength and i must sit. I don't know if you call that buckling..


If i keep all weight off the knee - which is hard to do and also I'm a little concerned about atrophy, the knee starts to feel okay and I wouldn't even know its injured until i bear weight. The injured/torn meniscus is on the inside of the right knee - right at that junction - i thought it was the bone cause the bone feels sore.

When i  rest my knees together, like when sleeping on the side with pillow between the knees, this makes that area hurt (really the upper bone). I wonder if I'm not allowing it to heal by doing this.. i can't seem to make it comfortable.

I have a feeling could be wrong that if I could just not stress it for a few days with weight that maybe it could do a little healing and then i could walk on it and the do some gentle rehab/walking etc. The crutches I guess will help  but the sleeping is an issue.

[tensters]

I was reading a little more and it seems that what my knee is doing is more of a pseudo-locking as opposed to true locking. The pain/swell etc causes the knee to bend a little and lose its range of motion to protect itself from further damage and then you limp etc. But if I were to sit down and relax for a second I would have full extension - which is one test that can show if one has true locking - something in the joint mechanically stopping motion.

I wonder though if perhaps when I am weight bearing on the knee - standing/walking - and in that orientation it changes the way the joint/meniscus falls and behaves and maybe there is something in the way in the joint besides the pain/swelling. And when I move to non weight bearing it moves back out of the way and i have relatively good extension?

I'm not sure if my knee buckles. It never does out of my control like I stand on it and it buckles. But once it goes into limp protect mode, it can become exhausted quickly and then it feels like i could lose control of it.. by that time I'm sitting so I don't get to see what would happen.

One question I have is about pain killers. I can acutally take the pain of this - its not that bad to be honest. The worst is when weight bearing and the knee doesn't cooperate. It's more just frustrating. Every site says take ant-inflammatories - especially ibuprofen. I've been taking Advil (ibuprofen) from time to time and I've noticed some bad things.

One, ibuprofen seems to make my blood pressure go up a lot. To the point i can feel it in my head - an almost 30 point rise. Took me a little while to notice this. I thought it was the stress of trying to limp around but I've tested it and it is advil.

Two, it bothers my stomach and makes me nauseous. Even with food.

Finally, it does take away pain and I can walk a little on it, but later its like the revenge of the knee - I have to pay for that "numb walking"with pain that i didn't feel on advil.

Is it okay to just not take advil or similar (unless of course pain was unbearable or I'm post surgery) and just use ice and forget the painkiller?

I remember with my other leg I never took pain killers even after surgery other than one pill that evening.

[vickster]

If you have side effects, don't take the meds. Talk to your doctor about pain management and alternatives. Get your BP checked (although hypertension doesn't really have clear symptoms). I take naproxen but with a stomach protector as been taking all year for shoulder.

You could take paracetamol (Tylenol) instead or try a topical NSAID like voltaren

If you have minimal pain, you may not even need anything. Ice and/or heat could be enough but talk to doctor

[tensters]

Great, thanks Vickster.

[tensters]

I have a couple of questions.

1. Do you think it is okay to tolerate a little limping in an effort to walk around a little to help build up the muscles and to move?

I have a cane and it sometimes seems to help a little bit but it also feels like it is weakening my leg more and is affecting the way i put my weight on my limbs. It's like reinforcing a walking pattern. Plus I still limp a little with it.

2. Pain at night. I think my sleep is being severely affected by the knee. I'm not getting a good sleep. I'll get a few hour and I wake up and it hurts - not terribly but enough. I also have nightmare/dreams about my knee. I sleep with the knees together on the side with pillow between. For some reason, it aches in that area with just the pressure of the other knee no matter how many pillow or what i use to cushion.

Is there something else I could try? Should i consider other pain killers nsaids? I think I once did try advil for sleep which gives me some off effects but it did not help all that much.

Thanks so much.