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ACL tear or sprain?

post #1 of 19
Thread Starter 

Almost 2 weeks ago I was playing in a soccer game, I had my foot planted and quickly went to move out of the opposing girl's way, well my leg stayed planted, so my body went one way and my knee the other. There was a loud pop (I just found out today that some players on a totally different field heard it pop), I immediately hit the ground and basically thrashed around like a fish out of water while yelling in pain. I couldn't walk on it or bend it, it was too painful. I went to the ER (veterans hospital, not the best of healthcare), he said it was just a sprain but the only test he performed on me was I think the lachmans, it was already 3+ hours after the injury took place, not to mention I wasn't laying down while he did it, I was in a wheelchair. It never had any large amount of swelling, it did swell though for about 4-5 days. Almost 2 weeks later I can walk on it fine, but going up stairs or up a curb or certain positions while moving send a pain through my knee. I tried to run on it, it didn't hurt but there was a weird sensation that I cant explain.

 

I had a follow up with my PCP, she put me in for a MRI, I'm still waiting for that appt. do you think its torn or really just sprained? Should I cancel the MRI appt??

post #2 of 19

My bet is that your ACL is blown. 

 

post #3 of 19

Yeah, that sounds like a blown ACL. Get an appointment with an ortho. NOW.

post #4 of 19

Also, the ER doc said he THOUGHT it was a sprain???? That's totally suspect.

post #5 of 19
Thread Starter 

Thanks for responding guys! Yeah, veteran healthcare isn't the best healthcare. I am still waiting for them to call me to set up an MRI appt, they only have 1 MRI machine!!! It's crazy but that is my only insurance. 

 

 

Do you guys remember what your's felt like when you injured yours (if u did)? I hate being left with no answers from my doctor.

post #6 of 19

Mine hurt pretty badly immediately, and I definitely felt popping. I think I remember feeling three pops, but I tore my MCL and ACL. When I went to stand up, the knee had no stability whatsoever. If I put weight on it, it felt like it was going to give out and that I would fall again. However, I do have to say that once the initial pain wore off, I don't remember it hurting THAT badly. Don't get me wrong - it hurt. But, for instance, I rolled an ankle really badly one time - didn't break it, but stretched the hell out of all the tendons and ligaments. That hurt for a lot longer than the knee hurt. Although, the knee would be stiff and sore from the swelling, but the ACL injury itself wasn't what caused the pain. In general, I think the ACL doesn't receive a ton of blood flow, so I think it doesn't sense pain as well as other areas. Also, mine is completely severed, which, according to my ortho, means that it doesn't hurt as much because it's not stretching or anything when I move. It's just NOT there. The MCL caused me more actual pain after the initial injury because there were still some fibers connecting it, so when I moved wrong I felt it. Also, there was a lot of significant bone bruising (typical with ACL tears because the bones experience trauma when they hit each other and possibly the ground), and that hurt for a while after.

post #7 of 19

I felt the pop in mine but was able to get up an put weight on it though it did hurt.  Urgent care doc said it was a meniscus as did a follow up to a sub doc for my primary care.  Knee still hurt though I was getting mobility back so my primary ordered a MRI.  I had a fully torn ACL.  The pop is a dead give away.  I passed the lachman test as well.  Get the MRI done as soon as possible and ID a good Orthopedic Surgeon now.  Good bet the ACL is torn.

post #8 of 19
Thread Starter 

Thanks. I finally have my MRI scheduled for this Saturday; I will be sure to update. I'm just excited to have some answers. 

post #9 of 19


didn't hear a pop and had almost no swelling. full detachment with bone bruising and meniscus tearing.  Not a lot of pain in the knee initially. My knee was highly unstable. could not walk on it without brace for  for several days.  Weird feeling is right on.  Hard to explain, just weird..
 

Quote:
Originally Posted by Jaisquared View Post

Thanks for responding guys! Yeah, veteran healthcare isn't the best healthcare. I am still waiting for them to call me to set up an MRI appt, they only have 1 MRI machine!!! It's crazy but that is my only insurance. 

 

 

Do you guys remember what your's felt like when you injured yours (if u did)? I hate being left with no answers from my doctor.



 

post #10 of 19

That definitely sounds like you blew you ACL.  It sounds like the classic description and much like when I blew my left ACL.  Glad you are getting the MRI to confirm it.  Make sure you shop for a good Orthropedic surgeon. 

 

I know when I ran or tried activities without my left ACL (I have blown the right too), I recall that it felt strange.  It was an out of body experience sometimes.  For example, while running, I could look down and watch it moving, and I was controlling it, but yet if felt different, somewhat less responsive, like I was detached from it and forcing it to perform. 

 

Best of luck.  Let us know what the final diagnosis is.

post #11 of 19
Thread Starter 

Finally I have the MRI tomorrow, I just hope it doesn't take too long to get the results.

 

Thank you guys for replying! It is now almost 3 weeks past injury; I go back and forth on if I think it's torn or not. Some days it feels fine, except for certain movements and then there are days like today, it's sore all day. 

 

2 days ago I was walking when my knee just buckled on me. I think I'm in denial cause I just played it off as coincidence. Sunday is game 2 of my new season, I hate missing games! I already missed game 1. 

 

And about that "weird sensation". I wish I could explain it to you all. Sounds like you guys know what I'm talking about!

.
post #12 of 19
Stay positive! I just had an intermediate skier spend 4 weeks w me for rehab after a complete tear skiing. They decided that surgery was not for them.

We did the work & the MD cleared them to return to cruising skiing this week!
Very rare, yet it is what is possible!
post #13 of 19
Thread Starter 
Well my doctor called, she said my knee had been dislocated but is back in place now. She said all my ligaments are fine. This scares me because I know something is wrong with my knee. If it doesn't get better, I am going to push for further testing.
post #14 of 19

I dislocated my knee 8 times, most of which were playing soccer. Yes, something is still wrong with your knee, if it was just  a few weeks ago. There is trauma that happens when the kneecap moves out of place like that; luckily you didn't tear a ligament, too, though, it looks like. Be patient. And find a physical therapist!!  

 

I had surgery on mine when I was a teenager; it never popped out since then, but the damage that had been done by the repeated dislocations is starting to feel not so good. I never injured that knee in any other manner, but there is crap in there, I can feel it, and it has started swelling up after I'm active. Taping it helps a lot (google kinesiotape). Do lots of research and try to stop it from becoming a recurrence.  THe "good" news is that it hurts less and less each additional time you pop it out ... everything gets loose and it doesn't tear as much stuff. Of course, that's not really good news. But, it doesn't hurt as bad. The first time is murder.

 

http://nemsi.uchc.edu/clinical_services/orthopaedic/knee/patellar_dislocation.html 

 

 

Associated problems normally occur with patellar dislocations, the most obvious of which is tearing of the ligaments that stabilize the kneecap itself. As is the case with all other joints, ligamentous disruption or tearing occurs to allow the joint to dislocate. In the case of patellar dislocation, the ligaments on the inside of the knee are the most commonly injured as the kneecap slides laterally. While tearing of these ligaments is unfortunate, they do have the potential to heal. Of much more concern, are the small fragments of cartilage and bone that often are knocked off of the kneecap or the lateral femoral condyle during the relocation of the kneecap. These fragments become loose bodies and usually require removal during an arthroscopic procedure. Patellar dislocations can cause significant quadriceps muscle injuries, which can be made worse due to the effusion within the knee or to early onset of exercises and premature return to play.

A condition referred to as patellar subluxation also exists. The problem exists on a continuum between patellofemoral malalignment and patellar dislocation. It can be sequelae of a traumatic dislocation or in situations where patellar hyperlaxity exists. A subluxation is a partial dislocation in which the patella attempts to dislocate but does not do so completely. Situations such as these are very disconcerting and often give the patients a sense of giving way or buckling. At a minimum, these situations should be treated with aggressive therapeutic intervention as the constant subluxation events not only will interfere with competition, but will also potentially cause repeated wear and discomfort within the patellofemoral joint.

.....Unfortunately, once a patellar dislocation occurs, especially when it occurs in a situation where hyperlaxity of the ligaments exists, which is commonly the case, recurrent dislocations can be expected. These are significantly problematic for athletes as they often come in the midst of the season. Conservative management of these problems in season with appropriate rest, appropriate hip and thigh muscle strengthening, and perhaps the use of a patellar buttress brace is appropriate.

 
post #15 of 19
Quote:
Originally Posted by Jaisquared View Post

Well my doctor called, she said my knee had been dislocated but is back in place now. She said all my ligaments are fine. This scares me because I know something is wrong with my knee. If it doesn't get better, I am going to push for further testing.


Glad they say your ligaments are fine.  I am sure there is other soft tissue trauma.  Hopefully, that will all heal.  The body will do it's best to return to a state of "normal", but it takes a while sometimes.  Do PT and let the knee capsule tighen up.  In PT, they should focus on muscle strength and muscle BALANCE.  You might have in inbalance in strength that makes the knee more likely to dislocate.  I'd suggest a brace for additional support while the knee is healing.  Best of luck.

 

post #16 of 19

ALL GOOD ADVICE!- classic example of why we post here. Doc says your knee is fine?  um really?  Seriously?  (where's that dr that was criticizing us for posting for help? )  Yes, it will definitely take time for all to heal and tighten back up.  during that time, you need to be very careful that you don't do more damage to the knee. Are you sure you didn't tear meniscus?

 

Quote:
Originally Posted by segbrown View Post

I dislocated my knee 8 times, most of which were playing soccer. Yes, something is still wrong with your knee, if it was just  a few weeks ago. There is trauma that happens when the kneecap moves out of place like that; luckily you didn't tear a ligament, too, though, it looks like. Be patient. And find a physical therapist!!  

 

I had surgery on mine when I was a teenager; it never popped out since then, but the damage that had been done by the repeated dislocations is starting to feel not so good. I never injured that knee in any other manner, but there is crap in there, I can feel it, and it has started swelling up after I'm active. Taping it helps a lot (google kinesiotape). Do lots of research and try to stop it from becoming a recurrence.  THe "good" news is that it hurts less and less each additional time you pop it out ... everything gets loose and it doesn't tear as much stuff. Of course, that's not really good news. But, it doesn't hurt as bad. The first time is murder.

 

http://nemsi.uchc.edu/clinical_services/orthopaedic/knee/patellar_dislocation.html 

 

 

Associated problems normally occur with patellar dislocations, the most obvious of which is tearing of the ligaments that stabilize the kneecap itself. As is the case with all other joints, ligamentous disruption or tearing occurs to allow the joint to dislocate. In the case of patellar dislocation, the ligaments on the inside of the knee are the most commonly injured as the kneecap slides laterally. While tearing of these ligaments is unfortunate, they do have the potential to heal. Of much more concern, are the small fragments of cartilage and bone that often are knocked off of the kneecap or the lateral femoral condyle during the relocation of the kneecap. These fragments become loose bodies and usually require removal during an arthroscopic procedure. Patellar dislocations can cause significant quadriceps muscle injuries, which can be made worse due to the effusion within the knee or to early onset of exercises and premature return to play.

A condition referred to as patellar subluxation also exists. The problem exists on a continuum between patellofemoral malalignment and patellar dislocation. It can be sequelae of a traumatic dislocation or in situations where patellar hyperlaxity exists. A subluxation is a partial dislocation in which the patella attempts to dislocate but does not do so completely. Situations such as these are very disconcerting and often give the patients a sense of giving way or buckling. At a minimum, these situations should be treated with aggressive therapeutic intervention as the constant subluxation events not only will interfere with competition, but will also potentially cause repeated wear and discomfort within the patellofemoral joint.

.....Unfortunately, once a patellar dislocation occurs, especially when it occurs in a situation where hyperlaxity of the ligaments exists, which is commonly the case, recurrent dislocations can be expected. These are significantly problematic for athletes as they often come in the midst of the season. Conservative management of these problems in season with appropriate rest, appropriate hip and thigh muscle strengthening, and perhaps the use of a patellar buttress brace is appropriate.

 


 



Quote:
Originally Posted by skidding View Post


Glad they say your ligaments are fine.  I am sure there is other soft tissue trauma.  Hopefully, that will all heal.  The body will do it's best to return to a state of "normal", but it takes a while sometimes.  Do PT and let the knee capsule tighen up.  In PT, they should focus on muscle strength and muscle BALANCE.  You might have in inbalance in strength that makes the knee more likely to dislocate.  I'd suggest a brace for additional support while the knee is healing.  Best of luck.

 



 

post #17 of 19

Jaisquared...the way you describe your injury and symptoms looks to me like a tear of one of the meniscus, external tearing of the fibers linking the meniscus to the tibial plateau can produce the poping noise, this injury cant be seen on the RMI but if the tearing extend from the outside to the inside of the meniscus the injury will progress in time... the tearing of those fibers will send a negative feedback to the corresponding quadratus muscles, decreasing stength in those muscles and leading to a weird feeling of an unstable joint, depending on the severity of the injury you should be back to normal within a 4-6 weeks periode, dont be surprise to see some atrophy of your thigh muscle...best of luck !

post #18 of 19
Thread Starter 
Thanks for all the advice. I picked up a brace today from my doc. She said I could play soccer again, I'm kinda skeptical thought. Not to mention, I'm terrified of having that injury happen again. She also got me in PT but not until March 19 (gotta love the V.A). I will be doing stuff on my own as well.

She said all my mensici were fine, I hope she is right. Also, this is my 3rd time dislocating my knee. The first time was 13 years ago when I was 16, playing soccer that time as well. The second time was a few months after that, will dancing to Nsync in my room lol. I don't remember them hurting this bad though and never lasting as long as this. Maybe becuse I'm older now.
post #19 of 19

Happens all the time, try to resist Justin Beiber for a while......  biggrin.gif

 

not a doctor and not trying to be one but how can you tell if you do or do not have a meniscus tear w/out an MRI?  3rd times not a charm, I would be VERY careful playing soccer or anything that requires cutting movements until that leg has time to tighten up

Quote:
Originally Posted by Jaisquared View Post

Thanks for all the advice. I picked up a brace today from my doc. She said I could play soccer again, I'm kinda skeptical thought. Not to mention, I'm terrified of having that injury happen again. She also got me in PT but not until March 19 (gotta love the V.A). I will be doing stuff on my own as well.
She said all my mensici were fine, I hope she is right. Also, this is my 3rd time dislocating my knee. The first time was 13 years ago when I was 16, playing soccer that time as well. The second time was a few months after that, will dancing to Nsync in my room lol. I don't remember them hurting this bad though and never lasting as long as this. Maybe becuse I'm older now.


 

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