Ask a PT….Where you can get advice on pain, injury, or fitness from a physical therapist.

This will be a weekly feature on Fridays in our blog, where we answer questions we get from our clients or posters on this site or our Facebook page.  So if you have a question about some sort of injury or problem you are having whether pain or fitness related drop us a line in the comments or Facebook message.

This week’s question comes from a friend who injured her knee playing recreational soccer: “I went to trap a ball with the inside of my knee during the game, and it hurt but  I continued playing on it for an hour.  Afterwards, it hurt to bend or straighten it, and it feels really stiff and achy. I’ve been icing it, but my question is- should I move it or not? Stay off of it? Should I go see someone?”

Without actually examining the knee, it is difficult to say for sure, but since this is a low-impact injury where you did not hear a pop and were able to continue to play on it, immediate medical attention is likely not necessary. The best initial course of action would be to cease running/impact/strenous activity, continue to RICE (rest, ice, compress, elevate), weightbear (walk on it) as tolerated, and maintain active motion of the knee. Do this for a couple days and let things calm down. If it starts feeling better, and there you have no episodes of the knee buckling or catching, you can begin a gradual return to activity. If it is soccer you want to return to, try jogging for a short period of time (5-10 minutes) once the knee feels good. Wait at least 1 day to determine if there is any increased pain, swelling, or other symptoms associated with the injury.  If there are no increased symptoms, go out side to an even surface with tennis shoes or a flat glassy area with soccer shoes on and set up some cones. Try jogging first at a moderate pace and try cutting at different angles at the cones. If this doesn’t bother you, progress to faster speeds. Again, wait a couple days to see if any symptoms come on.

If you continue to experience pain, swelling, and stiffness that inhibits your ability to move the knee in the same way you could prior to the injury, or you experience locking, clicking, buckling, or a general sense of instability, you may want to go to a physical therapist or orthopedic physician to rule out any ligament damage.

Often people will say, “shouldn’t I get an MRI?” One thing to keep in mind is even if there is evidence of ligament damage on an MRI, the course of action is often the same. In the case of an MCL or minor meniscus tear, conservative (i.e. non-surgical) treatment is most often the first line of action. This involves physical therapy or some means of rehabilitating the knee to return to prior function. This can take anywhere from a couple weeks to several months. And, a recent study in the New England Journal of Medicine showed that patients who underwent surgery for a meniscus tear had the same results at 1 year out, from a functional standpoint, that patients who opted for conservative care.

So the answer is not black or white, but the key is to pay attention to the symptoms and recognize what degree of medical attention is appropriate for you. If you are having knee pain or any of the symptoms mentioned above, and you would like a physical therapist to evaluate your knee, please give us a call to schedule an appointment at our Avon office (970)949-9966 or at our Eagle office (970)328-5230.

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