# Knee sprain?



## seant46

Has anyone had any experience with healing a knee sprain before? I hurt it just over 2 weeks ago, and went to the doctor who said everything should be ok in up to six weeks. They x rayed it so it looks like its nothing serious, but i am still limping with slight pain 2 weeks later. The doctor told me I shouldnt need crutches but yesterday I started to use them anyways because I thought I would be walking better at this point. 


A few questions if anyone has answers, or any advice is appreciated!


Is it ok so start physiotherapy(doc gave a prescription) now even though I still limp and have slight pain?

Will it heal back to %100 percent if I am careful with physiotherapy and everything?

If anyone has had this before, did you use crutches?

Thanks!


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## jml22

So the problem with the canadian system (im canadian) is docs almost never want to order an MRI for this kind of stuff. Also most GPs dont actually know anything about the musculoskeletal system.
So you say knee sprain, which means absolutely nothing in the real world.
How did you hurt it?
Did it pop or click? Did it swell up after you hurt it?
Can you walk? Does it give way? Has your knee ever given way?
Etc etc etc...

X-rays will only reveal bony stuff, so in the knee, it's basically fractures and arthritis and arthritis isn't always painful.
MRI will show soft tissue and blood flow to the area.
So when you say knee sprain, i think ACL, MCL, LCL, Meniscus etc etc etc....
You want to narrow down that list and proceed appropriately. If you have insurance i'd just go get an MRI. You can see a PT but not many PTs in canada can handle alot of this stuff. You can't treat what you dont know, i mean you can e stime ultra sound stretch this to hell, but if you did some major damage, it's not gonna get better.

When someone says it'll be better in 6 weeks that's because the body usually takes 4-8 weeks to heal stuff, if it can be healed by the body.


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## lo0p

I'm confused.
Your doctor told you it could take up to 6 weeks and you're worried because it's not 100% healed in 2 weeks?

If he told you not to use crutches then don't. If you're concerned about that give him a call.
And if he gave you a prescription for physical therapy then go.


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## seant46

jml22 said:


> So the problem with the canadian system (im canadian) is docs almost never want to order an MRI for this kind of stuff. Also most GPs dont actually know anything about the musculoskeletal system.
> So you say knee sprain, which means absolutely nothing in the real world.
> How did you hurt it?
> Did it pop or click? Did it swell up after you hurt it?
> Can you walk? Does it give way? Has your knee ever given way?
> Etc etc etc...
> 
> X-rays will only reveal bony stuff, so in the knee, it's basically fractures and arthritis and arthritis isn't always painful.
> MRI will show soft tissue and blood flow to the area.
> So when you say knee sprain, i think ACL, MCL, LCL, Meniscus etc etc etc....
> You want to narrow down that list and proceed appropriately. If you have insurance i'd just go get an MRI. You can see a PT but not many PTs in canada can handle alot of this stuff. You can't treat what you dont know, i mean you can e stime ultra sound stretch this to hell, but if you did some major damage, it's not gonna get better.
> 
> When someone says it'll be better in 6 weeks that's because the body usually takes 4-8 weeks to heal stuff, if it can be healed by the body.


Hmm I didnt think about an MRI as i dont really know too much about this. I may look into that. 

As far as which tendon it is, I am also not sure. I dont think its the ACL though but im not sure. The tender area is on the inside(left side) of my right knee. 

I hurt it boarding, just landed regularly and twisted it awkwardly. no direct impact just twisted it while absorbing the landing. I didnt hear a pop or crack. It did not really swell up at all i dont think though, maybe a little. My knee has never given way before this. I can still walk (limping slowly) without the crutches but it hasnt improved in 2 weeks. I hope its just because I wasnt doing R.I.C.E enough


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## seant46

lo0p said:


> I'm confused.
> Your doctor told you it could take up to 6 weeks and you're worried because it's not 100% healed in 2 weeks?
> 
> If he told you not to use crutches then don't. If you're concerned about that give him a call.
> And if he gave you a prescription for physical therapy then go.


Apparently it is a 2-6 weeks recovery if it just is in fact a sprain. I just am worried because I thought the walking would improve by now is all. I am just trying to get some other opinions other than 1 doctor.


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## seant46

I guess I'll know more when I go to physio hopefully they can pinpoint the injury like above poster was saying. I may also consider going for an MRI then too if I can.


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## jml22

seant46 said:


> Hmm I didnt think about an MRI as i dont really know too much about this. I may look into that.
> 
> As far as which tendon it is, I am also not sure. I dont think its the ACL though but im not sure. The tender area is on the inside of my right knee.
> 
> I hurt it boarding, just landed regularly and twisted it awkwardly. no direct impact just twisted it while absorbing the landing. I didnt hear a pop or crack. It did not really swell up at all i dont think though, maybe a little. My knee has never given way before this. I can still walk (limping slowly) without the crutches but it hasnt improved in 2 weeks. I hope its just because I wasnt doing R.I.C.E enough


You need to goto someone in your area that is trusted and can do a physical exam. 
why way did you twist, inwards or outwards?

So its probably a MCL sprain or medial collateral ligament sprain. If you hit knee on ice it can be a couple other things as well.

Regardless you need to get a physical exam done which includes, Anterior drawer test, Lachmens, joint line palpation, and valgus varus stress tests.
You can do other things but thatll sum it up the most. Depending on the level of sprain (confirmed by MRI) you should be ok. This physical exam can be done by DCs (find someone who has a CCSP certificate so search ccsp chiropractor in your area), orthopedists and orthopedic surgeons, there are more but that would be the best options.

Do you have any other questions?


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## jml22

seant46 said:


> I guess I'll know more when I go to physio hopefully they can pinpoint the injury like above poster was saying. I may also consider going for an MRI then too if I can.


You need reasoning to get an MRI, if osmoene takes a decent history and physical exam on you. If it's something minor an MRI won't be needed.
If it doesnt get any better then yes get an MRI because whoever diagnosed it got it wrong.


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## seant46

jml22 said:


> You need to goto someone in your area that is trusted and can do a physical exam.
> why way did you twist, inwards or outwards?
> 
> So its probably a MCL sprain or medial collateral ligament sprain. If you hit knee on ice it can be a couple other things as well.
> 
> Regardless you need to get a physical exam done which includes, Anterior drawer test, Lachmens, joint line palpation, and valgus varus stress tests.
> You can do other things but thatll sum it up the most. Depending on the level of sprain (confirmed by MRI) you should be ok. This physical exam can be done by DCs (find someone who has a CCSP certificate so search ccsp chiropractor in your area), orthopedists and orthopedic surgeons, there are more but that would be the best options.
> 
> Do you have any other questions?


I twisted it clockwise I think. No impact on ice or anything. I am going to follow up on your advice.

I think you answered everything you can without a physical exam, one more noob question though. If i am correct and it does happen to be just a sprain (MCL most likely) should it be able to heal back to %100?


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## lo0p

seant46 said:


> Apparently it is a 2-6 weeks recovery if it just is in fact a sprain. I just am worried because I thought the walking would improve by now is all. I am just trying to get some other opinions other than 1 doctor.


Then I would go see a second doctor instead of asking on an internet forum


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## jml22

Depends how bad it is and how you let it heal
It needs to heal, so dont be stupid like a lot of people are and say ok it doesnt hurt lets do this!!!
No, you hurt it because your body wasnt able to handle the force you put onto it.
So, if your PT is worth anything he would recognize that ok it doesnt hurt anymore the ligament looks good, lets stop this from happening agian. 
IF they give you a stupid ass quad stretch or hamstring stretch, fire them.
Here's how i see it, you said it was a normaml landing, if it was the end of the day your body was probably tired cause you didnt eat or drink water on the chair lift. If it was beginning you still didnt eat or drink right and you have some weaknesses going on.


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## seant46

jml22 said:


> Depends how bad it is and how you let it heal
> It needs to heal, so dont be stupid like a lot of people are and say ok it doesnt hurt lets do this!!!
> No, you hurt it because your body wasnt able to handle the force you put onto it.
> So, if your PT is worth anything he would recognize that ok it doesnt hurt anymore the ligament looks good, lets stop this from happening agian.
> IF they give you a stupid ass quad stretch or hamstring stretch, fire them.
> Here's how i see it, you said it was a normaml landing, if it was the end of the day your body was probably tired cause you didnt eat or drink water on the chair lift. If it was beginning you still didnt eat or drink right and you have some weaknesses going on.


Sorry one last thing, if they just suggest quad stretches or hamstring stretches, what should I do go to another PT?


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## jml22

I mean if they give you stretches it isn't all bad but in this day and age theres a lot more you can do so might as-well get the best bang for your buck.
I mean ask them what their plan is, ive seen some terrible practitioners who just stretch all day and dont get to the real problems.
You ever been to the gym and watch girls work out their butts? Well theres a lot of function in those exercises besides making your ass look great.

I would say since snowboarding is such a squat intense sport for the most part. 
I would find someone who will work with you and not just talk at you. So you go in and say, i love snowboarding. Show them how you squat... if they dont pick out things or unless you're perfect at it, unlikely since you just got injured. I would go with someone else.


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## seant46

Ok thanks jml22 your advice has been very appreciated I now have a plan from here on out.


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## seant46

So 2 months and 10 days after the initial injury I am still having constant knee pain and still walking with a limp. I'm on an MRI waiting list right now but when I went to the doc yesterday he strongly suspects a torn meniscus from examining it and when I get the MRI I suspect it will confirm that. 

I cant run or do any of my usually sports right now really because of the pain and even walking I limp. Im thinking I might need surgery once I get the results back. Im not sure if my knee will ever quite the same. Im kinda frustrated but im trying to get out of the feeling sorry for myself attitude, life could be a lot worse.


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## jml22

is it just painful or is your knee locking and clicking?


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## seant46

jml22 said:


> is it just painful or is your knee locking and clicking?


I may be speculating a bit that it is torn, it may not be. There is pain and a clicking a lot of the time when I extend it(the click doesnt hurt any more than the usual pain tho). My leg does not lock and has pretty good range of motion. I am really taking the R.I.C.E approach serious this time I may just not have rested it enough im hoping that is all. 

I just dont know if im supposed to try and do strengthening exercises even though there is pain, the doctor seemed to think it was ok. Im going to a new physio on monday for a second opinion. Maybe the pain isnt going away because my muscles are getting weak Im thinking.


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## jml22

Pain mean's something wrong. Any physiotherapist worth a damn will not rehab through pain. There is a paradigm shift in the rehab world because of people like gray cook. Rehabbing through pain will lead to faulty movement patterns and crappy function in the future.

Where is the clicking? Under your knee cap? Inside, outside?
I'd almost just go on crutches for 2 weeks. If your knee isnt completely locking, i surgery usually isn't warranted. 

What you can do is something called quad sets right now
Quad Sets - YouTube

Wouldn't do more than that until you're out of pain.


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## Olex

Wow, how long is the wait in Canadian medical system? That sucks, considering USA visit for it, maybe? I wouldn't mess around with knees.


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## jml22

There are private options in canada for an MRI, it'll cost you 350-1000 bucks
Exactly the same as USA, most people just opt for the free ones.
ALso if you have extended benefits, MRIs and all that godo stuff can be claimed back through your insurance.


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## seant46

jml22 said:


> Pain mean's something wrong. Any physiotherapist worth a damn will not rehab through pain. There is a paradigm shift in the rehab world because of people like gray cook. Rehabbing through pain will lead to faulty movement patterns and crappy function in the future.
> 
> Where is the clicking? Under your knee cap? Inside, outside?
> I'd almost just go on crutches for 2 weeks. If your knee isnt completely locking, i surgery usually isn't warranted.
> 
> What you can do is something called quad sets right now
> Quad Sets - YouTube
> 
> Wouldn't do more than that until you're out of pain.


The clicking is on the top on the knee around the meniscus area(close to the acl area i suppose? pretty sure its not the acl itself though, it hurts on the insdie so pretty sure its meniscus) I was thinking I should do crutches as well but none of the doctors or physio I have seen have said anything about them, but I think you are right. Its been long enough its time they are warranted, not sure why they wouldnt have recommended them but maybe i didnt make my symptoms sound obvious enough.

Thank you so much you have honestly been just as much if not more help than the docotrs/physio I have seen jml!



Olex said:


> Wow, how long is the wait in Canadian medical system? That sucks, considering USA visit for it, maybe? I wouldn't mess around with knees.


Not sure it will be over a month though im sure of that. It doesnt seem that ill need surgery though I may just have not been letting it heal properly. I wonder how much it would cost me to get a mri in the states though.


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## seant46

jml22 said:


> There are private options in canada for an MRI, it'll cost you 350-1000 bucks
> Exactly the same as USA, most people just opt for the free ones.
> ALso if you have extended benefits, MRIs and all that godo stuff can be claimed back through your insurance.


Interesting, not sure if I should do that or not since im really trying to save for college this fall but ill have to make that decision.


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## jml22

If you have private insurance, go get an MRI like tomorrow lol.
Or if you have 300-500 bucks, go get one tomorrow, seriously haha.

So here's my take, most knee injuries involving twisting involve multiple areas of the knee so for example an ACL sprain will involve medial meniscus and a collateral ligament most of the time.
Since it's been so long and you're still in pain, It could mean a few things, you keep doing damage to the knee because you're walking or something else that is aggravating it (whatever it may be). There's a chance you might have torn something and it's bone on bone now, but who knows til you see it on MRI.
I would definitely go non-weight bearing, aka get crutches. Start with those quad sets, if it hurts, don't do it!

Wait, do you have a pain at night that keeps you awake? Does it hurt regardless of position?


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## seant46

jml22 said:


> If you have private insurance, go get an MRI like tomorrow lol.
> Or if you have 300-500 bucks, go get one tomorrow, seriously haha.
> 
> So here's my take, most knee injuries involving twisting involve multiple areas of the knee so for example an ACL sprain will involve medial meniscus and a collateral ligament most of the time.
> Since it's been so long and you're still in pain, It could mean a few things, you keep doing damage to the knee because you're walking or something else that is aggravating it (whatever it may be). There's a chance you might have torn something and it's bone on bone now, but who knows til you see it on MRI.
> I would definitely go non-weight bearing, aka get crutches. Start with those quad sets, if it hurts, don't do it!
> 
> Wait, do you have a pain at night that keeps you awake? Does it hurt regardless of position?


Yeah my room is in the basement so i have to do stairs daily lol, obviously not good for healing. Gonna go on crutches now i already have some and I think ill take your advice and just get the mri done paying for it, I had no clue you could do that. Yes it hurts regardless of position but i notice it more on the days where I do more walking some days its not as bad. It does keep me up at night.


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## jml22

seant46 said:


> Yes it hurts regardless of position but i notice it more on the days where I do more walking some days its not as bad. It does keep me up at night.


Did you tell this to the doctor you saw?


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## seant46

jml22 said:


> Did you tell this to the doctor you saw?


I told him i have pain but i didnt say it keeps me up at night no, might not have made it obvious enough


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## jml22

How old are you?

Find an imaging center near you see if they do MRIs and then ask how much it is? Talk to them say you're a starving student with severe knee pain that is keeping you up at night. You've been told it'll be a 1-5 month wait and it's not something you can wait for.
Most imaging centers, especially new ones, will be starving for business so they might be willing to work with you if it's cash.


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## seant46

jml22 said:


> How old are you?
> 
> Find an imaging center near you see if they do MRIs and then ask how much it is? Talk to them say you're a starving student with severe knee pain that is keeping you up at night. You've been told it'll be a 1-5 month wait and it's not something you can wait for.
> Most imaging centers, especially new ones, will be starving for business so they might be willing to work with you if it's cash.


Im 21. Ok thats exactly what ill do hopefully it doesnt cost me a shit load but whatever its time to figure out whats going on!


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## jml22

You'll need an MRI order from your primary care, might be able to call them and say hey i'm going to get an MRI at a private imaging clinic, i don't want to wait.
Or maybe find out how long the wait will be at least.
Make sure you tell them

"Yes it hurts regardless of position but i notice it more on the days where I do more walking some days its not as bad. It does keep me up at night."

You're 21 and the person should have asked those questions.


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## seant46

Ok Im not really sure if i have any insurance to be honest lol, if i find i dont I just call the imagine center directly then?


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## jml22

Parents?
Youll be covered under them still if you're living at home or still labelled as a dependent. 
If not you can go through MSP depending on what province you're in.


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## seant46

Im in manitoba lol. Ill see if im covered under my dads company. Sorry what does MSP mean? this is a whole new experience for me this injury.


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## jml22

Medical service plan for incomes under forgot what lol.
Here's what my plan for you would be in person:
Find out how long itll be for the "free" MRI via manitoba health care.
If it's longer than a month start calling private imaging centers and plead your case.Find out your parents medical plan and find out if you're covered under them still.

When you plead your case, make sure you're talking to someone who can actually change the price. So if you call, plead your case and the person says they can't change the price, ask to speak to someone who can and then plead your case again.

If that fails, and your wait time is like 3 months or something stupid. maybe think about biting the bullet. Pretty much you want to rule out an ACL tear, but i don't think it's that because your knee would have swelled up really badly when you hurt it. To get your MRI, you might have to go back to your doctor, tell him about the night pain and how it keeps you up. Shit even remind him you're 21 and it's been 2 months you've had this pain lol. Drop the alarm bells on him so he will take you seriously.

Is your knee still swollen or does it swell up when you do stuff?
For now i'd go on crutches and do quad sets for sets of 10, 3-5 times a day everyday.


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## seant46

Ok sounds good. My knee honestly isnt very swollen(at least to the naked eye) that might be why I didnt think i would be having this problem last this long. It may sweel a very little bit when I do stuff but its hard to notice if it does, it looks pretty normal to the outside


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## jml22

Good luck, keep me posted
wouldn't hurt to get a second opinion from a PT as well, but find a good one.


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## seant46

Thank you so much for taking time for me and the advice! Ill def keep it updated.


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## paul

have you considered seeing a chiropractor who specializes in sports injuries? I chose to see him instead of my GP for my ankle when I hurt it this year on a rail. Was going to slow and I went one way, board the other.. nice twist going on with some swelling. Long story short he confirmed the sprain, did some acupuncture and deep tissue ultrasound therapy and I was on my way. Swelling didn't go away for 3+ weeks; this happened superbowl weekend. It still gets sore after I do any sort of physical activity such as boarding..racquetball etc..

I am in canada and that was also all covered by my insurance.. if not it would have only ran $25 anyway


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## jml22

^^^^ 
Great suggestion.
That's what I am


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## Deacon

All this advice and I didn't see anywhere R.I.C.E. Rest, ice, compression, elevation. It _sounds_ like you still haven't given it the basic care it needs.


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## seant46

Thanks for the replys guys. 

No I havent seen a chiro but my uncle recommend as well to see one so I might in the future. My knee is slowly getting better I think(Could have been right it just needed more rice:dunno. The pain is gone for the most part I'd say but it doesnt feel 'right' and strong like my left knee does. Im hoping this is just them being weak because I can tell the muscles around my right knee are meek right now. Hopefully physio and Ill be all back to normal.

BTW I had an MRI, showed absolutely nothing apparently(according to the mri tech). Im getting a second opinion from a reputable orthopedic surgeon to make sure. After all of the confusion I am pretty sure it is a partially torn medial meniscus(that the mri could have missed). If it is they generally dont heal on their own but sometime they can become non symptomatic and thats what im hoping for so I wouldnt need the surgery. Will know more after july 2nd my appt with the OS.

Because its more of a discomfort or weak feeling these days rather than pain like it was before I have started to do some stuff again. Went rollerblading today but am staying away from skating and tennis just doing low impact sports for now. About time I was getting a gut lol. Hopefully back to 100 percent or close to it by winter with physio or surgery whatevers needed


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