Knee pain still after 18 Months

[kane08]

Hi

Around about January 2009 I suffered a knee injury whilst playing football. Basically I went in for a slide tackle and got my left foot stuck in the ground but my knee still continued to go trhough the motion resulting in a very painful injury. I did all the usual R.I.C.E treatment and after about 4 weeks I managed to start playing again but I still had a pain on the inside of my left knee - any impact on that part was very painful and if I was to twist my knee inwards it feels as if the ligamnet is over stretching and very painful.

I ended the season aroung mid May & also had a hernia operation on August so was physically inactive for about 6 months. When I started training again in September everything was going fine and I seemed to be getting up to full fitness when I suffered another knee injury playing football. This time I was running in a straight line and got my caught in the ground and hyperextended my knee. I was out of action again for around 3 months and did all the usual initial treatments. It got to around January time 2010 and had an MRI scan which revealed no ligament damage but I had bursitis at the back of my knee. The doctor has re-itterated a few times that I do not need surgery. I had a cortizone injection at the same time as well. I also seemed to developed at little lump on the inside of my knee which my doctor said it was more than likely scar tissue.

I then started physio mid feb time in which after about 2 months the bursitis seemed to have heeled but still have the pain on the inner part of my knee twisting it inwards still pain and could not kick a ball properly still. Despite this I decided to start training again and a month into it again I injured the same part of my knee playing football this time getting my caught caught in the grass and twisting my knee inwards.

I have been at rest and not done and CV work at all since early April but I still seem to have the same problem with my knee - it constantly aches and feel like a deep aching pain on the inside and back of my knee, whenever I twist it inwards it feels like a muscle or ligament is twisting, I still have the lump on the inside of my knee, it feel svery unstable and weak and locks quite frequently.

I am starting to get worried that this may now be quite a serious problem like osteoarthritis. I have not had an xray only an MRI. Considering I have been playing football and various other sports for the last 18 years my knees have taken quite a beating. Hopefully from the above info you could possibly give me a indication of what may be the problem & how I can get it treated. I am only 24 and I know how complex knee injuries can be but I really am getting frustrated as I have had constant pain for the last 18 Months.

I look forward to your response.

Regards

Kane

[Heidi]

Hi Kane
Your knee problems could be a number of things. The kind of incidents you have described typically cause either ligament or cartilage damage, or sometimes both.
Given that you have re-injured your knee and it never completely cleared up after the first 2 times, I would suggest trying to get another MRI. These are better than x-rays anyway so I wouldn't worry about not having had an x-ray. Any bone damage would show up on the MRI anyway.
What treatment were you given from the physio i.e. manual therapy such as massage, ultrasound etc and exercises? If so which? and did you stick to them religiously?
http://www.sportsinjuryclinic.net/cybertherapist/front/knee/medialmeniscus.htm

[kane08]

Hi Heidi

Thanks for your quick response.

The physio I had was basic stretches hamstring, calf, soleus, quads & groin to hold them for 30 seconds each, twice, 3 times a days. I also have to do some other exercises such as lie down and lift my legs up off the floor and hold, then do the same with 1 leg etc. I did this for about 8 weeks and honestly stuck to it completly. The bursitis (clicking behind my knee) seemed to have gone and I went back training, not doing it as often or frequently to the point where I was just stretching before & after I trained.

Again the 3rd injury to my just seemed to be really inoxious on that I got my foot cuaght in the ground and it twisted but it just seems a coincidence that it is the same injury. I got signed off from the physio as she was happy with how I had progressed and was happy for me to basically get back to normality.

Now the clicking behind my knee has come back as well as the pain on the inside of my knee when bending inwards. I have gone back doing the exercises prescribed by the physio originally and the muscles seem to be gaining strength again and I am sure in no time that the bursitis will heal. I am just worried about the pain on the inside of my knee as I say this has been an on-going problem for some time. I am due to go for a cortizone injection & ultrasound so that may help.

If there is anything else you could recommend to help with the healing process I would be very greatful or any other info relating to my symptoms.

Thanks Again.

Kane

[Heidi]

Hi.
If that was the only strengthening exercise you were given then I would suggest that this isn't enough and you should be looking to strengthen the calf, hamstring, quad and groin muscles thoroughly with weight training exercises before you return.
I would definately recommend ultrasound. Cortisone shots can be helpful in some cases, although you can only have one so I would put it off as long as possible and go with the ultrasound and a more thorough rehab program 1st.