Minor Knee injury... Hopefully

[Mitt]

  So this weekend at a gig I hyper extended my knee one good time on a landing.  The funny thing is that I wasn't doing anything crazy either just jumping in place.  I was doing front flips and back flips earlier no problem... Damn Murphy's law! I was pretty tired after like 2.5 hours of bocking and interacting (tolerating  ) crowds of children, so i guess that was a factor also. 

  I do have some expertise with injuries since I am a senior at my university with a pre-med degree, and just overall experience conducive of my lifestyle.  I just wanted to get some second opinions from those that might have experienced a similar situation with similar symptoms.

  So heres the rundown.  I was bouncing in place doing simple leg work, and came down a bit off kilter which caused me to land a bit heavier on one leg as a compensatory measure of balance.  Unfortunately, the leg i landed on (left) was extended.  I'm pretty sure that was the mistake right there in conjunction with the angle I landed.  I felt my knee pop backwards, thought I do not recall hearing an audible "pop".  As soon as i realized my knee was forced in  a compromising position I tried to relieve pressure by bending it and falling to the ground on my back in a controlled break fall.  Which falling correctly is pretty instinctual for me due to many years of training, and living a pretty extreme lifestyle. So i was alright from the fall.  My knee felt pretty weak after the fall though.  I was able to stand back up and walk on it after a minute or so, though the knee still felt a bit weak.  Later that night my knee really stiffened up.  I had/have trouble fully bending and extending the knee.  There has not been any significant swelling.  There was signs of light bruising at the bend of the knee.

  So far I have just been keeping heat on it, compression, and strong magnets to promote circulation in the  weakly vascularized tendons and ligaments.  My father gave me a homeopathic anti-inflammatory which has been surprisingly effective on relieving the stiffness.  It has only been a day post injury, so I think I just need to rest my knee for a few days.

  Any other thoughts, or input?

- I really hope my symptoms improve well enough to perform at my gig (no bocking, just acro, body balance, rola bola, juggling, etc...) on Thursday in Birmingham, AL   

I apologize for the long essay! I just cant help it sometimes...

[Bill C.]

Stiffness in bending a knee is always caused by fluid acumulation in the joint.  Get enought fluid, and the joint will look swollen and the soft tissue below lower right and left of the knee cap will bulge out a little when you bend it.  It may not look swollen, but fluid in the joint and swelling is the body's way of putting a cast on that joint to keep it from moving so it will heal.  Bruising is basically bleeding under the skin, so that too is an indication that something tore, at least a little.

That said, the feeling of a pop when hyper-extending is never good.  If you have fluid in the knee, you most likely tore or stretch a ligament.  The usual suspect is an ACL (Anterior Cruciate Ligament) tear if hyper-extension was involved.  The fact that you weren't in excruciating pain tells me you didn't completely tear it - so that's good.  However, if you have partially torn that ligament in the past due to a similar trauma, it could be that the last of it let go with that pop - not causing much pain.  That is what happened to me when I finally tore my ACL.  It had been injured before and was barely hanging on when the final "pop" happened without a great deal of pain.  Hopefully you just stretched yours a little and your knee just needs to calm down for a couple of weeks.

Applying warmth now is probably okay, but an initial injury should be treated with ice to reduce inflamation and inhibit swelling asap.

Wear a hinged knee brace on both knees, folks!!!

[X-Eagle]

i also had an injury in my knees, not a long time ago...

well by now, i can trick on ground and jump on tramp without any orthosis...

by using stilts, i stillt need a orthosis by donjoy..

it is fixed on 90°.

Well this ist te problem with the stilts...  wo have a longer lever on your knee..

[Pendragon]

Applying warmth now is probably okay, but an initial injury should be treated with ice to reduce inflamation and inhibit swelling asap.

ICE! People, ICE!

http://www.fitnessandfreebies.com/fitness/heatorice.html

Here's a quote from the article
"Do not use heat on a new injury (for example soaking in a hot bath, using heat lamps, hot water bottles, deep heat creams, etc). These will increase bleeding and make the problem worse."

[Mitt]

Thanks for the input Bill.  I suspected my ACL was compromised.  I don't have a history of prior knee injuries, so its probably a small tear.  Also I don't have any drawer movement, or unusual tibial shifting when i bent my knee.  So that means my ACL is intact at least.  I just hate being injured! I wanna be on my bocks!  I do need to get a knee brace though before i get back to bocking again...

http://www.fitnessandfreebies.com/fitness/heatorice.html[/url]

Here's a quote from the article
"Do not use heat on a new injury (for example soaking in a hot bath, using heat lamps, hot water bottles, deep heat creams, etc). These will increase bleeding and make the problem worse."

Ice is used to control any type of inflammation, I didn't ice mine right away due to no significant signs of swelling.  Ice also causes vaso-constriction which will reduce the symptom of swelling to prevent complications, but will not promote healing.  The reason why ligaments take so long to heal is due to their lack of vascularture (blood vessels).  So once you have the inflammation under control, heat should be applied.  If inflammation returns, Ice again, then heat...etc.  Promoting circulation is one simple thing that can really speed up recovery time.   Just my two cents...

- Thanks for the input guys.

[Friis]

I read that hinged knee bracers were not good if you didn't have problem with your knees already. It said that you had to strap it so tight which made your blood slower and therefor caused injuries easier.

http://www.enduromx.com/forum/visainlagg.asp?inlagg=55978&topic=4&Sort=S_Datum&Status=svara&Str=
(in swedish)

[Bill C.]

Thanks for the input Bill.  I suspected my ACL was compromised. 

Could also have been the PCL.  Neither ACL nor PCL like hyper-extension much.

I read that hinged knee bracers were not good if you didn't have problem with your knees already. It said that you had to strap it so tight which made your blood slower and therefor caused injuries easier.

Unfortunately, I can't read the article (not knowing swedish) -- but I would think the short amount of time wearing the braces during bocking wouldn't cause harm.  Of course, any tightness restricts blood flow, including the foot bindings.  But, personally, I think the CHANCE of knee injury on bocks is high enough to justify wearing hinged knee braces during use.  It is very easy to hyper-extend your leg while strapped in bocks.  Wish I could read the article, though.

[Mitt]

I would agree with Bill.  Its really a cost to benefit ratio.  If you are choosing to subject yourself to a high risk activity such as power bocking, the benefit of supporting your knee would greatly out weigh what detriment you might suffer from wearing it for that relatively short period of time.  Your knee inst equipped from any lateral strain, thats why ACL injuries are so common for many athletes.  It's much better to brace as a preventative measure, rather than for reasons of recovery post injury.  I wish i would have been more adamant about it before injuring myself....  I guess you live and you learn.

[WhatTheFox]

I don't have the experience or background of Bill or Mitt, but I just bought a couple of hinged knee braces and feel TONS more comfortable and confident on my bocks (which I've had all of three weeks or so)

I saw the listing of different braces that someone (Bill?) posted and got one McDavid PSII (429R) $70 and one Dual Disk (422R) $50 since they didn't have two of the same in the size I needed.  I haven't made up my mind which I like better.  Does anyone think (or know) if it's a BAD IDEA to have two different models, or is a mis-match still way better than just having one?  I'm pretty sure 2 is better than 1, but would rather find out by asking a stupid question than messing up a knee (or two!)

Oh, does anyone know if knee braces are typically covered by an HMO if not prescribed by a doctor? My receipt conveniently identified them as (F) Flexible Spending Eligible (as compared to the burrito and soft drink I also got at the pharmacy)

Thanks! 

[coachgeo]

...Also I don't have any drawer movement, or unusual tibial shifting when i bent my knee.  So that means my ACL is intact at least. ...

Are you trying to test drawer movment  and the other tibial shift yourself?  Real hard thing to do on yourself.  Kinda impossible IMHO.

Get another Pre-Med to compare your two knee's movments, or better yet an orthapod. at the Uni. or maybe the Uni's big sport athletic trainer to check it for you.

[Bill C.]

It's too bad you couldn't get two of the same model WTF, but I see no harm in using two different models assuming they are basically meant for similar support and preventing hyper-extension.  If you can get used to the different feel they may have while wearing them, then I say wear both for a while and see if one style grows on you more.  By then, hopefully, you can purchase another of that same type.

There is no harm in wearing only one brace - but, naturally, you will only be adding protection to just that one knee.  But if one of your knees has had a prior injury, or just feels weaker, I would choose to use it on that knee if the choice is only one.

Reimbursement depends on what type of medical coverage you have, but I believe such an "off-the-shelf" purchase of a knee brace without a doctor's prescription DOES qualify to be put towards my HMO Flex Plan reimbursement.  I can put contact lens solution purchases towards it, so I'm sure a knee brace such as yours would also qualify.  You certainly should check into it by calling your provider.  If they say no, then submit the receipt anyway and see what happens.  You'll probably get it through.