Disclaimer: This is a warning to everybody who sprains his knee, based on my personal experience. Any problems caused by following my advices are not my responsability!
I live in Holland and I injured my knee playing badminton, in December 2010. I jumped, landed awkwardly and twisted the knee. I could flex it and stretch it in the full range of motion immediately after the injury took place.
I went to the hospital a couple of days later, to have it checked. It was very swollen and painful, I couldn’t bend or stretch the knee. I got a pressure bandage on and had to return to the hospital in 5 days. I left in crutches.
5 days passed and I went back. No improvements. I got an x-ray done, nothing was broken. I got another pressure bandage and was booked for another appointment in almost 2 weeks time.
Almost 2 weeks passed and I went for my 3rd appointment. Still no improvements. We are now getting close to 3 weeks after I got injured. I was recommended to do fysiotherapie, because I couldn’t strecht my leg. I was told that if I didn’t stretch my knee soon, I would not be able to fully stretch it again ever (!!!). I left without pressure bandage and with a document stating I should start fysiotherapie. I also had a new appointment in 2 weeks, with an orthopedic surgeon.
I got to the fysiotherapie 4 or 5 days after I was recommended starting it because New Year’s eve delayed my start. We are now 3 weeks after the injury.
I had some tests done in the fysiotherapie which pointed at potential problems in my Anterior Cruciate Ligament (ACL) and in the meniscus. My quadriceps muscle had already disapeared. This is a common situation when you injure your knee and stop using your leg: the muscle shrinks to oblivion in a couple of weeks. I started immediate fysio with 2 sessions a week, to recover the muscle, and I had exercises to do at home to regain the ability to stretch the knee and to regain muscle mass.
During the recovery I managed to have an MRI done, which I almost had to beg for. It’s an expensive test, doctors may be reluctant to do it. My orthopedic surgeon prefered to do the surgery ratter than the MRI. He thought I had a problem in the meniscus and not in the ACL. I argued that I prefered to have the confirmation via MRI before jumping to a surgery. He conceded, and the MRI showed no meniscus problem and a rupture of the ACL. Without the MRI I was going to have a surgery in the knee to fix a meniscus that was ok, and no ACL reconstruction. Then I would have to go to another surgery to fix the ACL. Yes, astonishing!
After 6 months I’m still doing fysiotherapie, the quadriceps is much stronger but still not up to the level of the one in the other leg. I can’t run and I have to be careful while stepping because the knee is unstable without that ligament. I’m up for surgery soon, in which I will have ACL reconstruction using a piece of my hamstring tendon.
- If you ever get a sprained knee, go to the hospital immediately.
- Ask for an X-Ray and have yourself booked for an MRI as soon as possible. If you are a sportive person and have ligament injuries, you want to have it operated as soon as possible and the MRI is invaluable in the diagnosis. You can live without that ligament, but the knee will never be stable enough if you do activities that involve knee rotation such as tennis, badminton, handball, etc. If you are not a sportive person and you have a sedentary life, you may be able to skip the surgery. Letting your knee heal while having fysiotherapie and building muscle around the knee should be enough to make it stable.
- Ask for fysiotherapie from day 1. The fysiotherapist should tell you to contract the quadriceps muscle often. This will minimize the muscle loss and cut several months out of your recovery process. Remember, in 3 weeks I lost all my muscle and, after 6 months of weights training, I’m still building up the muscle to get to the normal strenght levels.
- Push the doctors, ask questions, inform yourself. Some doctors just don’t care about your recovery time. After the rocky start I lost trust in the doctors that I had and for this reason I started to prepare the meetings with them. I read about the problem, I talked with people that went through the same process, I studied the different techniques used in ACL reconstructions to choose the one I thought was better.
- Don’t try to shorten the recovery time by cutting on fysiotherapie. Think about your future and do it properly. 6 months is the minimum recovery time after the surgery, 1 year for complete healing of the ligament implant.
Some reading material
Anterior Cruciate Ligament
Anterior Cruciate Ligament reconstruction
If you have such a problem, all the best to your recovery. In case of questions, just let me know.