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Mumsnetters aren't necessarily qualified to help if your child is unwell. If you have any serious medical concerns, we would urge you to consult your GP.

6 months into knee injury - would really appreciate advice on handling it.

(16 Posts)
ontosecondary Thu 04-Dec-14 11:10:55

DS is 12 tomorrow.
He had episodes of very sharp pain in his knees several times when younger.
Last June he injured himself in a goalkeeping fall. The injury never settled.
Over the summer he held off sport and wore a support bandage.
In September the GP said the support bandage had weakened the surrounding muscles sad and referred him to muscular skeletal.
Xrays and MRI were both clear, though the consultant had suspected cartilege damage.
Enter private physio who suspects the underlying issue is DS's pronation, buckling knees and gait.
The physio has prescribed pilates-like exercises. DS says that one of them (knee-bends) makes the pain worse.
DS doesn't "get" the exercises yet - even just from going to pilates classes, I can see he is using the wrong muscles and "cheating".

He cries a lot about the problem because football means a lot to him. I don't know how to handle it. I'd really appreciate any help people can give.

The pain is just on the inside of his right knee. It gets worse if he plays sport.

BirdintheWings Thu 04-Dec-14 11:17:04

It might be that he hasn't given it long enough yet for the exercises to help? We are 6 months into physio for knee problems with DD, and she doesn't half grumble about it, but i can see that she is gradually getting more stability in the joint.

ontosecondary Thu 04-Dec-14 11:57:54

thank you for replying.

May i ask a bit more about your daughter and the exercises?

BirdintheWings Thu 04-Dec-14 12:17:09

She hasn't had a specific injury, just a lot of ongoing knee pain (is quite knock-kneed) so the aim was to loosen tendons but strengthen the muscles.

She's had a succession of different exercises starting with stretches -- very much the sort of thing you'd do as a warm-up for running -- and now focusing more on strength. Some are standing, some lying down to help the hip muscles. The 'stand on tiptoe on one leg and raise and lower yourself by bending the knee' is a killer, I can't do it at all!

RoseyHope Thu 04-Dec-14 12:43:22

I had two injuries to my right knee when I was 11 and 14, and then 4 surgeries each year after the second injury. I tore one of the ligaments and my knee and then repeatedly tore cartilage.

It's odd that the consultant suspects a cartilage tear but it didn't show on the MRI. It might be a small one. The menisci don't have a good blood supply, so tears don't tend to heal on their own. They can cause catching, locking, clicking type pains when the knee bends. Minor keyhole surgery is usually required to remove them.

What are the knee-bends? Is it weight-bearing, like a squat? Weight-bearing exercises can be very good for building strength and also balance, which help the knee to be stable and prevent further injury. However they can also aggravate an already present injury by putting too much pressure on the joint. If that's the case, he could switch to non weight-bearing exercises where he lies on his side/back or is sitting down.

pronation, buckling knees and gait

If this is causing the problem, it can be tiring to solve, because the solution is working on his posture and how he walks and his muscle strength, rather than wear this brace/have this surgery. I resisted my exercises for months at a time because I wanted a quick fix, or they were boring, or I thought it was better so I stopped them early. It's difficult at that age to stick to something diligently. But it's important he keeps doing them, and finds a good routine with the physio that doesn't cause more pain.

It helped me to sit on the edge of a chair and raise my lower leg so it was straight. My kneecap would slide on a bit of angle, because I had general muscle weakness and problems with the kneecap sitting in its little track properly. I had to focus quite hard on tightening the VM muscle to keep my kneecap straight, rather than defaulting to using the other quad muscles which was easier. It took maybe two months before I could do it properly. It's not like tensing your calves or abs where it happens naturally; it's difficult to isolate that muscle and tense that one rather than the others. But doing that allowed me to keep my kneecap straight as I bent and unbent and helped stop further problems.

Building lots of strength, especially in his thigh muscles is really important. The joint needs the surrounding muscles to protect it from injury and overuse strain. If the muscles are strong, the knee will move soundly and smoothly. Balance is also really important, else the joint will be wobbly and unstable. I used to stand on one leg while I brushed my teeth, or wobble about on my brother's skateboard. Then the next times I would play sport and twist on my knee, or have a fall, my muscles had the habit of tensing and supporting the joint, rather than just being blobs of leg and leaving the knee to twist on its own.

Sorry that this has turned into a bloody essay! Not sure if it's helpful.

ontosecondary Thu 04-Dec-14 13:25:21

really helpful... am studying...

MissLivvy Fri 05-Dec-14 00:31:42

Can I suggest a referral to ISEH (Institute of Sports Exercise and Heálth) at UCH in London? Were fantastic with my son's ligament injury from rugby. Hadn't had any joy locally

ontosecondary Fri 05-Dec-14 14:05:49

Thank you Miss Livvy. Is that a "tertiary" hospital?

MissLivvy Fri 05-Dec-14 20:11:06

Not quite sure what a tertiary hospital is but it takes NHS and private referrals. You can go on their website ISEH and the referrals procedure is there. We only waited 2 weeks for an NHS referral, don't let a GP put you off. You can choose to be referred there under the Choose and Book process. Good luck

ontosecondary Sat 06-Dec-14 18:54:49

Tgat sounds encouraging. Presumably GPs try to gatekeep?

MissLivvy Sat 06-Dec-14 21:12:21

Yes they do. My brother had that experience when trying to get a referral to a London hospital specialising in respiratory medicine. Fortunately he stood his ground, or rather remained seated in the waiting room! He got his referral in the end. Best of luck

Ponyphysio Sat 06-Dec-14 21:15:40

Medial knee pain is often caused by poor foot position - an assessment by a podiatrist specialising in biomechanics might be useful?

ontosecondary Sun 07-Dec-14 10:01:43

Thank you.

We will see the podiatrist for assessment this week. I hope that will help.

ontosecondary Sun 07-Dec-14 10:02:09

Apologies, medial =?

RoseyHope Sun 07-Dec-14 17:22:25

Medial means on the inside of the knee. smile

ontosecondary Sun 07-Dec-14 20:17:22

Thank you.

Thank god for mumsnet.

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