Area around Knee Swollen; Problem and Remedies?

Discussion in 'Health & Fitness' started by TripleB, Oct 22, 2012.

  1. TripleB

    TripleB Hall of Fame

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    Played in the Single Team (3 singles players on a team vs. other teams) State Championships with weekend and ended up playing 5 matches (2 on Friday and Sunday, 1 on Saturday).

    During my Saturday match my knee started hurting (an injury I've never had before) and by the time I got home it was a little swollen. I went and purchased a knee brace in hopes of being able to make it through the match(es) on Sunday.

    I made it through the matches (icing in between and afterwards) but now my knee is swollen a lot. A golf ball size area (maybe a tad larger) is swollen on the outside and slightly above the knee. And a quarter size area is swollen on the inside and below the knee. There is not any 'popping' in the knee are but it's a struggle to bend my knee more than 90 degrees. It's somewhat painful when I walk but the biggest problem is that it doesn't feel like my knee is stable when I'm walking.

    I plan to go see a doctor but not sure how long it will take me to get an appointment.

    Can anyone give me an idea of what the injury might?

    Is there anything I can do to help it (other than ice and brace it) until I can see the doctor? Ointments/gels/etc.?

    Thanks for any and all help.

    TripleB
     
    Last edited: Oct 22, 2012
    #1
  2. ollinger

    ollinger Legend

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    The problem is hubris. You're not 15 years old, shouldn't be playing so much. One doesn't deal with a swollen knee by putting on a brace and going out to play the next day. "Ointments" and "gels"??? I doubt it. See an orthopedist and don't play for now.
     
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  3. Tim

    Tim Rookie

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    Given the circumstance I'd say you sprained your knee, which means you strained and/or tore one or more ligaments. Hopefully its not anything seriously torn but I would definitely keep icing it, 3 times a day for 20 minutes, and don't play anymore tennis till you see a doctor.
     
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  4. TripleB

    TripleB Hall of Fame

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    It was for a state championship, we only had 3 members on our roster, if I forfeited my court it would have made my other members have to win in order to get the team win, and I wasn't about to let my team down when playing for a state championship...even if playing on only one leg. Thanks for the advice.

    Thank you for your input and advice. I'll keep icing it and I plan to stay away from tennis for quite a while now.

    One of my coworkers mentioned putting 'Tiger Bomb' on it...anyone ever heard of this stuff?

    TripleB
     
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  5. movdqa

    movdqa Legend

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    > It was for a state championship, we only had 3 members
    > on our roster, if I forfeited my court it would have made
    > my other members have to win in order to get the team
    > win, and I wasn't about to let my team down when
    > playing for a state championship...even if playing on only
    > one leg. Thanks for the advice.

    Would it be worth having to go for surgery? I've had plenty of knee issues over the years but never let it go to the level that you've described. I've used knee braces but my problem is cartilege scraping and that fixes itself with a little rest.

    > Thank you for your input and advice. I'll keep icing it and
    > I plan to stay away from tennis for quite a while now.

    You might want to have a doctor check it out if it doesn't get better soon. The knee braces are to fix the knee mistracking. If you have a different problem, then the knee brace might not do much other than keeping the joint a little warmer. The quality of knee braces is all over the place. Some of the cheap sleeves don't do much while some of the types with steel rods restrict a lot of the different kinds of movement that the knee can normally do.

    > One of my coworkers mentioned putting 'Tiger Bomb' on
    > it...anyone ever heard of this stuff?

    It's Tiger Balm. I've never used it but you can look it up on the web.
     
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  6. Chas Tennis

    Chas Tennis Hall of Fame

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    You need to see a well-qualified orthopedic or sports medicine Dr now. Does anyone that you know have a good Dr to recommend for a knee injury? When arranging to get an immediate appointment make it clear that you have swelling at more than one location, instability plus your other symptoms.

    Don't do tests to see what makes it hurt.

    (Is a torn ligament attachment to your bone what is causing the swelling, some other torn tissue?..........)
     
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  7. TripleB

    TripleB Hall of Fame

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    To be honest, I've never had knee problems before, it didn't swell a great deal the first day, and you never know if you will ever get to play for a state championship again...plus my team was counting on me. Hindsight says I was stupid, but at the time I felt it was the right thing to do because I was playing in the number 1 position and felt our chances of winning would be greater if I didn't have to forfeit my match.

    I wore a brace yesterday during the matches that offered a little bit of support...just enough to keep the leg tracking correctly and to give me enough confidence to be on the court. Today (at work) I'm wearing one that limits the movement of my leg a great deal more.

    Going to my family physician this afternoon...basically because I've had congestion for about 10 days now and I need to get something for it. I'm going to have him look at my knee as well (he's a runner so he's pretty good with leg injuries). If I need something else I will see a specialist later in the week.

    Thanks for clearing the 'Balm' up...maybe that's why I couldn't find it.

    I appreciate your input.

    TripleB
     
    Last edited: Oct 22, 2012
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  8. TripleB

    TripleB Hall of Fame

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    Doctor says it's just strained ligaments...no tears and nothing permanent.

    Ice, rest, wear brace, naproxen, no tennis for a while, and start stretching program (or else I'll continue to have knee and hip problems).

    Thanks for everyone's input.

    TripleB
     
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  9. TripleB

    TripleB Hall of Fame

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    2nd opinion from orthopaedic doc says torn meniscus, cracked bone near my kneecap, or both. MRI next Tuesday!

    TripleB
     
    Last edited: Nov 1, 2012
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  10. movdqa

    movdqa Legend

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    Ugh. Good luck next week.
     
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  11. 3fees

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    Yes,,Whirlpool it.....
     
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  12. ollinger

    ollinger Legend

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    "strained ligaments" may be indicative of your GP's ignorance, as there's no such thing. "Sprain" is used to describe a ligament injury, "strain" for muscle or tendon. And it's denial to think of it as nothing permanent. Ligaments heal with a more disorganized deposition of collagen than what was there originally, so even a sprain means you have a substantially higher risk of recurrence. A torn meniscus or bone crack often means surgery, hopefully an arthroscopy but data published in the last six months now argues against doing meniscus surgery if the knee has significant arthritis seen in the MRI, as the procedure is ineffective. The point again is that playing as much as you evidently do is simply asking for trouble, as you don't allow your body enough rest periods to heal.
     
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  13. maggmaster

    maggmaster Hall of Fame

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    So what, in your opinion adults shouldn't play singles tournaments?
     
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  14. Frank Silbermann

    Frank Silbermann Professional

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    Do pros play five matches in three days? No, they do not. No one should, except maybe ten year-olds.
     
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  15. Chas Tennis

    Chas Tennis Hall of Fame

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    What bone is cracked?

    Your MRI will be examined by a specialist at the imaging lab. That Dr will write a report for your orthopedic Dr. Suggest that you request a copy of that report from the imaging lab as it is a checklist of the conditions of most structures in your knee. Research each term mentioned in the MRI report and the condition described. My MRI did not show the meniscus tear definitively but the MRI image was 'consistent with' a torn meniscus injury.

    I asked the Dr if I could see how my injury would heal. It was OK to try with my injury. He guessed the probabilities - 25% it would heal and 75% it would need surgery. After 4 months I felt that it would not heal on its own and got arthroscopic surgery. Good result for the 1999 injury & surgery.
     
    Last edited: Nov 1, 2012
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  16. ollinger

    ollinger Legend

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    ^^ Frank is spot on here. TripleB has posted in the past about playing three hours seemingly every day after work, then playing more than this on weekends. This is insanity. A middle aged adult who does this and doesn't get hurt is very fortunate, because that kind of regimen is simply begging for significant injuries.
     
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  17. maggmaster

    maggmaster Hall of Fame

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    I disagree, with appropriate conditioning and strength work you can maintain a heavy regimen through your warrior years. It is really all about slowly increasing the amount that you do, coupled with appropriate rest days and a good diet. If random guy suddenly starts training for 3 hours a day, yes he will get hurt. If he starts slowly and builds his base he is less likely to get hurt.
     
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  18. ollinger

    ollinger Legend

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    ^^ Since arthritis is a cumulative wear-and-tear condition that is evident in EVERYONE beyond a certain age, your point is lost on me. Muscles don't mitigate the load on your knees. There is no such thing as a muscle that supports weight. The best conditioned athletes in the world don't competitively get beyond their 30s -- sometimes 20s -- because "the first thing that goes is the legs." And what usually "goes" is the joints due to wear and tear.
     
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  19. Chas Tennis

    Chas Tennis Hall of Fame

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    I'm not certain that everyone has to get arthritis............?

    http://osteoarthritis.about.com/od/osteoarthritis101/a/Does-Everyone-Develop-Osteoarthritis.htm

    How can you distinguish the effects of

    1) age
    2) wear and tear
    3) failure to allow healing in a timely manner when injury occurs.
    4) posture issues that overload certain joint areas (such as my bow-legged friend who has arthritis and meniscus injuries where the cartilages are pinched from the bow-legged posture)

    ?? I'd say the research has not yet been done.
     
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  20. TripleB

    TripleB Hall of Fame

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    Unless it's a State Tournament I typically only play twice a week. Monday and Thursday nights. If I miss one of those days I may play on Saturday morning.

    Maybe you should send that information to the USTA of NC who set up the schedule for the State Tournament.

    It's on the inside of my lower leg bone, right below my kneecap. It looks like a small (maybe an inch long or so) diagonal line at the top of the bone with what looks like a small protrusion sticking out the side (doc said it looks like where the bone was trying to heal itself).

    Thank you for that advice. I'll to remember to ask for that information and do the research.

    As stated above, unless it's a state tourney (or I have some amazing demos), I typically only play twice a week. Coming from somebody who at one point ran over 30 miles a week, 6 hours of tennis doesn't feel like a lot.

    TripleB
     
    Last edited: Nov 2, 2012
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  21. North

    North Professional

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    What you describe sounds like a tibial plateau fracture, especially given all the swelling you initially had. If that is indeed what it is (sometimes hard to tell from just a general verbal description), the need for surgery depends on if there is any dislocation, displacement, or joint instability. If there is an accompanying meniscal tear, that may (or may not) be a further reason for surgical treatment, depending on the nature and extent of the tear.

    The other thing to be concerned with about tibial plateau fractures is the occurrence of post-traumatic osteoarthritis (which has permanent effects), especially if the fracture does not heal well and which is more likely in individuals over age 50. Actually, the majority of tibial plateau fractures occur in people over age 50.

    Bottom line... the tibial plateau is a critcal weight-bearing joint. If you have this fracture, do what your orthopaedist says and don't try to push to get back to activity sooner than recommended. If the ortho says no more tennis (I hope not), he/she means it.

    I wish you well, hope it all turns out to be much more benign than it sounds, and that you make a good recovery.
     
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  22. TripleB

    TripleB Hall of Fame

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    I'll try to describe the X-Ray. From the front view, at the top of the leg bone (tibia I would assume) directly beneath my kneecap, on the inside portion, there was what looked like a very thin line shaped like " / ". At the bottom of the " / " was a little protrusion sticking out the side of that bone.

    On the x-ray from the back view you couldn't see the thin line but you could still see the little protrusion sticking out the side.

    Thank you for the well wishes...they are greatly appreciated!!!

    TripleB
     
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  23. North

    North Professional

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    The larger lower leg bone is the tibia and the area you describe (on the top surface of the tibia, below the patella) is the tibial plateau. The "protrusion" may be a piece of the tibial bone, but the full dimensions of it (small slender chip of bone vs larger dispalced segment) can be difficult to read on plain x-rays. It may also be a fragment of another bone, though that is less likely.

    The MRI will give more information about the joint itself and any other structures, other than bone, that may be injured.

    Bummer of an injury. Five matches is a lot to play in 3 days. I play a lot of tournaments and have been lucky to get to the finals, or at least go fairly deep, at times. So I have played 4-5 matches in a (3 day) weekend. In the early rounds I probe my opponents' skills to try to find ways to make the wins easy on myself physically. So far (up to the 4.0 level I am at - you are probably at a higher level), I find many opponents who will still self destruct on a steady diet of junk balls, moonballs, dinks, etc. It's not fun to win that way but I figure if someone cannot handily beat that sort of stuff, they are not very good. So I win without expending much energy and get to keep moving on till I finally get to a better quality opponent who I can actually have a fun challenge playing.

    Hang in there - just a few more days till the MRI and then you can talk with the Ortho about the next steps.
     
    Last edited: Nov 3, 2012
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  24. TripleB

    TripleB Hall of Fame

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    Got results back from MRI yesterday and the doc gave me some good news and some bad news.

    Good News: No torn meniscus and no broken bone!!!

    Bad News: a "sizeable" piece of cartilage is missing from my knee, I'm going to have to have microfracture surgery (from what I understand: arthroscopic surgery to put four small holes in my bone, this will cause a "good" blood clot to form, and the hope is that it will turn into new cartilage), can't put any weight on my leg for 6 weeks after surgery (but will be exercising it 2 days after surgery), can't start running again until 3 months after that, and then I can try playing tennis 2 more months after that. :(

    Thanks for everyone's input.

    TripleB
     
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  25. Tim

    Tim Rookie

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    blah, thats a drag but at least you know exactly what you are dealing with just got to get through the process and hopefully you will be ready to go after that. Good luck!!
     
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  26. North

    North Professional

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    Cartilage - that makes more sense (prob more common than tibial fracture. The MRI did its job.

    Sorry you will be out of action for a while. Be patient with the rehab after surgery. Sounds like you have been in good shape physically to start with, so you have an advantage there. Hope all goes smoothly.
     
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  27. TripleB

    TripleB Hall of Fame

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    Went in for Microfracture sugery this morning at 9.30, went back for surgery around 10:15, home by 12:30, and on my CPM machine for Physical Therapy by 3:00!

    Must have been more extensive than my doc originally thought. Before surgery he said I could start running 4.5 months after surgery and on the court playing singles hopefully by June.

    Afterwards he told my wife that he had to remove 5 pieces of cartilage, that I probably wouldn't be running for long distances again, and that I should stick with playing doubles. Disappointed to hear that because I love singles, (used to) dispise doubles, and used my mobility to win matches.

    But at least I will be able to play tennis again!

    Thanks for everyone's help. Hope everyone had a blessed Thanksgiving.

    TripleB
     
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  28. Chas Tennis

    Chas Tennis Hall of Fame

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    Congratulations on being over the operation!

    Did the Dr identify which cartilage(s) were damaged?

    I had a torn medial meniscus. The Dr estimated that he removed 30-40% of it (maybe some other debris also?).

    I had taken maybe 6 months off total - 3-4 months trying to heal and 2-3 months after the surgery. When I started back my legs had weakened considerably from the lack of exercise. Regaining strength added a considerable and necessary time to my recovery. My operation was in Jan and I played about June.

    Your legs will not have been off as long.

    Best of luck!
     
    Last edited: Nov 26, 2012
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  29. movdqa

    movdqa Legend

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    6 months seems to be standard for surgery in getting back to tennis. One of my hitting buddies had surgery twice on his shoulder and started playing again after six months both times. The second time was due to a construction accident - not tennis-related.

    Any chance that they could replace the missing cartilage with lab-grown or synthetic?
     
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  30. Raul_SJ

    Raul_SJ Professional

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    If I understand correctly, your "articular cartilage" (at the end of the bone) is damaged but the meniscus is perfectly normal?

    What caused the articular cartilage to go missing? Was it the sudden injury during the weekend matches? Or years of wear and tear?
     
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  31. ollinger

    ollinger Legend

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    ^ what possible way could there be to answer such a question? It is likely both.
     
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  32. Chas Tennis

    Chas Tennis Hall of Fame

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    Acute Injuries & 'Wear & Tear'

    When I had my first meniscus injury it was late in a 2 hour tennis match, I was tired. I back pedaled to cover a lob and jumped up. When I came down I could feel the slight injury. For 2 months a slight pain at that location in my knee did not go away and occasionally my knee would be shaky in some turning positions. 2-3 months later it got much worse with a sudden bone-on-bone sensation, severe pain, scream, fall, etc..

    I have viewed that first meniscus injury as an acute injury and no time allowed for healing (or, if not healing, is there cartilage remodeling?). I do not understand what caused the feelings, so speculating -other mini injuries followed the first until the bone-on-bone sudden severe pain which was probably the tibular and fibular articular cartilages contacting each other or muscle spasms pulling my knee joint out of kilter. ?

    I view what happened in my meniscus injury as a series of acute injuries over about 2-4 months without any time off to heal. That seems different from the undefined medical term 'wear and tear'. Is wear & tear just failure to allow healing time for very small asymptomatic injuries?

    I suppose similar acute injuries could occur directly to the articular cartilages. Under what circumstances does the meniscus protect the articular cartilages?

    ADDED 12/11/2012 - Acute articular injuries & overview
    http://www.coachroblowe.com/injuries-lower-knee-cartilage-articular-overview.htm
     
    Last edited: Dec 11, 2012
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  33. Chas Tennis

    Chas Tennis Hall of Fame

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