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Dr. NS: How do you know if it's torn?

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theBearJew
Posts: 10951 - Karma: 15,633
Just got back from a pickup soccer game and my knee is fucked.

I was going for the ball trying to sweep my left leg around for the ball, cleat snagged the turf and my body followed. All my weight went onto my knee, felt and heard a pop, went down, and immense pain.

I've got pain pretty much all around the knee except for the top right of it.

Dec 21 2013 9:59PM
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*TURBONERD*
Posts: 15080 - Karma: 9,152
A pop is a really bad sign, and if somebody else can sort of move your lower leg away from your knee by pulling hard at it that's an even worse one. An MRI is the only way to be sure, though. Ice that fucker no matter what. I assume you're talking ACL, since you almost certainly wouldn't be able to support your own weight and walk if it was MCL.
Dec 21 2013 10:01PM
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NotGhood
Posts: 2809 - Karma: 1,255
that blows dude

if it still hurts like a bitch after a day or two go see a doctor
Dec 21 2013 10:03PM
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Caucasian_Asian
Posts: 2447 - Karma: 1,665
When I did my ACL, it felt like my leg was going to fall off.  Once the swelling came down I could pull my lower leg away from my knee.  That was fucked.
Dec 21 2013 10:04PM
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theBearJew
Posts: 10951 - Karma: 15,633
I was able to walk off the field with it. And there wasn't much swelling. I've had it iced and wrapped since I got home.
Dec 21 2013 10:06PM
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-WZ-
Posts: 3600 - Karma: 6,582
If you could walk on it maybe bad sprain? how strong is the pain?
Dec 21 2013 10:10PM
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theBearJew
Posts: 10951 - Karma: 15,633
Was the worst I've had in a leg injury. On the stupid pain scale that the doctors use, 1-10 it's a 7. Doesn't hurt so much when I'm not moving it but slight movements seem to hurt the most.
Dec 21 2013 10:14PM
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oil.
Posts: 2255 - Karma: 1,254
if it still hurts in a day or two, then it's urgent enough that you should've seen a doctor 2 days ago. if you're thinking you should go, go. if you think you can tough it out, sure. unless you're pinching for pennies, go see a doctor asap. if nothing is wrong, you gain the peace of mind knowing a doctor checked you off. if something is wrong, you find out early on, which minimizes the chance for complications.
Dec 21 2013 10:15PM
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DR.SHRED
Posts: 2134 - Karma: 503
i tore my acl 2 years ago by overshooting a jump by a lot and it hurt a little but i got back up and went to the lodge and found out i fucked both of my thumbs so i went back up the lift to go ask patrol if i could get a bag for snow and some tylnol and when i got to the top they wouldnt let me ski back down so i proceeded down the mountain in a sled. when i got to the bottom i noticed my knee hurt a little so i had a look, only to find out it was swollen as all hell. i could gemp on it but i knew something was wrong.
I let the swelling go down and was skiing again in about a week. skied on it for about 3 months then went in and had an mri and found out i tore my acl and meniscus.

I recently rehurt it jumping on the supertramp at woodward. I came down from pretty high up and it just buckled and heard a loud snap. i did that twice in the same night. It was swollen pretty bad for about a week.

id say there is no way to tell for sure if you actually tore anything without an mri. Id just ice it 4+ times a day and take it super easy and go see a doc if you can afford it and if not then ust get super strong
Dec 21 2013 10:20PM
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.MASSHOLE.
Posts: 7472 - Karma: 11,419
Let the swelling subside.

If you didnt hear a pop/see your entire kneecap move (happened to a friend, tore everything in her knee), then it is almost impossible to tell without an MRI.

Any advice here will be subpar compared to an MRI/official doctors report. But seeing as how MRIs can be $$$$$, wait for a solid 48 hours for the swelling to decrease.So just ice and range of motion over the next 48
Dec 21 2013 10:28PM
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7springsprod
Posts: 2661 - Karma: 3,181
Only way to tell for sure is an MRI.... I feel so bad for you though because you more than likely tore something in there..... I know the feeling all too well. Mine didn't swell too bad but hurt like a mofo for at least a week.. Definitely by the story it sounds like something is in 2 pieces though..
Dec 21 2013 10:35PM
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theBearJew
Posts: 10951 - Karma: 15,633
I'm gonna try get an MRI on it Monday unless things change. My only hope is it's not torn because I can put weight on it.
Dec 21 2013 10:43PM
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Lemuel
Posts: 14486 - Karma: 10,627
When I walked into ski patrol after my retear they said there was no way anything could be wrong the way I was walking. My ACL was completely disintegrated when they went in for surgery.

First time it was very painful right off the bat and swell like a softball. Second time it didn't hurt at all, just a "ghostly" feeling that something was no longer attached and after about an hour it started to swell. It's different for everyone. I didn't hear or feel the pop either time. If it is swollen and painful for ~72 hours after injury, ACL could definitely be the case.
Dec 21 2013 10:52PM
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Lemuel
Posts: 14486 - Karma: 10,627
Hate to tell you but ACL doesn't have much to do with weight bearing. Good luck with the MRI man.
Dec 21 2013 10:54PM
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*TURBONERD*
Posts: 15080 - Karma: 9,152
Yeah, it's perfectly possible to walk without an ACL.
Dec 21 2013 11:08PM
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willifast
Posts: 248 - Karma: 299
I'm no doctor but would an ultrasound work? if at all possible avoid a huge hospital system they work on commission and will give you an MRI even if it's not needed (it probably is in this situation) best of luck
Dec 21 2013 11:09PM
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theBearJew
Posts: 10951 - Karma: 15,633
Can't tell if sarcasm. Damn NS And it's sarcasm.
Dec 21 2013 11:19PM
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oil.
Posts: 2255 - Karma: 1,254
meh. partially true. you can walk on a partially torn acl, but the acl basically connects your knee to your tib/fib. without it, you can almost feel your whole knee area sliding around over your lower leg. from my experience, people who tear their acl are able to stand but feel extremely unstable when doing so.

source: ski patroller, seen too many torn acl's for my liking
Dec 21 2013 11:47PM
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casual
Posts: 6712 - Karma: 6,748
No, it really is possible, and sometimes easy to walk with a torn ACL. People tend to assume because it is such a serious injury with a lengthy recovery that it must be totally debilitating, and it isn't. It's counterintuitive, but, if you break your tib and fib, you're not going to walk. Your leg is flopping around. However, with that injury, you could be back skiing in as little as 6 wks, most likely 8.

Tearing your ACL, is the opposite. It can either be excruciating, or not, it can either swell like a balloon immediately after, sometimes very little, it can produce a loud pop, sometimes it doesn't, and for the most part, after the initial few minutes of pain, most people can walk away from it. As for swelling and ability to walk, that can vary based on whether you destroy your meniscus, and whether you sustain a nasty femural head bruise, or a tibial plateau bruise.

All this is to say that you should 100% go to the ortho doc and get it looked at. Everyone is hollering MRI, but the truth is, most doctors can diagnose ACL tears with a simple physical pushing and pulling on your lower leg/knee to something like a 90% certainty.
Dec 21 2013 11:51PM
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7springsprod
Posts: 2661 - Karma: 3,181
Yes the ACL is basically only used for balance in the knee. When I tore mine I could walk on it but my knee would buckle 10 times a day. Its not fun let me tell you. I know people who have skiied with an ACL in 2 pieces.
Dec 22 2013 12:04AM
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*TURBONERD*
Posts: 15080 - Karma: 9,152
I can say from experience it's true, and I'm not being sarcastic.
Dec 22 2013 1:21AM
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Jeebus.
Posts: 4904 - Karma: 5,822
Torn down for what?
Dec 22 2013 1:22AM
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*TURBONERD*
Posts: 15080 - Karma: 9,152
This is true, but an MRI is more accurate. Granted, it's quite expensive, but if you can get your insurance to pay for it I highly recommend it.
Dec 22 2013 1:23AM
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Seth.S
Posts: 630 - Karma: 1,631
Sounds like ACL from the mechanism of injury you described. The ACL stops your Tibia from sliding forward so, if someone can pull your tibia forward - you tore it. Have someone perform an Anterior Drawer test
Dec 22 2013 1:42AM
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Blake.P
Posts: 9894 - Karma: 3,585
My bet is acl. I tore mine last January when I are shit on a jump, skied down, rode the lift back up, and skied down again fine, it just hurt. And then I skied the next two days, taking it easy because it felt really sore, but not unstable or anything. Finished the season before getting it checked out in June, when I was diagnosed with a complete acl (when they got to it there was nothing at all left of it) and a partial tear to my lateral meniscus. Also the first ortho (not my surgeon) told me it was only a meniscus and it didn't even come out that it was an acl until the mri, because normal acl checks were fine and showed it was most likely intact
Dec 22 2013 2:17AM
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-Dan
Posts: 7125 - Karma: 51,629
Go to a Dr, AT, or PT.
They will do this:


if you are already swollen they will say, cant tell, mri. if you aent swollen and you pass yay, fail? mri
Dec 22 2013 2:23AM
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theBearJew
Posts: 10951 - Karma: 15,633
Went to the DR today. She couldn't move it in one of the ways she wanted to. Ended up getting an MRI on it but have no orthopedic to look at it yet. With tomorrow being Christmas Eve I don't think I'll get to show them to someone till after the holiday. Shitty thing is I am out of town from the 30th-6th so I may have to wait even longer to have someone even look at this stupid CD.


Doc who looked at it today said it might be an MCL tear.
Dec 23 2013 8:03PM
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theBearJew
Posts: 10951 - Karma: 15,633
Well the doctor called this morning,

Torn ACL
Torn Posterior Meniscus
Strained Meta Collateral Ligament.





FUCK.
Dec 24 2013 9:37AM
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JAHBRADOR
Posts: 3003 - Karma: 17,028
Ahhh fuck dude. that sucks.

Ive got a pretty long term wrist injury atm. It fucking blows at the start but stay as positive as possible. It honestly really helps.

Try and find some things to do, guitar, programming, editing etc.

Also, try stay as active as you can, i do a lot of lower body exercises because its my wrist vise versa for you obviously. If the rest of your body is strong the healing process SHOULD be shorter.

Heal up soon meng.
Dec 24 2013 10:13AM
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elinde
Posts: 1466 - Karma: 3,048
Vibes dude that sucks so bad. You know when you are going to get surgery?
Dec 24 2013 10:13AM
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Bogs
Posts: 4296 - Karma: 1,361
When I blew my knee out I walked away from it. Some people can, some people can, it's not much of an indicator if your tore something or not. Only way to really know is to go to a doctor.
Dec 24 2013 10:36AM
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Bogs
Posts: 4296 - Karma: 1,361
whoops. some people can, some people can't*
Dec 24 2013 10:37AM
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Bogs
Posts: 4296 - Karma: 1,361
yep. even if you fail a PT may get it wrong without an mri. When I hurt my knee I went to a physical therapist first who thought it was first an mcl then meniscus. Wasn't until I went to a doctor who was a knee specialist that I found out it was an ACL
Dec 24 2013 10:41AM
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Anathema
Posts: 21048 - Karma: 5,061
loud pop, knee twist in, pain, immediate swelling.

your acl is gone.
Dec 24 2013 10:42AM
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Pitolairas
Posts: 665 - Karma: 1,174
I tore my ACL and meniscus, and I only felt pain those ten seconds after the injury. As far as walking, I could almost walk in normal fashion, but had no pain whatsoever. Maybe this was because of the damage in the meniscus, cartilage damage and bruised femur. Nevertheless I opted for surgery cause the instability that I felt on my tib while trying to run was quite uncomfortable.
Get an MRI, get your knee manually tested by a doc and let them tell you how to proceed.
Also, loud pop is always bad and there is no such thing as partial tear. Even if you tear your ACL a bit, the lack of blood irrigation through time may cause the ACL to be completely tore.
Dec 24 2013 11:08AM
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*TURBONERD*
Posts: 15080 - Karma: 9,152
Feels, dude. I did this in March 2012 and then my second run back the day after Christmas the next year. Rehab and find an outlet, and come back strong. Find a good surgeon.
Dec 24 2013 11:34AM
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Bodhisattva_
Posts: 5749 - Karma: 2,009
I heard it usually bleeds if it's the first time and it tears
.....
Oh wait we're talking about knees
Dec 24 2013 11:35AM
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theBearJew
Posts: 10951 - Karma: 15,633
Not sure. I am going out to Phoenix for a week was planning on doing some hiking around Sedona/Grand Canyon so that's out now. Ill be back on the 5th and seeing an Orto doc then. I want to try and find the guy who does this for the professional teams around here and have them do my surgery. Hoping I can get it sooner than later.
Dec 24 2013 12:38PM
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Blake.P
Posts: 9894 - Karma: 3,585
while you are gone, definitely do as much leg work as you can. squats, hiking is good, leg lifts. hamstring raises, etc. keep it as strong as possible before surgery. then ICE, to keep the swelling and pain to a minimum. also get surgery as soon as you can, preferably with a orthopedic surgeon that works with athletes (they generally have a more aggressive return regiment, plus they are generally better for active people. i had the seahawks ortho surgeon do mine).

after that, hit pt hard and do as much as you can without over working it (your quads will literally melt away so try to prevent that). do all the exercises your doc gives you for before you start pt, then take pt seriously, doing all the exercises they give you.

depending on the doc, they will only refer you to pt for up to like 12 weeks, i would recommend doing it past that. i did pt up to about 5 months after my surgery. try to find a pt that works with athletes and is also aggressive, you will have an entirely different experience with one that works with younger athletes getting them back to sports versus somebody that works with older people that focus on getting them back to day to day activities.
Dec 24 2013 1:17PM
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JAHBRADOR
Posts: 3003 - Karma: 17,028
This, this is good advise.
Dec 24 2013 1:47PM
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*TURBONERD*
Posts: 15080 - Karma: 9,152
All this is very true. Also, if given the option and it's affordable/covered by insurance, use a passive motion machine immediately after surgery for a couple days; it will greatly preserve your range of motion. Also, nerve blocks are the way to go over prescription painkillers if you have the option.
Dec 24 2013 2:42PM
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Blake.P
Posts: 9894 - Karma: 3,585
I used a CPM machine for like 10 days. It sucks but you may as well because you can just do when you are laid up onthe couch. Also Cummings, (In my experience) the nerve block lasts for like a day, and then prescription pain killers for like a week or two after that
Dec 24 2013 5:36PM
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*TURBONERD*
Posts: 15080 - Karma: 9,152
You must've gotten a different nerve block or smaller dosage, then. I've had the surgery twice and the nerve block lasts 48 hours full strength then started to fade over the next 24. I only ended up taking a few generic ibuprofen or acetaminophen after that.
Dec 24 2013 6:14PM
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theBearJew
Posts: 10951 - Karma: 15,633
Thanks for all the info guys. This thread will be great help when I finally get the surgery.
Dec 24 2013 6:58PM
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feihlination
Posts: 8356 - Karma: 1,084
this thread kinda sucks on all phases. all that "loose" knee shit that is moving, swelling, pain.

kinda cool for guys to know what to do in such a situation based on past experiences from fellow nsers, but my knee simply hurts from reading this thread, haha

vibes dude and get back soon.
Dec 24 2013 7:08PM
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Charlie_Kelly
Posts: 11954 - Karma: 12,297
My mom doesn't even have an acl in one of her knees. Walks, skis, runs fine. For all OP knows, could be a full tear. Get an MRI (though it seems like you are already).
Dec 24 2013 7:17PM
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CRiP
Posts: 1323 - Karma: 482
hang in there OP. I just got my acl surgery yesterday so Im just a few steps ahead of you
Dec 24 2013 9:03PM
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Bodhisattva_
Posts: 5749 - Karma: 2,009
Fuck ya Lindsey Vonn is skiing right now with no ACL and says she is still gonna make a run at Sochi... Pretty much said the same thing like she can ski but her knee is always in danger of giving out..
Dec 24 2013 9:16PM
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2_fadez
Posts: 7780 - Karma: 4,183
TIGER DID IT! TIGER DID IT!
Dec 24 2013 9:23PM
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paige.
Posts: 1932 - Karma: 924
Sounds similar to my dad's experience. He was told it was a meniscus tear so he kept skiing and skimboarding. In his last physio appointment months later she tried a new manipulation, gave him a confused look, and sent him to an ortho. The MRI showed the ACL fully torn. Based on the level of stability and function my dad had in his knee the ortho actually suggested he skip surgery because the ACL didn't seem too necessary.
Dec 24 2013 10:19PM
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