My symptoms are: after intense running (playing ultimate - in which I don't have any knee pain) when I am walking normally, I occasionally get intense pain in the knee, as if some part of the knee has got a little bit out of line. This especially occurs when the leg is almost straight, e.g., when going down stairs at the point of putting weight onto the leg. This condition is now persisting for several days, so I need to do something about it. Having read some of the medical documents on ACL injury, I think the apparent looseness is consistent with having a stretched ACL (I don't think I've actually torn it). A medical friend suggested `damaged minisci' as another hypothesis.
Has anyone had similar problems? Would a knee brace help with this sort of problem? Does anyone have a recommended brand of knee brace? Are there particular stretches and exercises that are a good idea? And are there exercises that are a *bad* idea?
Please, if you have had similar knee problems, could you send your advice to me and I will put it all on a web page here: Knee problems.
Thanks, David
From europe.shiva.com!agw Tue Oct 22 13:04:51 1996
Don't take any chances with your knees!!
Go to see a Sports Physio - your Sports Union should be able to help you.
If something is wrong, you could be making it much worse. I know too many
people who have buggered their knees playing ultimate!
Miggins (Sneeekys)
From: dmurray@soton.ac.uk
not sure if he will reply
talk to Paul Schuricht aka Sonic as I think he has had similar problems
phs@uk.ac.soton
I've had knee problems on and off since I was about 15. You'll
probably recognise me as the STAN player who always wears two
knee supports (they're not often used for layout protection!).
My knee problem effectively comes down to loose knee caps (Patelas!).
This problem shows itself in two ways:
1. My knee caps are more prone to dislocation and,
2. Sudden twisting movements and sometimes long road runs can cause
pain. This being due to areas under the knee cap becoming bruised from
jarring of the bones within the joint (this is probably simplified).
I once went through a spell of doing shuttle runs, which resulted
in the need to go to a Physio therapist for 3 months. This was useful
in that it taught me how to increase the strength of the muscles
around my knee. This mainly involved straight leg raises with ankle
weights. See a Physio for details!
Unfortunately I don't do these exercises as often as I should, hence
the knee supports, which I think helps while playing Ultimate. I
don't wear them for running or gym work, where movement is generally
controlled.
I hope this is useful!
Steve
STAN
From: P.H.Schuricht@soton.ac.uk
To: mackay@mrao.cam.ac.uk
Subject: Knees
My advice is the same as that which has already been sent,
go see a physio, prefferably a sports physio.
check with your athletic union at the university, they may have a
list of good physios you can see. (you may also be able to claim some
money back off them aswell)
down here the physio i go to is 25 quid for the first hour session, then
20 quid for each subsequent hour session. (normally it's 35 and 25, but i
get the student rate, and i can claim some back from the uni)
don't take any advicem on excersises over the net, if you do the wrong stuff
it could shaft your knee completely.
generally you can't go wrong with icing you knee for 10-15 mins after playing
(i have 2 pack of frozen peas in the freezer specially for icing injuries)
ibuprofen is also good for taking away pain and reducing swelling, but
don't try and do to much while drugged up as you won't notice if you injure it
further.
also you haven't said where in your knee it hurts. which will make a difference.
hope this helps
Paul
ps. if you do go to a physio take some ibuprofen gel with you, if you get
ultrasound on your knee, tell them you have the gel, as it helps the
ultrasound apparently.
David,
Firstly the obvious: SEE A DOCTOR! (preferably a knee specialist, The
knee is a very complex area - I had a lot of not very good advise &
treatment from docs not spealising in knees). I had treatment at the
Wellington Knee Unit in London, very experienced surgens who have all
performed hundereds of knee ops.
My situation was a ruptured ACL, torn MCL and lots of meniscus
(cartlidge) damage as well as othe ligament damage and several small
fractures. So I had the reconstruction surgery 6 weeks ago. Walking is
now fine, but I will not be able to play Ultimate for about a year and
will be undergoing physion untill that time also.
Your problem does not sound the same, although the pain sounds similar
to the cartlidge related pain I had. But then I'm not a doc!
Exercises on injured knees should be 'closed chain'. That is they must
not pull the joint at all.
Any exercise with your feet taking the weight and the force pushing
the knee is OK. Running is not (the action to your knee is like your
lower leg away from the joint and pulling at the ligaments). Leg
presses are good (low weight, lots of reps), as are ham curls. The
best exercise (according to my physio) is done without weight. This is
just straightening you leg and tensing the muscles, then move you toes
towards you (without any weight on the leg at all). Concentrate on
flexing the quads (especially the inside one, the VMO, as this is the
on which weaken the most). This exercise is very good throughout the
recovery, as it pushes out the swelling and is not painful. It is very
important to ice the injury regulary and to keep the swelling down. A
swolen knee will not recover (You need only 5mils of fluid in the knee
joint to stop the quads woring properly - and therefore recovering -
but if you can see swelling, then there is at least 10mils there)
What is really bad is leg extensions (where the weight is at the
bottom of your shin and you straighten your leg), this puts a lot of
shearing force though you knee, and pulls the joint apart.
As for what type of brace, don't know. Apparently my graft will be
(almost) as strong as a a real ligament by the time the muscles have
recovered enough to be able to play again, so I won't be getting
one...
Regards and good luck!
Matthew Porter
You may hear from these people anyway, but a short list of those I know who have(experienced) knee problems is:
Adam Batchelor - damaged but not ruined ACL and cartiledge AND displaced patellaSonic (Paul Schuricht) - incorrectly tracking patella
Aaron Altman - miniscus problems
Jeff Jackson - general overuse !
Dr Paul Marfleet - ACL damage (I think) and the only Doc I know who can relate
to the "injured-but-dying-to-play" syndrome that Ultimate players live on.
All should be at Nationals this weekend (except Jeff), all will be in the Druidscrowd !
Take Care
Wayne
Ouch.
If it is a damaged meniscus, than it is damaged in some way dramatically
different from mine.
When I had torn cartilage, it felt very much how you describe it, except that
it would hurt when I would sit for a long time, and then try and straighten it
out to walk, as well as being stiff after running a lot.
The damaged meniscus never really hurt, it would just physically catch, and
prevent me from walking or running at all, as it would hang up and keep me
from being able to bend my knee without a catch.
Apart from that, I have arthritis in both knees, and this sounds a lot more
like what you have mentioned, if you feel no instability in your knee when
you run. I will be just walking along, and all of the sudden I will get this
intense surging pain at what feels to be right behind the knee cap.
Usually, people who have torn or stretched their ACL or MCL feel it
happen, and experience swelling. Afterwards, when they try to cut, they
feel the instability in the joint, it has a completely different feel to it.
I don't know if that helps any, but having just come off of a 5 month layoff
due to a torn meniscus, I don't think what you have sounds the same. It
could be torn in a different way. Either way, I would get it checked out by
a SPORTS Medicine Orthopedist. I know they are a difficult to
find specialty here, but it is worth travelling to see one, as their expertise in
issues that are prevalent in sports related injuries is invaluable. They see
the same kinds of injuries day in and day out.
Wish you luck, and again, congrats on qualifying,
Aaron
From: Toby Green
You should consult the ultimate doctor, Paul Marfleet. You can write to him at:
11 Fitzwalter Rd, Colchester CO3 3SY
Good luck
Toby
David,
If you want to feel better about your knee then I suggest you watch
Adam Batchelor running about these days ;)
But seriously - if it's that bad then go to a doctor and if he won't do
anything fast pay for a physio as they often know specialists who can sort you
out. I had a repetative shoulder injury which was permanently cured within a
month by my physio for a total cost of less than 80 pounds - sometimes it's
worth spending money to get to the bottom of these things.
Pete.
Physio in Cambridge:
Sue Storey charges 15 pounds per session. She lives
very close to you in Girton and has treated myself, Arfon, Matt and Graham
so knows all about Ultimate.
27 Hicks Lane
Girton
277064
From: aflores@lehman.com (Aram Flores)
To: mackay@mrao.cam.ac.uk
Subject: Re: Knee problems
David,
I have had the misfortune of messing up a knee pretty severely
which required a series of operations to return to some sense
of normality. Given that I have struggled with this injury
through a reasonably successful Ultimate career I feel I am
in a position to offer some helpful advice.
The two most important factors in healing persistent injuries
are low impact excercise and icing. If you want to play
seriously you MUST do rehab after hurting yourself, but any
physio should tell you this. If you feel you have done
structural damage to your knee you will need to see an
orthopedic surgeon (very drastic as they always want to
operate), if you feel that it might be a sprain then go
see a physio who should reccommend icing and excercise as
well as some feel good stuff like ultrasound.
If you have hurt your knee seriously you have three choices
(don't make this decision lightly): retire, get a brace and
hobble around while playing, or have surgery. If you opt
for the surgery be sure that you can handle the rehab - it
SUCKS. If you don't work hard at rehab the knee will never
work properly again, in which case you basically had an
expensive and painful surgery for the same result wearing
a brace would have provided.
I am very dubvious of providing advice on injuries I have
never seen, but from what you describe it does sound like
a cartilage problem. These vary greatly in severity so I
would start with a physio, they are much easier to see
than surgeons and are very unlikely to cause you to do
further damage to your knee. They will (should) also
tell you if you need to see a surgeon.
I hope this is helpful and not to depressing
Aram
Dear David,
This letter is in reference to your enquiry about knees.
Over the summer I had a lot of problems with both my knees which
was a direct result from not stretching properly. I don't know if
this is relevant to your problem or not, but it hurt down both
sides of the outside of the knee. There is a muscle called IBS
(don't quote me on that) which is a common cause of injury if you
don't stretch it properly. If both knees hurt it is probably that
you aren't stretching a muscle properly. I can't recommend going to
a sports physiotherapist enough...it's expensive but worth it.
The stretches that I were given were very useful. Stand with both
legs together and knees slightly bent. Keep your hips forward. Take
your left leg and place it behind your right leg and reach down to
your left foot with your left hand. Do the same for the other leg.
I hope this works, it really sorted out my problems, but you should
really get checked out by a doctor. I would recommend really
warming up for about 20 minutes and warming down as well.
Good luck!
Diana Worman
David,
I am sure that most response to your question are prefaced with the best
possible advice ... "consult a doctor who specialises in sports injuries" -
I will be no exception.
I will share with you my knee story from 1988. It was in Leuven, Belgium
during the WUGC 3/4 play-off against Sweden that I had my knee joint
'over-extended' when an opposition player landed heavily on my straightened
leg - he was going one way and I was going the other, I had just caught the
disc he was hoping to intercept and was trying to stop ASAP (hence my
straight leg). The knee joint was bent slightly against the normal - Ouch!
It hurts just thinking of it - and within minutes it ballooned up. Had the
collision occurred a fraction later, then *he* might have come off worst
having hit hard on a particularly boney knee which was partly bent to
absorb my deceleration.
Medical help was on hand immediately, but the (GB team) doctor said that
little could be done until the injury trauma had abated ... about 48 hours
or so. After a slight detour to Luxembourg I ended up at home watching the
Olympics on TV for a few weeks while my knee tried to repair itself. I was
fortunate indeed that I had only 'stretched' and not snapped my POSTERIOR
Cruciate Ligaments (PCL). They remain slightly loose and I need to take a
little care with them.
One bit of advice that I was given to help protect my new weakness was to
build up the muscles 'around' the injury site i.e those front and back on
the upper leg (quads and ???) as well as the calf muscles.
I have never needed to use one of the complicated 'knee scaffolds' and
don't even use the neoprene supports and (so far at least) I have played on
for another eight years without a recurrence of the knee problem.
Problems with knees and ankles are an Ultimate players nightmare - get
yourself sorted out properly if you want to avoid early retirement or
constant frustration. SEE A QUALITY DOCTOR.
Best wishes,
Sam Neilson,
Stan.
She gave me heat and ultrasound and told me to get leg weights and do some exercises in a gym. She pushed and niggled at my leg in a painful way, detecting old hardened inflammations which the ultrasound was intended to dispel. She believes my problem is to do with insufficient muscles in the vicinity of the patella, and the build-up of old hardened gunk. She recommended doing leg lifts in a gym with the bad leg, and wearing leg weights, and (of course) doing stretches to get more flexible.
I am a bit surprised with this verdict as I have had patella problems before (very inflamed knees when descending mountains) and the recent knee pains seemed different.
She recommends against wearing a knee brace in my case because the aim is to get stronger muscles to hold the knee together; a brace might encourage the muscles to give up bothering.
She showed me a good quad stretch. The standard method is to put your heel up on a bench with your toe up and lean forward. She pointed out that there are many ways to lean forward, and the best is to keep your back upright, indeed, stick your chest out like Sam Fox, and push your upper body forward, as if peering over a wall. You only need to peer forward about 1cm and instantly you get a huge quad stretch.
I will go back again on Friday.