Is my knee ever going to get better?
July 5, 2012 1:14 AM   Subscribe

Is my knee ever going to get better? I fell about two months ago, and it hurts and pops incessantly.

I went skiing and fell hard. I twisted my body in such a way that my torso was one direction and my knees the other. There was a popping sound and I could hardly stand to put weight on my leg. The knee was swollen immediately. I couldn't straighten it completely without pain for a couple of weeks, and bending it also hurt, too.

Two months have gone by. I can walk and bike without discomfort, but there is still pain when I put weight on the outside edge of my foot (pain on the side of my knee, not in the knee cap or thigh.) When I rub the side of my knee, I can feel inflammation and swelling around the bones. My knee also pops continuously. It pops probably one hundred times a day. I guess it's probably a ligament, but sometimes I think my knee cap is out of whack.

You're not a doctor, sure. But have you had an experience similar to this, and how long did it take for you to get better? Or do you know anything about knee injuries? Will wearing a brace really help? It's annoying as hell, and I really can't stand it, but I'll do it if it helps. What else should I do? Will I be able to ski this winter?

I would go to the doctor, but I don't have insurance, and I was pretty sure they wouldn't be able to do anything, anyways. I only want to go if it's going to matter. I've broken a rib and hurt other areas of my body, and it seems, unless it's broken, they send you home with nothing but a bill.

posted by amodelcitizen to Health & Fitness (15 answers total) 2 users marked this as a favorite
I have ripped a cruciate ligament before (drunken bronc-riding incident) and it felt a lot like what you are describing.
I strongly advise you to see a physiotherapist, who will be able to diagnose exactly what damage you have done, and give you specific exercises to strengthen the muscles in your leg that can take the strain and keep your leg positioned properly while your ligament mends.
Wearing a brace isn't going to be enough to keep your knee positioned safely.
You won't need many physio visits if you are sensible about doing the 'homework' they give you - an initial consultation and one or two follow-ups.

The more you try to walk about ignoring the damage, the more harm you are doing. It's worth getting it sorted, even if you have to spend this year's ski budget on it.

My (accelerator side) knee freezes now if I drive for hours (I have to fall out of the car with that leg "locked" in position, it's hilarious to bystanders) , I can't jog (not that I ever did!) and it gave me some grief when I was heavily pregnant, but I could manage ski-ing fine.
posted by Catch at 1:37 AM on July 5, 2012 [2 favorites]

Nthing the "you're hurting yourself by not getting help" thing. A physiotherapist is a maybe in my head, primarily because whenever I've done something like what you're describing to one of my joints (or one of my family members has done it to themselves,) they usually talk steroid injections and then rehabilitation type stuff.

I'd expect decreased, but permanent, popping. Like, 5 times a day instead of 100. Joints don't play nicely once you've messed them up once, in my opinion.
posted by SMPA at 2:03 AM on July 5, 2012 [1 favorite]

First the bad news: if you don't get to the physio/surgeon, it will get worse. Next the good news: If you go to the physio/surgeon, it won't get worse. 15 years after arthroscopy, the health of my knee depends on the health of all the supporting muscles around the knee. Depending on the extent of the damage, a professional can get the pain/inflammation/cartilage debris around your knee back to a point where your muscles can begin to take the strain off the damage. If you've torn a ligament, of course, all bets are off: you have to have surgery and anything up to a cast to hold it together. In sum, I don't think you have a choice---suck it up and go to the man (woman).
posted by alonsoquijano at 2:15 AM on July 5, 2012 [1 favorite]

While I've never done anything as severe as what you describe, I once managed to dislocate my kneecap while dancing to Petula Clark. As has been said above, returning to comfort and stability was a matter of physio. The good thing is that, as you are otherwise active, the vast majority of the benefit would be down to how diligently you did your exercises. This gives you a degree of control and the chance of minimising the costs.

Waiting for this to get better while it gets worse is overwhelmingly likely to be a case of spoiling the ship for a ha'porth of tar. Whatever help you need, you need it sooner rather than later.
posted by howfar at 2:30 AM on July 5, 2012

Yeah, doctor then physical therapy. I won't get better on its own and can get worse. Physical therapy helped me when I slipped on the stairs and got a torn meniscus.
posted by mermayd at 2:58 AM on July 5, 2012

Holy crappers, dude. I know you don't have any insurance, but come on, if you can afford to go skiing you can afford to see a doctor. Walking around on this thing for two months may have done god knows what to it. See a physio immediately. Get a good one based on recommendations from any friends with serious athletic hobbies, and explain you can't pay for too many sessions.

Sorry, I'm not a doctor or anything but you may need surgery, that sounds serious, and two months walking around on it could have really screwed with the cartilage.
posted by smoke at 3:23 AM on July 5, 2012 [4 favorites]

I'm not a medical doctor, but I've been around a lot of knee injuries, and the popping is a bad sign. Can you get a friend to do a quick Lachman or Drawer and a Varus stress and Valgus stress test? If you find that you've torn a ligament, my understanding is that it's not going to heal on its own, and that you're going to need surgery to fix it, especially if you want to remain active.

My general understanding of braces is that you don't want to be wearing one for the long term, because the muscles get weaker. I do know people who walked around with torn ACL's for years, but my understanding is that knee injury is strongly correlated with later development of osteoarthritis, which means that if you don't get it fixed, you may eventually need a new knee.

Anyway, if it hasn't healed after two months, you really really want to see a doctor, probably an orthopedic surgeon. This will probably not be cheap, I'm afraid.
posted by Comrade_robot at 3:44 AM on July 5, 2012 [2 favorites]

unfortunately some injuries never heal properly on their own. there's no way of knowing whether this is the case without getting at the very minimum an exam by an orthopedist and probably an mri. this is so important it's worth getting a job with insurance for. you just cannot let this slide.
posted by facetious at 5:04 AM on July 5, 2012

About 10 years if it's busted in a way that heals. I did something to my knee coming out of a bad forward roll. It ached and popped and for years if bent my leg more than 90° it would lock and I'd have to force it straight (which hurt like hell). No kneeling or squatting, problems getting in and out of vehicles. Prone to giving out if I stepped just a little bit weird. Really took about 10 years to get to the point where I could slowly squat and bend it without it locking every time and it went from hurting like hell to just OW when it did lock. Ten years after that and it's back to about normal. Still wobbles a bit every once in a while when I step on it in just the wrong way but otherwise it's all good. Don't think I would try skiing on it though without going to some sort of exercise trainer first to build up extra strength.

So go see a doctor or it may get horribly worse, or it may take ages and ages to get back to a semblance of normal.
posted by zengargoyle at 6:59 AM on July 5, 2012

The longer you wait to see a doctor, the more potential damage you are doing, which means it is more likely to never heal. Do whatever you need to do in order to see a doctor, and soon.
posted by markblasco at 7:55 AM on July 5, 2012

Your decision is long term quality of life. My ex torn her ACL. Symptoms were similar to yours. Her choices were surgery or rehab. Surgery was recommended if she wanted to be active in sports and running and hiking. Rehab was the option if she wanted to avoid surgery, have a reasonable use of her leg and less short term pain.

I think by not going to a doctor (and I am not a doctor) you are really just limiting your options. The damage to your knee is already done. The question is what steps to take to mitigate, correct or reverse the damage.
posted by JohnnyGunn at 9:28 AM on July 5, 2012

Yes, go to the doctor. Purely anecdotal, but my husband hurt his knee in high school and never had it treated. It kept getting worse and worse, until he was taking so much advil that he gave himself an ulcer. He finally had surgery a few years ago, and he does still have some pain (for which he can no longer take NSAIDs), but it's much better than it used to be. It's possible he would have no pain if he'd gotten it really checked out when he was a teenager.

Your knees are important. You should find a way to see a doctor, if it's at all possible.
posted by ashirys at 10:57 AM on July 5, 2012

This sounds a lot like what happened to me. In my case it was a simple patellar dislocation. My knee moved to the outside of my leg and I managed to push it back in myself. I went to a sports medicine clinic, but luckily I have insurance. I suggest purchasing an individual insurance policy if you can. I called an insurance broker for help when I got mine and I recommend doing that. I am a bit fuzzy on how pre-existing conditions are dealt with now that SCOTUS has passed the PPACA but the broker can explain everything. I advise you to ask questions without volunteering a ton of information.

The other option is to find a charity hospital, sliding scale community clinic, or uninsured person's charity in your area. Where do you live?

In any case, you need treatment. My injury is considered to be not very serious and even so, I need at least a week (or several) of immobilization and RICE (rest, ice, compression, elevation). After that, the doctor said I would need at least six weeks of physical therapy rehab exercises for strength and range of motion. I am in a walking brace and using a cane and my leg is week and I can't bend or straighten it. It feels like my knee is about to pop out every time my quads in the injured leg fire. The doctor said I will have to wear a sleevelike knee brace for months and keep my leg muscles strong forevermore. He thinks I tore the MPFL, which holds the patella in place. I won't need surgery, but I will always need to exercise.

It sounds like you may have torn your ACL, which is something I feared I had done, but didn't. That's a potentially more serious injury and may require surgery. It will definitely require physical therapy. You need to make sure you get a diagnosis and a referral for PT, and dedicate yourself to recovery and prevention afterwards. Knee injuries are nothing to take lightly.

Good luck! I truly sympathize with you.
posted by xenophile at 11:50 AM on July 5, 2012

Thanks for all the insights. As much as I hate it, I made an appointment with the PT for today.
posted by amodelcitizen at 12:18 PM on July 5, 2012 [1 favorite]

Orthopaedic surgeon here. I would be most concerned with an ACL tear or a meniscus tear with the symptoms you describe. If you live near a medical school or a hospital with an orthopaedic residency, they likely have a "staff clinic" that treats medicaid or uninsured patients.

I have a tremendous amount of respect for physical therapists but they aren't well-trained with diagnosis. See an orthopod first, get your diagnosis and then see the PT for treatment. My guess, and that's all it can be on the interne,t is that surgery may be in your future.
posted by karlos at 6:38 PM on July 5, 2012 [3 favorites]

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