Basic Life Skill: Knee Injury
January 6, 2021 7:19 PM   Subscribe

I just fell extremely hard onto pavement and took the brunt of the fall with my knees. I've never had an injury like this before. What do I need to look out for and do over the next couple days?

So I'm a dipshit and went running even though it was much later than usual and I was super tired and distracted by the Events of the Day. I missed a curb and fell so quickly that I really couldn't catch myself at all...It's a miracle I didn't literally smash my face in. But I did smash my knees in. I'm a runner and it's basically my only form of stress relief these days so I need my knees back in action ASAP.

I am pretty sure nothing is broken; I walked the mile home from where I fell and while it certainly wasn't fun I can put weight on both knees.

There was a fair amount of bleeding and a lot of it looks to be under the skin? When I ran water over the area it just seemed like the blood didn't budge. I have gently cleansed all of the wounds and put bandages over them.

One knee is noticeably worse than the other; it has much larger scrapes/bruises and is a little swollen. I'm icing that knee right now. The other knee will have to wait until my other ice pack freezes :-/

So right now I have my legs elevated and one knee iced. I took pictures of the original injuries so I can keep track of any changes. What else should I do? Apart from quietly sob, which is also a thing I'm doing.
posted by We put our faith in Blast Hardcheese to Health & Fitness (29 answers total) 2 users marked this as a favorite
I am not a doctor but I suspect that if your knee was broken, you'd certainly know about it. I think you are doing just about all you can short of seeking actual medical assistance. Perhaps take some ibuprofen if you can.
posted by turbid dahlia at 7:28 PM on January 6, 2021 [3 favorites]

Response by poster: (I feel a little silly asking essentially a question about what very well might just be some Extra Strength Skinned Knees but I have an absurdly high pain tolerance, so when something on me actually HURTS I get a bit worried.)
posted by We put our faith in Blast Hardcheese at 7:32 PM on January 6, 2021 [2 favorites]

Best answer: You’re already halfway into the acronym RICE for soft tissue sporting injuries, Rest (which you’re doing) Ice (soon) Compress (lightly with a bandage or strapping) and Elevate (on the lounge).

You’ll expect bruising up and down your leg, which is nothing to be worried about. It’ll be hard to bend your knee for a while, ditto. See a doctor if you see signs of infection, or if you’ve got joint pain after three days to a week or so, otherwise, self-pity and painkillers and rest. Getting back to it too early is a way to reinjure yourself.
posted by Fiasco da Gama at 7:44 PM on January 6, 2021 [6 favorites]

Get on an ibuprofen schedule to keep things from swelling up too much. For the next few days, take it on schedule even if you don't feel like you need it at that moment. The anti-swelling effects of it are cumulative, plus you want to stay ahead of the pain.
posted by Blue Jello Elf at 7:52 PM on January 6, 2021 [1 favorite]

I'm sorry you're in pain.

I had a relative who underwent a similar injury, falling on just one knee though, and the result was that her kneecap was fractured. I wasn't there, so I don't know the specific symptoms it produced, but she had to be rushed to the hospital in an ambulance; so I'd think that if the circumstances are “not fun but walked a mile”, others are correct that you don't have that level of severity of injury.
posted by XMLicious at 7:59 PM on January 6, 2021

I took a nasty spill off my bike about eight years ago and ended up with bursitis. If you notice that one or both of your knees appears to be significantly puffy and filled with fluid, it's a pretty sure sign.
posted by mykescipark at 8:05 PM on January 6, 2021 [1 favorite]

For me, RICE is a great start, but I also supplement with an anti-inflammatory like Ibuprofen if you can stand it. It will keep the swelling down, and in these types of injuries, swelling = pain. All other information given by Fiasco da Gama is good and should be heeded.
posted by seasparrow at 8:14 PM on January 6, 2021 [1 favorite]

To add on to seasparrow, you can alternate Ibuprofen (for swelling) and acetaminophen (Tylenol, for pain) in 4-6 hour increments, depending on dosage. It works really well.
posted by dbmcd at 8:23 PM on January 6, 2021 [2 favorites]

I did something like this once, did the RIE (no C) + ibuprofen, was really sore for a few days, then had to wait 2-4 weeks for the surface wounds to scab over and heal. There’s great advice in this thread already and you’ll likely be fine if you follow it.
posted by A Blue Moon at 9:46 PM on January 6, 2021

Best answer: My husband also has a high pain tolerance and was walking on his broken leg (admittedly only hallway lengths, not half miles). If it were me, I’d be watching to see the pain reduce significantly by 48 hours after the accident. I’d also call my doctor in the AM and try to schedule an appointment sometime in the next week, just in case you need it (cancel it if you don’t).

Edit to add: that said, I’m sure it’s more just soreness than broken bones. Follow the advice above with nsaids and acetaminophen. I’m sorry this happened and hope you heal up soon!
posted by samthemander at 10:14 PM on January 6, 2021 [1 favorite]

Just a data point: I once fell on a hike and then walked a mile and half on a broken leg under the mistaken assumption that because I could walk, it wasn’t broken. If things don’t seem to be improving tomorrow, consider a visit to urgent care.
posted by roger ackroyd at 11:36 PM on January 6, 2021 [3 favorites]

Best answer: I've done this more than once, and the last time I went to an urgent care equivalent, they cleaned the wound and gave me a tetanus booster (I had a gash needing stitches on my hand too). My experience was (1) every muscle in my body hurt like hell the following day and I had a big headache, maybe from the shock or maybe from bracing too late, and (2) mine healed like a big graze, with a tender, swollen, bruised knee that didn't get hot or ooze but was not fun to walk on for a few days and took a few weeks to get back to normal, with ice and elevation and ibuprofen intensely at the start.

If you're not feeling a lot better, or if the wound is hot/you have a fever/you see red streaks radiating from the wound/there's anything but clear/bloody discharge, I'd see a doctor - you're going to be easing back into running even if everything's fine, but you don't want to delay treatment for/recovery from anything more serious.

It's such a horrible feeling, I'm sorry, and I hope you're back out there soon!
posted by carbide at 12:20 AM on January 7, 2021 [1 favorite]

I'm probably too late on this, but the Ice part of RICE is no longer recommended even by the guy who originally came up with the acronym, Gabe Mirkin. The research shows icing actually delays healing. Allowing inflammation to take its course is likely better.
posted by Flock of Cynthiabirds at 12:38 AM on January 7, 2021 [4 favorites]

Fractured my foot a couple weeks ago and wasn’t sure it was broken until the X-ray. I’d head to an ortho urgent care to reduce the risk of covid. Good luck!
posted by jessca84 at 1:47 AM on January 7, 2021 [1 favorite]

I am also a runner with an overly high pain tolerance. I'd say follow the advice above and see what develops in a few days. A couple of days of increased swelling and colorful bruising should be followed by slight but steady improvement, if that's not the case then maybe you did fracture something. If it were your kneecaps you'd know but there are of course other bones there with delicate little tips.

If these were my knees I'd make a doctor's appointment for 4-5 days from now, and in the meantime lots of rest and elevation, light compression, NSAID of choice. A daily photo wouldn't hurt and might help your doctor get a better scope of the problem.

If your doctor uses any kind of online patient portal, you might even be able to send the photos from the first two days to the nurses station for an intermediate opinion on whether you need further treatment.
posted by The Librarian at 2:49 AM on January 7, 2021

Use your brain/a delivery from a pharmacy to get the compression going on. Read more about proper compression of knees. Shop online to see what compression accessories are available at the local drug store. I've had much better results when I've compressed my (occasionally injured/twisted) ankles.
posted by amtho at 2:51 AM on January 7, 2021

In fact, if you have a regular doctor just call their office today and ask to speak to the nurses line. Describe what happens and see what they think, can't hurt.
posted by The Librarian at 2:51 AM on January 7, 2021

Get checked for meniscal damage once the worst is past. Took a year for me to discover that damage after lading in my knees.
posted by J.R. Hartley at 3:50 AM on January 7, 2021

Best answer: If it makes you feel any better, I wanted to share that I did this exact same thing on election day-- went out for a run as stress relief as it was getting dark, wasn't focused enough on what I was doing because I was thinking about the election, and wiped out on (not even very) uneven sidewalk straight onto my knee. Limped home bleeding in total defeat.

My knee actually hurt a bit more the day after than it did the day of, especially in the morning. It stiffened up and hurt to put weight on. I wouldn't assume you've broken something if you don't see immediate improvement, I'd give it at least two days with no improvement before you start to freak out.
posted by geegollygosh at 4:27 AM on January 7, 2021 [2 favorites]

Yeah. So, shortly after graduating high school I fell down on my knee while hopping over a chain. Caught my toe on the chain and came down with my full weight on my fully-bent knee. I have a legendary pain tolerance, so I walked around a half-mile to my car, drove home, etc. That evening my knee was extremely swollen. Went in to the MIT Health Plan and got x-rayed. Turns out I had cracked my patella and needed to spend the summer in a groin-to-ankle cast.

Lots of bad things can happen if your patella gets pulled away from where it is meant to be, which is a main worry If you have damage to the patella. It sounds like your fall wasn’t nearly as forceful as mine, but if you have pain a day a lot of swelling after 12 hours or so, I’d recommend at least contacting a doctor for advice.
posted by slkinsey at 6:14 AM on January 7, 2021

I am not a doctor but I suspect that if your knee was broken, you'd certainly know about it.

Confirming this - because you have just described, in almost every detail, the exact way I broke my own knee back in October. (I wasn't running; it was a much more comedic pratfall-y kind of thing where I stepped forward with my left foot, it hit something slippery and just kept sliding and I did a sort of split with my right knee whanging hard into the sidewalk.) I immediately knew something was wrong because 1. it hurt like holy hell, and 2. my kneecap was visibly shaped wrong. I was also not able to put any weight on it; I sat on the ground waiting for the EMT to get there, and the pain started fading; but when they picked me up to put me in the stretcher, that hurt like hell again (it felt like someone was grabbing me around the knee and squeezing real hard). Even a week later, when I was trying to get myself down the stairs in a leg brace to head out for my knee surgery, my knee buckled and that also hurt like hell.

Note, though, that it did not hurt when people touched my knee as such. My fracture was pretty big and gnarly; it broke into four pieces, first in half across the front and then the bottom half also broke into a couple of pieces, and the halves had been pushed apart wide enough that you could stick a fingertip into the gap. It's such a classic sign of a patella fracture that the ER doctor brought a couple of med students over to examine me, and they were all touching that knee and feeling where the gap was - but that didn't hurt at all. (They kept asking me.) It was only when I tried to put weight on it that it hurt (a lot).

My only caveat is that from what I understand, a hairline crack in your kneecap may not be as evident as what happened with me. Conveniently, I've also had another kind of minor fracture that I first thought was a bad muscle thing; I broke my foot 8 years back, and actually limped home on it thinking it was just a really bad sprain. It wasn't until two days later, when I noticed the pain was just as bad after two days of RICE, that I went to my doctor and discovered it was a break. (They congratulated me, though, for having done the RICE treatment, because it was what kept me from needing surgery.)

So I wouldn't worry yet; if your knee was broken above and beyond a crack, you would know. Trust me. But if the pain is still about the same after a couple days of RICE treatment, then maybe schedule a doctor visit just to double-check how things are, and that there isn't a tiny crack there that may need other attention. But from what you've said is happening I'd be more willing to bet that the bone itself is fine.

Good luck!
posted by EmpressCallipygos at 6:18 AM on January 7, 2021

Keep in mind if it's not broken there can still be damage to ligaments etc that may need attention. I would suggest visiting a doctor if you're still having any pain after a reasonable healing time, speaking as someone who didn't do that and still has knee pain years after a similar accident. Mine definitely wasn't broken and I thought all the pain was coming from the badly skinned/bruised surface but as it turns out there was also some internal damage.
posted by randomnity at 8:44 AM on January 7, 2021

Response by poster: Thanks all! I don't have a regular doctor, but I think I might brave the Urgent Care for this one. The swelling has gone down and I'm walking more comfortably but the kneecap definitely feels...weird. I wish I had paid better attention to my knees before so I could tell what was different!
posted by We put our faith in Blast Hardcheese at 9:12 AM on January 7, 2021 [2 favorites]

So, I sprained my knee pretty impressively once on a trip abroad. If you can bend your knee more or less comfortably, you probably didn't do that, good on you. If the knee won't bend, or bends only under painful protest, you may need a cane for a while, if only to help you out of chairs.

I also gave one of my knees a large area of road rash in a bike spill a little over a year ago, and it sounds like you might have some of that going on. Disinfect it as best you can, and perhaps try a hydrocolloid bandage (Tegaderm, Duoderm) -- I didn't and was (... eventually) fine, but a lot of cyclists swear by them.
posted by humbug at 3:07 PM on January 7, 2021

If you're walking more comfortably, that's a good sign, I think. Still wise to go see urgent care to figure out "what the heck happened". But the improvement sounds promising.

A tip you will probably hear, if you need to navigate stairs - as you're making your way up or down stairs, when you're going up, lead with the good leg, and when you're going down, lead with the bad one. (The mnemonic they taught me - "Up with the good, down with the bad.") It may not be a bad idea to adopt this now for safety's sake.
posted by EmpressCallipygos at 5:04 AM on January 8, 2021

Hey, this has happened to me! Twice! Once catching my bike tire in a railroad track, and once schwasted on a cobbled street in high heels. It sucks big time!!!

I will reiterate ibuprofen and RICE, especially the icing and compress. All the medical advice above sounds great. Your kneecaps will be super duper tender for days/weeks afterwards. I didn't go to a doctor either of my wipeouts, but multiple people told me I should have. I feel fine now.

Use topical disinfectant on your wounds. After the initial worstness of the wounds has subsided, I would suggest applying vitamin E oil, or lotions/petroleum jelly which contain it, to the affected areas on your knees. I had massive, noticeable scars for years after my first wipeout, and then when I hit the exact same spot on my second one (whoo), began applying vitamin E topically. It seems to have helped a lot with making the scar tissue less noticeable.

Wishing you a speedy recovery!
posted by wintersonata9 at 2:23 PM on January 8, 2021

Response by poster: Thank you all so much for your advice and reassurance! Everything has continued to improve pretty linearly (though today, as carbide predicted, my arm and shoulder muscles decided to finally be quite sore about things).

The swelling is all gone, replaced with some gnarly bruising, and while things feel a little uncomfortable while walking or bending it really feels like it's coming from the wounds on the skin surface--just has that tight, scraped feeling of an abrasion rather than a bone or joint thing.

I am still leaving things open to visit an urgent care over the weekend if it seems advisable. Honestly, if there wasn't a pandemic raging I would go without hesitation just to be on the safe side, but I just don't know that this is worth taking up the time and resources of some Extremely Busy and Tired healthcare workers.

Man, this week fucking sucked! Thanks to you all for making it a little less sucky.
posted by We put our faith in Blast Hardcheese at 4:37 PM on January 8, 2021 [3 favorites]

Response by poster: WHOOPS just in case anyone comes across this question in the future--I spoke a little too soon! The skin wounds just would not heal, and even though I was keeping them clean/covered/antiseptic'd, today they got abruptly worse and I developed a fever. So, I went to the doc and sure enough--infected. Additionally, though I was walking much more comfortably, the doc did not like a few things my knee was doing when she bent/strength tested it, so she ordered x-rays and eventually diagnosed a severe sprain.

So yeah, moral of the story, just go to the doctor the first time you think of it and not a week later. :/
posted by We put our faith in Blast Hardcheese at 10:30 PM on January 13, 2021 [4 favorites]

I’m sorry this happened to you. It sounds like you made the best choice you could with the information & pandemic resources you had. I’m glad you’re getting care! And isn’t it oddly validating when a doctor says “oh yeah, you’re hurt,” even if they can’t do much? Hoping you’re on the mend by now.
posted by samthemander at 11:59 PM on February 12, 2021

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