Knee problems 5 months down the road

Apr 15, 2012

• Dominic McVeigh asked The Guru for the following Physiotherapy Advice:

  Hi! 5 months ago i took a heavy fall in Rugby on my right knee. I had significant swelling and pain to the front of my knee. With ice and rest this went but still I cant fully straighten it without pain and going downstairs causes major discomfort. I have taken anti inflams and iced for nearly 5mths however it just doesnt seem to want to go. How do you recommend i get back from this?

• The Six Physio Guru responded:

  Hi Dom
  .
  Pretty interesting that you can't straighten your knee, which is
  fairly indicative of only a few things.
  .
  I'll go for the most obvious and that's an irritated infrapatella fat
  pad (the squidgy bit below your knee cap). It's huge and pretty under
  diagnosed for giving problems.
  .
  Every time you straighten your knee your irritated fat pad is squished
  between your femur and tibia (top and bottom bones) - the more this
  happens the more it swells, and then less available space there is for
  the fat pad to be compressed, and so it blocks the knee.
  .
  Going downstairs gives a similar issue, but I think the vast majority
  of these symptoms is that your kneecap "drags" through the fat pad
  increasing your pain.
  .
  What you need to do is see someone who can comprehensively assess your
  kneecap, fat pad and all the other workings of your knee. You may need
  to be taped and shown things like inner range quad control and lower
  limb balancing stuff! The McConnell (a specific way of dealing with
  knees and fat pads) approach will rock this, and you!
  .
  Good Luck
  
  .
  
  

2 Comments

• Clint Responded:

  Apr 25, 2012

  Hello there I have a question, I had ACL surgery back in November 23 / 2011, it's been 5 months and I can't straighten my leg fully , like my other leg I can straighten and over extend it , but can't do it with my other knee just wondering if its going to get better if I keep up with my exercises and going to the gym. Thank you for reading my question.CK

• The Six Physio Guru Responded:

  Apr 25, 2012

  Hi Clint

  .

  You really need to be able to fully straighten your leg after an ACL recon, in fact it's one of the top things you try to achieve as soon as.

  .

  There are some common reasons as to why you may not be able to such as they joint has contracted into a slightly bent position (then continue to stretch it straight), you may not have control of the last bit of your quads contraction (keep working on IRQ and terminal extension drills) or you may have a Cyclops lesion in the ACL.

  .

  Some people never achieve full extension and live full and happy lives, they may be prone to more advanced degenerative changes years down the line, though.

  .

  A revisit to your surgeon may not go amiss......