What's wrong

[snaughton]

My first post so help appreciated....
I injured my left knee 4 weeks ago playing rugby union.
Was lying on the ground after a tackle (on my side) when fallen upon by a (fat!!) forward. Knee was pushed inward, stressing the medial. Don't think there was any twisting involved. I heard (along with everyone else within 5m) the pop as something tore.
physio came onto the ground, conducted all the tests (ACL, MCL) and concluded that I had done my MCL - no movement with ACL test. I experienced VERY little pain at the time, and since haven't had much pain (apart from when I got my foot caught under the brake pedal and twisted my leg getting out of my car). Swelling was minimal (I did start icing immediately though). I saw a specialist at Hospital emergency approx 8 hours later (for X-rays, which were negative). Specialist confirmed Grade 2-3 MCL injury.
However, when I went back last Monday, he said I may have torn my ACL as well - couldn't tell from the physical test as he thought there was some movement but still a hold point. I am having an MRI Sunday.
Anybody else had a similar experience?
My knee feels OK - still tender on the inside where the MCL attaches, but feels quite stable (I only wear a range of movement brace until I get home - feels OK walking around home). Wouldn't want to try running/sidestepping though.
Any ideas/comforting thoughts?!?

[Alla]

Hi there
Sorry that you hurt your knee, they arent nice when they cause problems like this... worst thing is not knowing what it wrong.
Anyway, I had a similar thing happen, I slipped over and wsa told that I'd torn the LCL on my right knee. Got around for nearly 5 months on a seemingly ok knee, but every so often it would give out. I ended up pretty frustrated with local drs so travelled to MElbourne to get it sorted. In less then a month it was all sorted out. I'd completely torn the ACL, and had it reconstructed within the month.

I had no swelling with the original injury, and very little if any pain. so dont let anyone tell you that if it doesnt swell it isnt an ACL injury. I had a negative response for the pivot and drawer tests but a positive for the Lachmans. When the OS tried to look at my knee I'd built up all sorts of protection mechanisms so it was hard to tell, but he said he was 95% sure I'd torn the ACL. On scoping that was what had happened and he reconstructed while he wsa in there. I'm 4 weeks down the track and feeling way better.... just going through the rehab which has truely been the worst bit.

As I said, I didnt really have any stability though, once the little bit of swelling I did have went down that was it. I couldnt run, walk the dog or carry anything heavy without feeling unstable. So for me surgery was the only option. I'd see how you feel after a little while... although dont leave it too long.... muscle wasteage is a big problem for me because I;d walked around on a damaged knee for 5 months without using the muscles correctly. It has made it tougher after the surgery.

Alla

[injuryupdate]

My first post so help appreciated....
I injured my left knee 4 weeks ago playing rugby union.
Was lying on the ground after a tackle (on my side) when fallen upon by a (fat!!) forward. Knee was pushed inward, stressing the medial. Don't think there was any twisting involved. I heard (along with everyone else within 5m) the pop as something tore.
physio came onto the ground, conducted all the tests (ACL, MCL) and concluded that I had done my MCL - no movement with ACL test. I experienced VERY little pain at the time, and since haven't had much pain (apart from when I got my foot caught under the brake pedal and twisted my leg getting out of my car). Swelling was minimal (I did start icing immediately though). I saw a specialist at Hospital emergency approx 8 hours later (for X-rays, which were negative). Specialist confirmed Grade 2-3 MCL injury.
However, when I went back last Monday, he said I may have torn my ACL as well - couldn't tell from the physical test as he thought there was some movement but still a hold point. I am having an MRI Sunday.
Anybody else had a similar experience?
My knee feels OK - still tender on the inside where the MCL attaches, but feels quite stable (I only wear a range of movement brace until I get home - feels OK walking around home). Wouldn't want to try running/sidestepping though.
Any ideas/comforting thoughts?!?

I'll have my money that your ACL is OK. The MCL is very easy to examine and you almost certainly had a grade 3 MCL if you don't have pain and everyone thinks you have done the medial.

However, a combined MCL/ACL is a ridiculously unstable injury where the knee just floats in the breeze. I'd be amazed if you had torn both at the same time without the examiners picking it quite clearly. If you have a grade 3 MCL, even though the ACL was intact it may feel as though it had slightly more anterior movement. The MRI should confirm this good news.

By contrast, Alla's experience is the opposite and also not uncommon. Whenever there is an isolated diagnosis of LCL made, it is always a bit suspicious that maybe the real diagnosis is ACL tear.

[Alla]

Yeah, I guess that the similarities I saw were in the fact that there was some doubt in the diagnosis and that the physical tests didnt give a conclusive answer straight up. Whether that was because the first few PT/DRs that I saw were not that experienced in diagnosing my sort of injury (and all said that I'd not done anything serious because it didnt swell up) or not I'm not sure. It wasnt until I saw a sports injury specialist that I got a diagnosis that made sense, and the diagnosis was made very quickly.... no messing about (they knew what they were on about!!)

Alla

[snaughton]

Well - just got back from seeing a specialist. MRI results are in, and my ACL and PCL appear intact. Big relief!!
A high grade MCL tear was evident though, so I am still 6 weeks or so from resuming any sport.
My sisters fiance had a recon a couple of months ago, and for a while i was having visions of racing him to a full recovery.
I have physio exercises to keep me busy, and my next project will be researching an exercise program that will help protect my knee when I return to sport.....

Good luck Alla, I am sure you will tackle the remaining rehab head on.
Like you said, the hard bit is not knowing what is wrong......