Down and Depressed: Knee Pain

[miamisam25]

I hit my left knee into the corner of a wooden drawer while walking in my apartment 4 months ago. The impact was pretty hard but i thought i would shake it off (consumed ibuprofin and heat/ice treatment during this time) and did not see a doctor until a month after the injury.

Days after the injury, i would wake up feeling sore and tight around the left knee again i just ignored it and went about my daily life (going to work everyday, etc).

4 weeks after the injury - I went to see a GP who said it was nothing serious and gave me prescribed anti-imflammatory and a muscle relaxer (1 month dosage). 2 weeks into it i told her it was no improving, she gave me a prescription to go see an orthopedic.

6 weeks after injury - I went to see an orthopedic who gave me a cortisone shot and said the swelling would go down in 3-4 days. It did not go down 2 weeks later.

8 weeks after injury - I went to see the orthopedic again who said the only thing left for me to do was an MRI.

10 weeks after injury - got the results from my MRI and it can be viewed in the following link www(dot)islandstuffusacorp(dot)com/report.jpg

11 weeks after injury - i saw another orthopedic who specializes in sports injuries. After examing me, he said that my muscles shut down in my left knee from the impact and that my patella wasn't tracking. He recommended 4 weeks of physiotherapy at 3 times per week (12 sessions total).

12 weeks after injury - present (14th week) - I've done 2 weeks of physiotherapy and my condition is improving but the swelling is STILL present. My therapist said that it's scar tissue which she massages in ever session for 10 mins. I also do a series of exercises and have the ultra sound and electric stimulation machine on my left knee in every session.

Is the scar tissue/swelling every going to disappear? What can i do? It's sooo frustrating and i'm still psychologically limping when i walk due to the swelling. It's been over 4 months now and it's still there

[cujo66]

First, welcome to EF.
Second, don't know about the scar tissue breaking down. I had surgery earlier this year, and the thing that they had me start right away was massaging the scar to break up the scar tissue. Which was pretty gross. Your's had quite awhile to build up so it may take awhile to break down, rub the area a few times a day on your own, for a few weeks.
As far as the limp, you gotta put that outta your head. I was told right off to stop walking with a limp. I'd had my injury for almost a year and had made it worse about a week before I finally had to have the surgery so it was hard to start walking normal again. You've gotta just put your mind to it and be aware how you are walking. I have discomfort still and I have to focus on how I'm walking.
Also I guess when a joint recieves some sort of trauma, the muscle shuts down. Mine turned to mush and I had to rebuild it again. The operated knee is still much weaker than the other knee.

Maybe this will help you feel a little better about you condition.

Here is the scope from my surgery for my torn ACL and shredded MCL.



The top left shot shows the totally torn ACL.
The replacement was made out of a piece of the tendon of my knee cap, which is where the scar came from.

Here is my new ACL being installed.



Feeling any better?

[miamisam25]

cujo66, i know my situation is not as bad as yours but i have slightly improved since the injury. I have also been told by EVERYONE who has seen my condition that i DO NOT need surgery.

Yeah, the limp is a psychological thing that i just got to get out of my head. At times, when i have something else on my mind, i walk normally.

The fact that the left (injured) knee is still swelled up just contributes to my limping.

Do you have any advice on how i could reduce and eventually eliminate the swelling?

[Vizigoth]

Use ice on the knee after P/T and after any massaging of the knee that you do. Doing so will reduce inflammation which is the mechanism that aids the development and building of more scar tissue. If you want to accelerate the recovery process and have a high tolerance to pain, you can seek out an Acupressure Therapist and have them break up the scar tissue. The process can take weeks or months, with one treatment every week or so. This treatment will redefine your concepts of pain, and you will think you were a wienie when you thought your knee was bothering you.

I saw an Acupressure Therapist to break up large amounts of scar tissue in my calf. He was an Acupuncturist Physician who had fled Cambodia in the '70s. Both the soleus and gastrocnemius groups had taken some bad licks and I had lost nearly all of the mobility in that part of my leg. It was down to about 15% of what it was supposed to be able to do, in terms of flexibility and movement. It took about six months of treatments with a treatment every week or two to get the leg back to about 90% mobility. The pain was remarkable, and even today (20 years later), I sometimes ask myself if it was worth it.

[liza larence]

Sounds like the IMPACT caused a patellofemoral pain syndrome, due to damage to the cartilage on the inside of your kneecap (patella)...a cortisone shot in the joint can greatly reduce the inflammation, and a "Chopat" strap worn around the knee just below the kneecap can take the pressure off the patellofemoral surface, much like a tennis elbow strap worn around the elbow. NBA players suffer from this condition, and wear these things all the time....After this many weeks, I'd be stickin ya with a little depo-medrol and strapping you up. (You wear the strap all day, especially during sports, etc)
Quite often, the condition can disappear.
An exercise that will help is leg extensions, just the last 6-8 inches before full extension, high reps, with toes turned out. DONT flex the knees past 50 degrees. We call these "quad sets" and they will also stabilize the patellofemoral joint.

[miamisam25]

Liza larence: Thank you for your very informative feedback.

For the chopat strap, do i get the normal one such as the one in
www(dot)muellersportsmed(dot)com/chopatkneestrap.htm

OR

Do i get the Dual-Action one such as the one in www(dot)footsmart(dot)com/Product.aspx?ProductId=133

To clarify the leg extensions, i'm just repeating the motion which is 6-8 inches before full extension, correct? Also, when you say not to flex the knees past 50 degrees, I am basically not bringing my knees all the way down (90 degree starting position), but rather about half way down and then back up, correct? Do i hold at the top (full extension) for a second or two? Also, how many reps and how many sets do you suggest i start off with?

My physiotherapy sessions consists of: 15 mins walking on the treadmill along with mini-squats and calf raises. After all this, i do some stretching and then have the ultrasound machine on me for 10 mins followed by a 10 min massage on my injured knee area to break up the scar tissue and then finishing off with icing and the electric stimulation machine for 15 mins. Today i start week 3 of physiotherapy.

You feedback on this would be highly appreciated too. Thank you so much in advance.

[liza larence]

Sam...for the strap, I am only familiar with the Chopat one, but the dual-action sounds pretty cool...get the least expensive one first You have to wear it all the time when you are up.
You got the leg extensions right...just the "lock-out" (full extension) dropping about 45 degrees. Do 4-6 sets of 20-30 reps with really light weight, flexing and holding a sec or two at full extension.
Definitely continue with the PT...it does wonders!

[stephenlavin]

knee pain ...i could write a book on it .......over 18 months i suffered in my knees ....... 90% pain free today ....thank god .....my advice is simple ..if your treatment is workin and the pain is regressing then you stick with it ...overcoming any injury takes one thig above all else ..patience !!!!
I know how you feel buddy but if as you say treatment is helping then stick with it .

for my problem i spent two months doing single leg squats on a decline to help with the injury .... I would do them every day .....they were murder ..painful ....tiring ...but the specialist said that was the way it was supposed to be ...i was doing up to 5 to 6 sets of 50 on each leg ....definately helped ....finally got a steroid injection behind the patella tendon which for now and hopefully for good has cured the problem .....

I tell you this above all else buddy ...follow the specialists advice .....they know more than anybody ..good luck with it