Advice re knee - possible ACL tear?

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Simon Templar

25+ Posts
Looking for some input from some of you other aging athletes.

If you've had a knee problem - ACL tear or stretch, PCL, MCL etc - how did you guys know you tore something?

I was playing basketball a couple of weeks ago, and had to come down on my right leg with all my weight when a guy fell in front of me on a fast break and I had to kind of hop to the side to miss him.

Since then my knee just doesn't feel "stable". There's some odd occasional pain, and swelling as well. But I can't point to anything specific.

Not looking for a diagnosis per se, but does anyone have any opinions or insights given what I've sketched out? When you incurred your injury, did you know right away?

I'm hoping this will just heal and go away, but I think I may be in denial.

Thanks.
 
I knew I tore my knee because I heard the pop. I can't imagine walking after what I did so I really couldn't tell you what it would have felt like because I didn't try.

The doctor can feel your knee and get a pretty good idea of what's going on but they can only tell with an MRI.
 
It's possible that you only tore meniscus cartilage. I did that and had to get it scoped because my knee would occasionally give out. The surgery was simple and I was back playing hoops in 3 months. More Info

God help you if it's an ACL or MCL. You won't be playing basketball anytime soon.
 
Are you a UT student? Make an appointment with their sports medicine people. They're good. They'll basically do tests for instability by isolating and manipulating the leg. I tore my ACL among many other things from a contact injury like six weeks ago at Gregory (I was boxing out and someone fell into the outside of my knee and collapsed it inwards). I don't think I can tell you much as far as similar symptoms b/c mine was just pretty severe with **** like bone chips flying out, torn lateral meniscus, and a strained LCL. I couldn't walk out of Gregory. I was on two crutches for about two and a half weeks, then one crutch for three more weeks. Now I've been to rehab at UT (which is also good) and I'm starting to be able to walk kind of normally. I'm going to have surgery at the end of the month.

But whatever, since mine was a contact injury, I don't think there's any reason to think that because you're walking that it's ok. But I'd also say I wouldn't guarantee a tear b/c a lot of the instability is just because the swelling is pushing things apart. Make an appointment and get it checked out. Try to relax as much as possible b/c I apparently "guarded" with my hamstring the first couple of times they did the ACL stability test and that held out hope until the MRI revealed it was clearly very torn.
 
I tore my ACL five years ago. Most of the time you'll feel a "pop," but you can still walk on it if there's not a lot of other damage. I finished the game of volleyball I was playing, and went to a dance the next day. My knee swelled up hugely, and was really sore and stiff for a couple of weeks, but then was more or less normal.

I thought I had just sprained it severely or something, so I didn't see anyone. It gave out on me a few times over the next six months, with the swelling reoccurring. That's when I finally went in.

Getting in to a doc is the best thing to do. I went to Carey Windler at Austin Sports Medicine. The Link He does a lot of the UT athletes. He's a badass, and I recovered from the surgery in really good time, according to my PT/everything I'd read about the normal recovery time.
 
Absolutely go to the Dr. I walked on a complete ACL rupture for a year. Everyone calling me a *****. Turns out the cartlidge was torn and jammed up in there enabling me to walk, but not run. It wasn't until I demanded an MRI that they found the damage. "Oh gee Mr Lowery, it is a complete tear. How do you walk?" You tell me *******. Now fix it.

Question, did your knee immediately swell or over the course of an hour or so?
 
I've had three ACL reconstructions and yeah, I pretty much knew immediately with all of them. The first was on my right leg and was ACL, MCL, and partial PCL so it was immediately obvious something was really ****** up. Think McGahee's injury but directly from the side.

The other two were were both on the left and were ACL only. I knew with both of them because I kind of felt the joint open up and displace for a second. Basically, the knee noticeably buckled to the inside. With both of them, there was a good bit of swelling, but surprisingly the pain wasn't too bad. I could still walk after both of them and had to wait two months or more until the end of the semster to have surgery each time. Mine didn't just feel a little unstable during this time though. It would completely buckle if I took a wrong step, and that **** probably hurt worse than the original injury.

Anyway, instead of asking what it feels like now, I'd ask what you noticed when it happened. Did it buckle in or out, pop, crunch, etc? Usually it takes some joint displacement to tear the ACL.

Having some swelling, pain, and instability for a couple of weeks doesn't really tell you a whole lot. You'd have all of those from a sprain, cartilage tear, ACL, etc. However, if it's still feeling this way after four to six weeks, I'd say you need to go get it checked it out.

Sounds to me like you may be afraid of going to the doc and him telling you something you don't want to hear. That's completely normal, but if you go and get good news you don't have to worry about it anymore and can start therapy on it. If it's bad, it's not going to get much better on its own and you're just extending the wait until you can hoop, run, or do anything athletic.
 
Great responses so far. Really appreciate it.

I live in San Francsico, and although there are plenty of good sports med guys I can only hope I find one as good as Dr. Winder. I know him from way back.

I wasn't aware of anything at the time - in fact it's more of a going back in my mind thing and trying to isolate an event that could have caused the probem that I decided that move playing basketball had to be it. There was never any moment when I though something had happened - no popping, no buckling (that I'm aware of).

It's been about 3 weeks or so. Didn't really notice much until I went back to Austin for a wedding and went for a run around Town Lake, As I was stretching I noticed the swelling, and although it loosened up as I ran, didn't feel right. The swelling doesn't seem to last long; last night I shot a few baskets - didn't really run at all and pretty flat-footed jump shots and just about immediately thereafter there was swelling above the knee cap (no pain though) - in fact a guy in the weight room that I ball with noticed it and commented.
 
Did any of you guys that had ACL reconstruction get tendonitis after your surgery. I tore my ACL/MCL my SR year in HS playing football. For 2 weeks after I got off my crutches I had tendonitis in the area where they repaired my MCL. About every 50 steps I took, I would get shooting pain through my leg and fall on my face. It sucked ***.
 
You know, that realy doesn't sound like an ACL, especially not a ful tear. Maybe another lig, or, as mentioned, some other damage in there. I know someone who sprained her MCL and had similar problems.

I never had tendonitis problems postop. Sounds like a *****.
 
Get your doctor to order an MRI. I twisted my knee while jogging back in January. Heard and felt the pop right away. Typical macho reaction - "I'll rest it for a few days and let it recover." It didn't, so I gave up and went to my family doctor, who ordered the MRI. Torn cartilage in two places. Just had the scope job last Tuesday, and was walking by Thursday. Went back to work Monday on crutches. Saw the ortho surgeon today for first follow-up visit, and he is starting my on my rehab exercises today. Wish I hadn't waited as long as I did! BTW, I think I fit the definition of "old athlete" fairly well - I'm 61!

HornHuskerDad
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After the basketball incident, did you finish the game or was it something that pretty much made it impossible to play? Like goofybevo, it doesn't sound like ACL to me. Obviously, it's not a gradual injury, so I'm pretty sure if you had one you wouldn't have to think back trying to remember when it could have happened. With an ACL tear you may not know the exact injury, but you know immediately that something is very wrong with the knee.

Honestly, I think not knowing exactly when it occurred rules out a sprain. For example, If you've ever turned an ankle resulting in a slight sprain you feel immediate pain and usually have to stop for the day or at least for a while.

I'd probably guess a minor cartilage tear or tendon strain. Any problems with the knee locking up or making cracking noises? If it was cartilage you'd probably have at least one of those symptoms. Swelling above the kneecap makes me think a strain or tendonitis. My swelling was always below and to the sides of the kneecap in the spaces on each side of the patellar tendon.

BHood-My first surgery was the same one you had and I had a little bit of patellar tendonitis for a month or so, but nothing on the side of the knee near the MCL.
 
Insightful questions TX-HORNS.

No issues when I was hooping. In fact, I played a few more games. I've always had loose ankles, and sprain or roll over those all the time, so I agree that usually you know right away when you do something.

The knee does lock up sporadically and it does make a kind of cracking noise - so yes to both of those questions I'd say. The swelling (after an activity) I notice is right above the knee, although I'm sure it's not isolated there.

HornHusker - I think it's universal among guys to "walk it off" or "ignore it and hope it goes away". You do have me beat in age, but doesn't stop my buddies from playing the age card with me. It sucks getting old.
 
Sounds like when I sprained my MCL. I guess I did it playing sofball, but it didn't swell until the next day. It was swollen for about 3 days and I finally went to the doc. It only hurt when I moved certain ways. I wore a brace for about a week and took about 3 weeks off from athletic activities. I still rode my bike for exercise.

It got better, but I reinjured it while having sex of all thing. That was fun to explain to the doc. After another month it was fine. No surgery and it hasn't bothered me since.

The MCL is a wide/thin ligament so it partially tears fairly easy, but it heals relatively fast.

Your deal sounds a lot like mine.
 
The locking up sounds like a torn meniscus more than an ACL tear.

I have torn my ACL three times. The third time, I optioned to not have the surgery and wear a brace with my few remaining sports (beer league hockey and old man rugby). I run with the torn ACL - without a brace - averaging a 5K/five times a week. I am lucky because despite my knee injuries, I do not have arthritis in the knee (confirmed by xray and MRI). My quads and hammy have taken over for the ACL.

You can walk, run, and do most anything without an ACL. (the same is not true for an MCL). I knew when I tore my ACL each time because it was a "drawer movement" - where the thigh bone slid on top of and over the tib/fib (lower leg). I heard a pop the first time, but never heard a sound with the 2nd and 3rd.

I tore a meniscus that sounds a lot like yours. I had a feeling of instability (when in fact, the ligaments were stable). The arthoscopic surgery was easy and I was up and around the next day. The ACL reconstruction was much different, much more painful and a much longer rehab.

Good luck.
 
Thanks guys.

So a torn meniscus will still demand surgery? Not somethiing that can or will heal on its own?

Do you think its okay to run or spin on it until I get into the doc? I think hoops is definitely out for awhile.
 
You can live with most torn mesnisci. The surgery is pretty simple though. With mine, they snipped out the torn piece and I played rugby two weeks later (post staple removal). And I am a baby about pain.

There are different kinds of tears, but knee locking (from what I have been told) is usually a torn meniscus. Go see a doc.
 
From the locking and cracking, I'd say it's probably cartilage.

As washpark said, you can live with a torn meniscus. The type of tear and its location will determine how it affects you in the future. From what I know, only the outermost 20% percent of knee menisci have a blood supply. So, small tears on the edges may heal themselves eventually if nothing is done to continually reopen the tear (while there is bloodflow around the edges, it's not a lot thus healing is somewhat slow). Since there's no bloodflow in the other 80%, tears in that area will not heal on their own.

Regardless of where the tear is, I'd go see an orthopedic surgeon. Even if it's a small tear on the edge, it will heal much quicker if it's scoped and cleaned up or sutured back together, so you'd be back on the court a lot sooner. If it's a tear in the avascular section it'll probably need to be fixed to ever feel 100% again. Plus, unrepaired menisci can lead to degenerative arthritis, which probably isn't something you want to risk. My dad had that **** before he got his knee replaced and it didn't look too fun.

Washpark - After tearing my left ACL for the second time, I tried to go the no surgery route, but it didn't work for me. Went through PT, built up the hammys and quads, etc. Unfortunately I'm just one those people whose knees are built so that the ACL is required equipment. Sports weren't a problem at all wearing a brace, it was just normal everyday walking around that made me decide to go have another reconstruction. About once every three weeks i'd step off a curb or something and the damn thing would sort of pop out of joint or shift, and hurt like **** for three days. After it happened while walking across campus and left me in a heap on the ground, I got up, limped home and called to schedule surgery.
 
tx horns - that's too bad. There was no way I was going back in for another ACL reconstruction. My knee already looked like a roadmap - I have the nice frankenstein double scars from when they used to literally peel the skin back to get at the knee. I have been lucky without an ACL. Part of my ability to live for the most part without an ACL comes from the fact I brought my weight way down. When I was playing rugby seriously (as compared to old boy rugby I play now, which is much more friendly and forgiving for the body), I was about 225 - with a lot of upper body weight from heavy lifting. I debulked my upper body and bulked up my legs after I decided to go without an ACL. I dropped 25lbs, lowered my center of gravity and have not had a real problem since with the lack of an ACL. I had a great PT therapist here in Colorado.

But, all knees are different and my tears were from extremely violent collisions. Overally, I have pretty tight joints. People with loose joints, probably need every ligament and more. If you were hurting from just casual exercise, it is my understanding you are accelerating the degenerative process, which can lead to a lot more problems.

Bad knees are bad, but shoulders and ankles are much worse, by the way.
 
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It could be anything. You really must go see a DR. I also recommend Dr Carey Windler. He had over 25 yrs experience & if surgery is required he is not a cut-happy DR & takes his time in repairing your knee. I had surgery last month with the same symptoms you are having from basketball play. I thought it was a tear but it was just loose cartilage & bone spurs. I'll be playing again next month. DON'T PUT IT OFF THOUGH....GOOD LUCK!
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