Knee pop injury

[bangerjc 3]

So last night I was standing in from of the other teams net and some big goon tried to body check me out I stood my ground and I felt a pop on the outside of my left knee.  Woke up this morning knee is twice the size and can't walk. Buckles at times and can't straighten or bend it. 

 

Went today to hospital got xrays and explained what happened and that it popped.  Doctor says xrays look fine. Take a break off hcokey for a week and that was it. Wtf? No mri? Anyone have an experience with this? From reading online it appears to be my lcl. 

[BenBreeg 493]

Mri’s are expensive and docs have been moving away from just ordering tests in every situation.  If it persists go see an orthopod.

[Vet88 674]

They should have done an ultrasound (as well as the xray), that will show any tears or disruption / inflammation to the lcl or surrounding tissue. An mri is the next level of resolution if the ultrasound and xray cannot identify the issue.

[SirJW 207]

See a specialist. 

[caveman27 208]

22 hours ago, bangerjc said:

So last night I was standing in from of the other teams net and some big goon tried to body check me out I stood my ground and I felt a pop on the outside of my left knee.  Woke up this morning knee is twice the size and can't walk. Buckles at times and can't straighten or bend it. 

Went today to hospital got xrays and explained what happened and that it popped.  Doctor says xrays look fine. Take a break off hcokey for a week and that was it. Wtf? No mri? Anyone have an experience with this? From reading online it appears to be my lcl. 

Could be a number of things, ACL, LCL, meniscus.

So, I've had ACL reconstruction. During the injury, I felt a sharp pop and limited mobility. After the injury, maybe an hour later, the knee started swelling up, like a grapefruit size and I could hardly bend it.

After the swelling went down, the pain went away, but every once in a while, when I turned, I could feel a sharp pain inside the knee.

So, my doctor told me to come back in a week after the swelling goes down, because the swelling could also be affecting the pain and would not provide an accurate X-ray. So, I waited. The swelling did go away. The pain was still there so I went in. I got an x-ray and physical examination. Then, he said I would need an MRI to get a better view of the insides.

 

So, you do need to take some time for the swelling to go away to see if the pain persists afterwards. You said you got injured in a game one night ago. Once the swelling goes away, your pain symptoms may change or go away or stay the same. Ice it. Take it easy. After a week, the swelling should go away and pain level should decrease, you can probably resume your usual activities. See how your knee feels. If pain persists, see your doctor again. Note when pain occurs, going up steps, going down steps, running, standing, kneeling, turning, jumping, kicking, bending, certain angles, leg fully extended, etc. and tell that to the doctor. 

Edited October 11, 2019 by caveman27

[evor1 6]

i would assume since you finished the game and didnt feel immediate pain its not a tear.  i jammed my knee before and it didnt hurt immediately but after it swelled up it hurt pretty bad and i couldnt walk on it.  went away on its own after awhile but definitely took longer than a week.

[bangerjc 3]

On 10/16/2019 at 1:40 PM, evor1 said:

i would assume since you finished the game and didnt feel immediate pain its not a tear.  i jammed my knee before and it didnt hurt immediately but after it swelled up it hurt pretty bad and i couldnt walk on it.  went away on its own after awhile but definitely took longer than a week.

Something popped and I had to crawl to the bench I thought for sure I was toast. I couldn't stand on it let alone skate. I sat on the bench for a period then went out and finished a few shifts. (stupid I know) but I got an apple on the game winner lol. 

 

So I took two weeks off and the pain and swelling went away. But the need didn't feel quite right. A little bit of pain when I go past Parallel in a squat form and when I extend my leg fully it clicks. My other knee kinda clicks too but the Injuried one definitely more. And I csn rotate my knee when it's straight and I get a little click/pop feeling. It's not painful.  I played a pickup game Wednesday with a brace. It didn't feel great but I was able to get through it. I played pickup ahain today with a brace and when I was skating backwards and pivoting on the Injuried leg I felt a sharp pain and thought I did it again. I was able to finish out the skate  minimal pain but def was going in 1st gear since I think i renagged whatever it is going on in there.   I wonder if this would require an mri or just More rest. Here in Ontario mris take months. 

I hurt my knee a couple years ago and got an mri 6 months later. What's the point? Doctor told me I had a hair line crack at that time. Lol. 

 

Frustrating! I missed 3 games already and I figured I was good to go.  It almost feels tight and a little unstable it's hard to explain. I kinda walk with a limp. I may be doing it subconsciously because it feels better not putting full pressure on it 

Edited October 25, 2019 by bangerjc

[psulion22 402]

On 10/10/2019 at 7:00 PM, Vet88 said:

They should have done an ultrasound (as well as the xray), that will show any tears or disruption / inflammation to the lcl or surrounding tissue. An mri is the next level of resolution if the ultrasound and xray cannot identify the issue.

Winner, winner, chicken dinner.

First course of action is an evaluation by a orthopedist.  During that, the doc will asses likely injuries by your description of the incident and the symptoms, and perform some manual tests.  Depending on what those injuries are likely to be, he will order X-rays (for hard tissue damage), an ultrasound (for superficial structures), and/or a MRI (for internal soft tissue and hard tissue injuries).  An Xray will probably not show damage to a LCL, which sounds like the likely injury here.  A LCL sprain or tear can be diagnosed with an ultrasound, as can an external meniscus tear.  If the ultrasound doesn't yield results, and there is additional symptoms and pain not associated with those injuries, the doc will order a MRI.

The good news is that ultrasounds can be done in an office visit and don't need special scheduling or facilities like a MRI does.  Moreso, LCL injuries can be treated with rest and PT, surgery and MRIs are usually not required.

Unfortunately, given your description of the event and injury, I think there's a good chance that it's your ACL.  LCL injuries usually are caused by a hard impact to the inside of the knee, which you didn't indicate.  ACLs are typically inured when twisting the knee with the weight on it and the foot planted, or a sudden change in direction or speed.  In your case, that sounds like what happened.  It may be your meniscus also.  Pain from that injury usually manifests itself when rotating the knee while it's bent - for example pivoting while skating backwards.  Pain while bending could be either or both.  Meniscus injuries don't typically cause instability though, so you probably injured one ligament or another.  LCL pain would be isolated to the outside of your knee, typically either above or below it where the attachment points are.  This also likely means you will need an MRI to determine the extent of the damage.

Edited October 26, 2019 by psulion22

[salibandy 21]

I'd go see a physiotherapist - they're the ones trained to diagnose and manage musculoskeletal issues. 

Clearing the x-ray means no avulsion injury (tendon/ligament did not rip off its attachment to the bone) - it does not clear a ligamentous or tendinous tear. An MRI may be indicated if the subjective or physical examination points towards a tear. Ultrasounds aren't very reliable so we don't use them a lot here - and similar to the MRI, it has to be indicated for it to be ordered. With a full ACL rupture, you'd feel the pop on the inside of the knee and would be unable to skate on it after, so if anything it likely wouldn't be a full tear of that, at least. A meniscus tear could cause instability because its job is to provide stability. Clicking and catching is what might be expected from a meniscal tear.

There isn't close to enough information given here to direct any kind of advice, actually. Something is definitely torn (any kind of sprain or strain is a tear, just to what degree) or there wouldn't have been oedema. See a physiotherapist is my recommendation.

[bangerjc 3]

On 10/10/2019 at 7:00 PM, Vet88 said:

They should have done an ultrasound (as well as the xray), that will show any tears or disruption / inflammation to the lcl or surrounding tissue. An mri is the next level of resolution if the ultrasound and xray cannot identify the issue.

I know it was urgent care the last time I went for my last injjury they ordered me an MRI, the doctor didnt give a shit, your xrays are fine, take a week off hockey. lol  

Im looking into driving to buffalo from toronto to expedite an MRI out of pocket.

[bangerjc 3]

On 10/11/2019 at 1:12 PM, caveman27 said:

Could be a number of things, ACL, LCL, meniscus.

So, I've had ACL reconstruction. During the injury, I felt a sharp pop and limited mobility. After the injury, maybe an hour later, the knee started swelling up, like a grapefruit size and I could hardly bend it.

After the swelling went down, the pain went away, but every once in a while, when I turned, I could feel a sharp pain inside the knee.

So, my doctor told me to come back in a week after the swelling goes down, because the swelling could also be affecting the pain and would not provide an accurate X-ray. So, I waited. The swelling did go away. The pain was still there so I went in. I got an x-ray and physical examination. Then, he said I would need an MRI to get a better view of the insides.

 

So, you do need to take some time for the swelling to go away to see if the pain persists afterwards. You said you got injured in a game one night ago. Once the swelling goes away, your pain symptoms may change or go away or stay the same. Ice it. Take it easy. After a week, the swelling should go away and pain level should decrease, you can probably resume your usual activities. See how your knee feels. If pain persists, see your doctor again. Note when pain occurs, going up steps, going down steps, running, standing, kneeling, turning, jumping, kicking, bending, certain angles, leg fully extended, etc. and tell that to the doctor. 

Great advice, so you were able to still skate on your knee before you had the ACL reconstruction?  I played twice this past week after the injury with a brace on.  Something def not right, but im able to play.  Friday was a warning sign that i felt i could injure it  more if i kept playing.  Def want to see whats going on, going to go see a specialist this week, or drive to buffalo for an mri from toronto.

[bangerjc 3]

On 10/16/2019 at 1:40 PM, evor1 said:

i would assume since you finished the game and didnt feel immediate pain its not a tear.  i jammed my knee before and it didnt hurt immediately but after it swelled up it hurt pretty bad and i couldnt walk on it.  went away on its own after awhile but definitely took longer than a week.

I hope you're right and it's not a tear, but I felt a strong POP sensation. Definitely alarming.  I stayed off it for about 2 weeks, pain was minimal but couldnt straighten my leg 100%. Played Last wednesday (got through ok) then played friday and I def felt a pain again when i was skating backwards and was quite alarming.  Instead of guessing/waiting to play with hopes of hitting the ice soon im going to go get it looked at further.

[bangerjc 3]

On 10/25/2019 at 9:13 PM, psulion22 said:

Winner, winner, chicken dinner.

First course of action is an evaluation by a orthopedist.  During that, the doc will asses likely injuries by your description of the incident and the symptoms, and perform some manual tests.  Depending on what those injuries are likely to be, he will order X-rays (for hard tissue damage), an ultrasound (for superficial structures), and/or a MRI (for internal soft tissue and hard tissue injuries).  An Xray will probably not show damage to a LCL, which sounds like the likely injury here.  A LCL sprain or tear can be diagnosed with an ultrasound, as can an external meniscus tear.  If the ultrasound doesn't yield results, and there is additional symptoms and pain not associated with those injuries, the doc will order a MRI.

The good news is that ultrasounds can be done in an office visit and don't need special scheduling or facilities like a MRI does.  Moreso, LCL injuries can be treated with rest and PT, surgery and MRIs are usually not required.

Unfortunately, given your description of the event and injury, I think there's a good chance that it's your ACL.  LCL injuries usually are caused by a hard impact to the inside of the knee, which you didn't indicate.  ACLs are typically inured when twisting the knee with the weight on it and the foot planted, or a sudden change in direction or speed.  In your case, that sounds like what happened.  It may be your meniscus also.  Pain from that injury usually manifests itself when rotating the knee while it's bent - for example pivoting while skating backwards.  Pain while bending could be either or both.  Meniscus injuries don't typically cause instability though, so you probably injured one ligament or another.  LCL pain would be isolated to the outside of your knee, typically either above or below it where the attachment points are.  This also likely means you will need an MRI to determine the extent of the damage.

Thanks, going to try my best to get an MRI, but here in Ontario they take 3-6 months.  Kind of defeats the purpose.

 

[caveman27 208]

2 hours ago, bangerjc said:

Great advice, so you were able to still skate on your knee before you had the ACL reconstruction?  I played twice this past week after the injury with a brace on.  Something def not right, but im able to play.  Friday was a warning sign that i felt i could injure it  more if i kept playing.  Def want to see whats going on, going to go see a specialist this week, or drive to buffalo for an mri from toronto.

So, I tore my ACL during a fencing tournament in the late summer. I wasn't playing hockey or skating at that time. Fall came around and I wasn't playing any hockey after I found out my ACL was torn. I got the surgery in the winter and it took awhile to rehab, after recovery. I got a graft from my patella and I my range of motion after surgery wasn't progressing as well as the doctor wanted to see. I went to physical therapy to help with range of motion. They also hooked up this machine to send electric pulses to my quads to get them to activate during therapy. That was fun and weird. It was probably eleven months before I was 100% good to go with any sports, and going 100% in the gym with leg workouts. I was a bit worried on my first time on the ice, but I was able to do everything, hockey stop, t-stop, crossovers, skating backwards, etc. without a brace.

Probably doesn't answer your question since I wasn't back to playing after my injury. But, the thing that told me something was wrong was when I was walking and then, I stopped and turned left, I would get a sharp pain in the middle of my knee. Kind of like a little tiny knife held by a mean leprechaun who magically poked only the inside of my knee on the same 2mm spot. This was happening well after the swelling was gone. Then, it would also happened when I was pivoting to turn on my left foot. Of course, my right knee was fine and I could turn and/or pivot on my right foot without problems. Walking straight, going up and down stairs, and doing squats in the gym wasn't a problem either.  

Edited October 27, 2019 by caveman27

[krisdrum 233]

OP - could have been a dislocation of your knee cap.  I did it a few summers ago doing family stick time with my son.  Went to avoid another kid, caught an edge and pop.  Got back up, managed to skate to bench.  Was in pain, but it subsided.  Skated a bit more, but it didn't feel right, so I jumped off.  Was still bothering me, so later that day went to urgent care and they thought I dislocated the knee cap and then it popped back in.  Gave me a brace to immobilize it, which I wore for a few weeks. 

[bangerjc 3]

51 minutes ago, krisdrum said:

OP - could have been a dislocation of your knee cap.  I did it a few summers ago doing family stick time with my son.  Went to avoid another kid, caught an edge and pop.  Got back up, managed to skate to bench.  Was in pain, but it subsided.  Skated a bit more, but it didn't feel right, so I jumped off.  Was still bothering me, so later that day went to urgent care and they thought I dislocated the knee cap and then it popped back in.  Gave me a brace to immobilize it, which I wore for a few weeks. 

Hey had an mri waiting for surgeon appointment on thr 9th of December 

Turns out I have tears in acl, lcl and meniscus as well as bone bruising.  Thr nurse from my doctors office didn't give much info and said wait for my appointment 

[bangerjc 3]

Saw surgeon yesterday he didn't mention anything about surgery. He said if I want to play hockey just get a brace. He gave me a quotation for $1700 for a donjoy.  Found them online for half the price. 

 

Question, has anyone played with a donjoy armour? How does it compare to say a shock doctor or mcdavid hinged brace? 

[Vet88 674]

Grade of tears? There is a lot more of a conservative approach these days to dealing with tears but when they get to a certain level no amount of time is going to return them to a decent state. imho he should have gone through all the options with you and what to expect with a conservative approach / rehab programme.

[caveman27 208]

On 12/10/2019 at 6:53 PM, bangerjc said:

Saw surgeon yesterday he didn't mention anything about surgery. He said if I want to play hockey just get a brace. He gave me a quotation for $1700 for a donjoy.  Found them online for half the price. 

 

Question, has anyone played with a donjoy armour? How does it compare to say a shock doctor or mcdavid hinged brace? 

Wow, people are selling donjoy braces online? Not sure if there's going to be a crackdown, that's a prescription-only medical device unless laws have changed.

I have a Breg, but not for hockey use. I got it decades ago. Still good as new as I hardly used it. It's too wide for the pants and shin pads.

[BenBreeg 493]

Why would knee braces be prescription-only?  To get insurance coverage would require a prescription  but just to purchase?

[bangerjc 3]

10 hours ago, caveman27 said:

Wow, people are selling donjoy braces online? Not sure if there's going to be a crackdown, that's a prescription-only medical device unless laws have changed.

I have a Breg, but not for hockey use. I got it decades ago. Still good as new as I hardly used it. It's too wide for the pants and shin pads.

I'm pretty sure anyone can buy these. 

 

I just got custom fit for one lastnight, it seems like I won't have to modify anything of my shin pads to get it on.  The Defiance 3 is quite streamline. 

[bangerjc 3]

If anyone needs a knee brace in Ontario let me know I have a guy who is excellent. 

[psulion22 402]

On 12/11/2019 at 5:57 PM, Vet88 said:

Grade of tears? There is a lot more of a conservative approach these days to dealing with tears but when they get to a certain level no amount of time is going to return them to a decent state. imho he should have gone through all the options with you and what to expect with a conservative approach / rehab programme.

I had a Grade 3 tear of my MCL last year - 90% torn.  My Ortho used to work in the NBA.  I was never given a serious surgical option.  It was possible but completely unneccesary, even for my severe injury.  I was given extensive rehab.  Not even a brace.  After I returned to skating, I tweaked it a little and the doc suggested a cheap compression brace with flexible supports, nothing with a hinge, until my body got used to the laxity.  I still wear it but mostly because it feels weird to go without it.  He was adamant about not using strong support for collateral ligament injuries because they will often lead to further, and possibly worse, injury.  Cruciate ligaments need them because  they're under constant stress and see more dynamic forces applied.  But collateral ligaments see less frequent stressors.  Typically the body can support itself from most forces better than a brace can.  If you need the brace to keep you from injury, especially after the initial recovery, then the force is probably too strong for the brace anyway, and the brace and ligament will fail regardless.   Just what I was told.

[bangerjc 3]

22 hours ago, psulion22 said:

I had a Grade 3 tear of my MCL last year - 90% torn.  My Ortho used to work in the NBA.  I was never given a serious surgical option.  It was possible but completely unneccesary, even for my severe injury.  I was given extensive rehab.  Not even a brace.  After I returned to skating, I tweaked it a little and the doc suggested a cheap compression brace with flexible supports, nothing with a hinge, until my body got used to the laxity.  I still wear it but mostly because it feels weird to go without it.  He was adamant about not using strong support for collateral ligament injuries because they will often lead to further, and possibly worse, injury.  Cruciate ligaments need them because  they're under constant stress and see more dynamic forces applied.  But collateral ligaments see less frequent stressors.  Typically the body can support itself from most forces better than a brace can.  If you need the brace to keep you from injury, especially after the initial recovery, then the force is probably too strong for the brace anyway, and the brace and ligament will fail regardless.   Just what I was told.

Makes sense, thanks for sharing your experience. How's the knee now? 

I played lastnight in my new donjoy Defiance 3 it felt fine, although mentally I know it's not so I was being very careful about quick stop and starts etc. Although I was fine cutting hard etc.  It's insane how fast you get out of hockey shape when you haven't skated in a couple of months. My legs were so full of lactic acid that was more of an issue then my acl tear lol. 

I'm going to continue light skating with my brace, and putting another one on my good knee just in case. Until I get a 2nd opinion about surgery.  I don't have any Instability but my knee definitely feels a little sore today, more so when I squat down near the bottom. Not sure what that means but gonna rest it until next week and try ahain wirh the brace. 

 

This injury blows! 

[psulion22 402]

On 12/14/2019 at 11:57 AM, bangerjc said:

Makes sense, thanks for sharing your experience. How's the knee now? 

I played lastnight in my new donjoy Defiance 3 it felt fine, although mentally I know it's not so I was being very careful about quick stop and starts etc. Although I was fine cutting hard etc.  It's insane how fast you get out of hockey shape when you haven't skated in a couple of months. My legs were so full of lactic acid that was more of an issue then my acl tear lol. 

I'm going to continue light skating with my brace, and putting another one on my good knee just in case. Until I get a 2nd opinion about surgery.  I don't have any Instability but my knee definitely feels a little sore today, more so when I squat down near the bottom. Not sure what that means but gonna rest it until next week and try ahain wirh the brace. 

 

This injury blows! 

It's good now.  No problems with it that make me feel like it hasn't recovered fully.  The MCL, or LCL, isn't a major structure for most things.  As long as the ACL/PCL and bone bruising healed correctly you should have stability and no pain.

But you must be doing PT.  It's either intense PT or surgery.  Just sitting around waiting for it to feel better and slapping a brace on it is absolutely not going to work and will lead to further injury.