knee problems

[choxx]

Hello, I'm a 33 year old male. I played basketball again last January after a very long lay-off. I usually hit the gym for a few weeks before playing basketball after a long lay-off. But this time, I played immediately. The first two games(1 week) were ok...did not feel anything. On my 3rd game(2nd week), I felt a pain on my right knee(like a needle that struck on the left side of my patella) when I went for a lay-up. The pain was gone after landing but It was a bit uncomfortable. I resumed playing because it was not really painful. There was no swelling after the game. On my 4th game(3rd week), I felt again the same pain when I tried to intercept a pass while back-pedalling. But after that, It was gone again and no swelling. On my 5th game(same week), I played on a different venue. The floor was slippery. I did not experience any pain while playing even if I made some controlled running due to the slippery floor. But after the game, the swelling began(but it was not painful)! I was wondering because the swelling was on the right side of the knee and on the back of the knee and the pain that I had was on the left of the patella(but inside). I stopped playing after that and the swelling subsided after 2 weeks. I have no problem walking straight but i feel uncomfortable when making lateral movements. Did I torn a ligament? Please help! TIA.

[Heidi]

Hi
Its difficult to advise you as to what you may have done. It may be a ligament injury, although generally you would feel pain or a popping/tearing feeling at the time of injury. It is also unusual if it were a ligament injury, to feel it initially on the inside of the knee and then to have other symptoms on the outside/back of the knee. Usually ligament injuries are quite pinpointed with their symptoms.
Have a look at the knee injuries section and see if you can find anything which resembles your injury: http://www.sportsinjuryclinic.net/cybertherapist/knee_injuries.htm

I would suggest lateral collateral ligament injury, meniscus injury and patellofemoral pain syndrome.

[choxx]

Yes, I did n't hear a popping sound and did n't experience a tearing feeling either.

Anyway, thanks for your swift reply. I'll check out the link you gave me.

[choxx]

After more than a year of resting my knee and doing some biking and weight-training exercises, I started playing basketball again. I felt no pain in my knee while playing but when I woke up the next day, I felt a sharp pain as I walk down and climb the stairs but no problem when walking. There was no swelling also. I consulted my physiotherapist and he ordered for an MRI.

Here's the MRI result:

Interpretation-
The anterior cruciate ligament near its insertion is in the coronal, sagittal and oblique sagittal images appears thickened with intrasubstance increased signals.
The anterior cruciate however remains taut.
The posterior cruciate is intact.
The medial and lateral meniscus remain of normal configuration and signals.
The medial and lateral collateral ligaments as well as the quadriceps and patellar tendons are of normal appearance.
The, patella, tibia and fibula are otherwise intact without evidence of fracture.
The patellar retinacula are well formed.
There is however no significant joint fluid effusion.
The rest of the soft tissue structures are unremarkable.

Impression-
Low grade partial intrasubstance tear, anterior cruciate ligament near its insertion is entertained.
No demonstrable meniscus tear.
No evidence of joint effusion.

I will see my doctor later this week.

Can you kindly explain to me the MRI results? My physiotherapist also mentioned about Patellofemoral instability. Is it possible base from the MRI results? What might be the possible treatment? Will I be able to play basketball again?

Thanks in advance.

[Heidi]

Hi
Basically most strucrures within your knee are absolutely fine. The only thing they have found is a problem with the ACL, although very minor. The ligament itself is intact (not torn), although there may be some mild damage at one end of it, where it attaches to the bone.

This kind of injury geenrally wouldn't require surgery and would be treated conservatively through physical therapy and rehabilitation.

As for patellofemoral pain, this wouldn't show on an MRI, although some signs of it such as joint effusion or damage to the articular cartilage which lines the back of the kneecap.

[choxx]

Thanks for the reply.
It's good to know that it's only a minor one. After therapy and rehab, will I be able to play basketball normally? Thanks again.

[Heidi]

No reason why not, barring any other complications!

[choxx]

I'm so happy to hear that. Thanks, Heidi

[sportsman]

[QUOTE=choxx;3589]Hello, I'm a 33 year old male. I played basketball again last January after a very long lay-off. I usually hit the gym for a few weeks before playing basketball after a long lay-off. But this time, I played immediately. The first two games(1 week) were ok...did not feel anything. On my 3rd game(2nd week), I felt a pain on my right knee(like a needle that struck on the left side of my patella) when I went for a lay-up. The pain was gone after landing but It was a bit uncomfortable. I resumed playing because it was not really painful. There was no swelling after the game. On my 4th game(3rd week), I felt again the same pain when I tried to intercept a pass while back-pedalling. But after that, It was gone again and no swelling. On my 5th game(same week), I played on a different venue. The floor was slippery. I did not experience any pain while playing even if I made some controlled running due to the slippery floor. But after the game, the swelling began(but it was not painful)! I was wondering because the swelling was on the right side of the knee and on the back of the knee and the pain that I had was on the left of the patella(but inside). I stopped playing after that and the swelling subsided after 2 weeks. I have no problem walking straight but i feel uncomfortable when making lateral movements. Did I torn a ligament? Please help! TIA.[/QUOTE]

Hi choxx my friend had a similar problem with associated meniscal tear. He plays basketball at pro level so went to see this knee Surgeon based in Surrey, George Tselentakis who repaired his meniscus and is now playing pro again after a short time of rehab. I don't know where you are based but I ve heard a lot about this guy who does some pretty well known sports personalities. Google him. hope you get it sorted out soon!

[choxx]

@sportsman: base on the MRI, I don't have meniscal tears.

@Heidi: After months of rehab, I felt my thighs became stronger. I was able to barbell squat with weights about 75% of my bodyweight.
I was able to jog without pain for almost 2 weeks. Just this week, I played basketball again(about 20 min. on the court). As I
was playing, my legs felt stronger than before and I'm not feeling any pain while playing. The morning after, I felt a bit of pain
at the back of the patella when going down the stairs, but it is very tolerable. I have no problems going up. I also noticed that
it swelled a bit(the skin is not warm and reddish but more of fluid accumulation). I am resting and icing the affected knee thrice
a day since the pain started. The pain was reduced but swelling remains. I suspect I either have a patella mal-tracking or synovial
plica syndrome. Do you agree? What do you think should I do now? Thank you.