Knee injured on holiday - on crutches & worried

[HolidayHobbler]

I’ve buggered up my knee on holiday and am posting here while sat on the sofa of a holiday cottage as my adult kids and partner are having fun on the beach.

It happened 2 days ago. I’m in the Highlands of Scotland and was on a walk. We were ascending through dense ferns and quite boggy ground. My foot got slightly submerged in a section of mud and while I put my other leg up onto higher ground slightly off to the side, and pulled up other foot out of the bog, it gave this enormous clunk and crunch and sharp pain. I let out an expletive and everyone looked on with concern. I was determined not to make a fuss and gently placed my foot back down and was surprised I could actually stand on it.

I walked a bit further and went very gingerly. Every now and again if my foot went on a slight angle I’d get a sharp pain and feel and hear a clunk. We stopped soon after for a picnic. We set off again going downhill this time - I tried to take it carefully but I suddenly felt my knee completely buckle underneath me with a clunk my DD even heard. This time I was buggered. The rest of the climb down took an hour and a half. I used my partners walking sticks like crutches, went on my DS’s back, shuffled along on my arse and managed to get to our car.

I called NHS24 and they advised going to the nearest A&E Minor Injuries Unit the next morning to get it looked at. It didn’t swell up horrendously - just a bit puffy and warm. Took ibuprofen and slept downstairs on the sofa.

I got seen at hospital and they did an X-ray and physical examination. Nothing was broken or showing any bone damage or evidence of any tendons/ligaments having ripped off and left raggedy edges/floating bone fragments etc… the manipulations and movements they asked me to do didn’t give them any indication of tendon/ligament damage. So I got given an exercise sheet, crutches, an ice-pack, ibuprofen and the RICE instructions - told to raise my knee above hip height and not put any weight on it for next 48 hours, and then start exercises.

I’m trying the exercises now but am just really worried. I can’t get my knee straight. I can put my foot flat on the ground but anytime I try and put a bit of weight on it - it just feels like it’s going to collapse. I’m shit at using the crutches - I just can’t get the hang of them and have stubbed and badly bruised my little toe on the other foot. I have managed to manoeuvre down 2 shallow steps to sit outside in the garden but then couldn’t get back up them. I ended up going on my arse and shuffling up but then couldn’t pull myself to standing - I managed when my DS noticed me on the floor - he helped pull me up but I inadvertently put weight on my bad knee and felt the same ‘caving in/collapsing sensation, clunk and pain again.

I’ve got a bit better on the crutches and can get myself on and off the sofa, over to the kitchen table and back and forth to the loo (thankfully there’s a downstairs toilet and shower room!)

I’m sorry for this essay but I’ve nothing else to do. The Dr said if there’s no improvement in a week to access help in my local area. I live in a major Scottish city. I’m just wondering if it’s normal to feel this debilitated when there’s been no major injury to my knee? Should I ask to get an MRI done as I believe x-rays are only good for showing bone damage, not ligament, soft tissue damage? I’m wondering how the hell im going to get on at home with its 7 stone steps to the front door and only an upstairs loo?! I’ve let work know I won’t be in for at least the first half of the week. I walk to work everyday - 25 minutes each way - how long is it going to take before I can do that again?

I would really appreciate hearing off any physios or anyone else who’s had a knee injury and can share their journey towards recovery. I’m quite scared that I’ll never get it fully functional again. Should I just go to my local A&E/Minor injury clinic when I get home (if no improvement has happened) Would they turn me away because I’ve already been seen elsewhere? I return home Sunday so have another 2 days of holiday to ride out.

If you’ve read this far - thanks

I don't know how things work in the Scottish NHS, but when this happened recently to my son, we went to the local 'urgent treatment centre' (which is our local hospital's version of a minor injuries unit) and they referred him for an MRI -- which actually came through quite quickly (within about ten days). If something similar happens again I'd go that route rather than via GP (who would probably just send us to the urgent treatment centre!)

The initial inflammation (which might be what is making it difficult to straighten your leg) does go down. Use ice and ibuprofen if you can, get a strong knee brace (not the cheap ones - you want one with a bit of structure; ask at the pharmacy), keep it raised. Son is 21, strong and fit and healthy, and he has found it a right bugger. He's on the mend, but slowly. He found he could begin to put some weight on it after three or four days, and it has gradually improved from there.

Yup, don't think they allow us to request this in Scotland. We could only request lumbar spine and head MRIs in fact I think it was only head CT we could request.

What a range of experiences - thanks so much. I think I’ll see what the score is when I wake up tomorrow and either call NHS24 or head straight to A&E (I’m in Glasgow) I don’t think the GP route is going to speed anything up but will obviously self-refer to NHS physio once I’ve established the immediate cause/course of action if I’m not automatically referred.

My instinct is telling me that it needs further investigation and once that happens I will dutifully follow any advice, exercise plan recommended. I feel it needs some support - it’s not the pain I feel when trying to weight bear it’s the sense of instability and ‘looseness’ coupled with the bone clunking and clicking.

I will pay for an MRI if one is not forthcoming and I continue to feel so unstable. I just had a big birthday and a bit of money so I’ll just put it towards my knee rather than all the other lovely things I had planned.

I’m conscious I haven’t exactly got youth on my side but neither am I ready for the knackers yard yet!

Right, called NHS24 and they’ve set up a video consultation for me at 11. See how that goes. Whether I get fobbed off with ‘keep taking the tablets’ or, hopefully, they get me an appointment to be seen in person by someone. We shall see.

Before an MRI I would see a sports physio and see what they suggest. They are very good at recommending scans if needed. They might just say you need time to heal.

Good luck with the zoom call.

Ask for an NHS referral to the rapid response knee clinic, all hospitals have them for knee injuries seen in A&E, similar service to fracture clinic for A&E breaks. Sounds like an ACL or Meniscus tear, there would of been fluid build up called knee effusion visible on the X-ray which indicates ligament damage, a lot of A&E doctors over look this as they are purely looking at the bone for fractures. You will need an MRI and this clinic is the correct place to get one.

@HolidayHobbler look at my post above, forgot to tag you.

You need an MRI I did a similar thing got referred for one had it done within 10 days and am now awaiting surgery all courtesy of NHS Scotland.

Video call over. Bit limited about what I could show him with my cack-handed IPhone camera skills! At one point it looked like it was going down the ‘knee injuries take time, keep icing it, take ibuprofen etc…’ He was surprised that I hadn’t been given a knee-brace or a tubi-grip and I said ‘so was I!’

He made me show him how I mobilise on my crutches and whether I could weight bear. I got up on them and said I’m not comfortable forcing myself to put weight through it as it feels so unstable and he was good with that. I explained that I’d been trying some of the exercises but was getting some crunching and clunking that stopped me. I think my mentioning the feeling of ‘Instability’ rather than feeling sore, was a deciding factor in him getting me another in-person assessment at the minor-injuries unit this afternoon.

I’ve read through old threads about knee injuries on Mumsnet and one person advised using chat GPT to summarise the way to describe the accident/subsequent symptoms and that was actually really helpful in just organising my thoughts before sitting down in front of the camera. I was able to zone in on the important stuff rather than waffling. I was able to be very precise about the criteria of my local health board in getting a further assessment. Basically it came down to not being able to weight-bear after 6 days despite following all advice, and feeling that my joint was dysfunctional/unstable. No fibbing, just cutting out a lot of the inconsequential stuff!

I still don’t hold out much hope of getting an MRI but I will be in the loop of having a proper physical assessment (he warned me it won’t be pleasant!) and referral to physio and/or possibly orthopaedic/Musculo-Skeletal services. And at the very least I might get a proper knee-brace.

Even if it’s ‘just’ a sprain he says I’ll be on crutches for ‘at least’ 2 weeks with significant healing time after.

I want to come away from this afternoon’s appointment confident I’ve been thoroughly assessed. I want to be certain I’m doing the right sort of exercises appropriate to my exact injury - rather than just a generic set that might not be right. I’ll be surprised if they give me an MRI but it would be good if I could be referred for one at a later date? Or maybe the physical examination will rule out the need? Who knows?

@BinBagDress I’ll enquire about the rapid response knee clinic so thanks for that. It might not be applicable if I’m having this appointment in the minor-injuries clinic though? Who knows but it’s all part of one of Scotland’s major hospitals that includes the A&E and orthopaedics unit so it might be the same clinical staff/unit? I’ll let you know.

@Sheswatchingyou that’s so encouraging to hear your story of treatment by the Scottish NHS. Good luck with your surgery and thanks for coming on here to post. My injury might not be severe enough to require such invasive treatment but it’s good to hear it kicks in when it’s really needed.

My appointment is at 2.30 and I shall, of course, report back.

Sounds like good progress @HolidayHobbler and definitely having your thoughts organised is helpful to you and to those assessing you.

Hope this afternoon goes well

OK - I’m back. Waited an hour and a half and then was wheeled in and lay on the couch (a paramedic saw me outside the clinic trying to badly hobble up the ramp on my crutches and offered me a wheelchair which I appreciated!) The medical person (Doctor? Nurse? Not sure of title) went away and looked at the x-ray sent through from Fort William and agreed with their assessment that it didn’t give any visible indications of concern. She asked me to bend my knee up - straighten it out and press against her hand underneath my joint - cross it over my other leg, attempt to lift it off the couch, straight-legged - She seemed very reassured from observing me do/attempt these movements and feeling around my knee, that all my important ligaments/tendons were still attached/intact.

She said the swelling and bruising that’s starting to come up around my knee and calf muscle, would suggest I probably have small tears in my meniscus or even in a ligament/tendon, and that there’s bleeding going on but that ‘it’s still early days, barely a week’ since I had the accident, so see how it goes. If, a week from today there doesn’t seem to be any improvement, to get in touch with my GP, who she’ll write to today. If they feel a need for further investigation they can refer me on to orthopaedics and perhaps suggest a scan - but not before 4 weeks? I need to give it that amount of time to heal first.

She said I’d need some physio to help strengthen my knee and got me to scan a QR code to self- refer to the NHS physio service. I asked if it was likely I would see one soon, and was referring for a scan something a physio could do but she said she didn’t know anything about the current wait times and only the GP could refer.

I asked about a brace or some support around the joint and she said we don’t use them - they’re not recommended.

I’ve just got to hope they’re right and I will start to feel an improvement. She said not to rush to weight-bear if I don’t feel ready but keep doing the sitting down/lying down exercises. Her answer to my question as to why my knee felt so unstable and crunchy/clunky was kind of ‘it’s to be expected’ because I clearly gave it a traumatic wrench and the tissues and ligaments will be inflamed.

So I’ve just got to stay put. I feel housebound and trapped because I can’t get out my own front door and garden without shunting on my backside down the steps and along the path to the pavement. But hopefully it won’t be forever. My biceps are at least getting a work out and my good leg is too / I’m basically doing a pistol squat coming down and coming up off the floor and sofa, and lifting myself up and down the many stairs!

I’ll report back in a week and let’s see where I’m at then. I will look into the costs for private physios and a private MRI to see if it’s feasible but hang-fire for at least another week.

I didn’t ask about a ‘rapid response knee clinic’ @BinBagDress because she seemed so unconcerned by my condition I think she might have laughed??!

So I shall keep doing the exercises and gingerly try and put a bit of weight on it - but I’ll not rush that process.Thanks again everyone for reading my very long posts and for being so informative and supportive.

i admire and appreciate your diligence in updating! Sorry you’re going through all this - what a rubbish end to your holiday.

I appreciate that you’re giving it a week and think you’re right to be cautious. IME the waiting times for referrals are lengthy, esp for orthopaedics. I’ve also had very mixed experiences with NHS physios.

Just some thoughts from someone who’s been through similar… There are a couple of places near / in Glasgow that do MRIs without referrals and apparently they give you images and report within a few days. An NHS physio might not consider it to be helpful or be willing to look at it (again maybe just in my experience) but a private one might. A private physio might be able to recommend you a place that they usually deal with.

Wishing you all the best - I know it’s hard but keeping your spirits up and trying not to worry can really help. Let others help you too.

Glad it seems that there’s nothing too dire to worry about but sorry it looks like it’ll be a longer recovery than first expected.

Don’t forget to ask for a sick note tomorrow to take you up to the end of 4 weeks.

Glad you’ve been thoroughly assessed.

Hope it does settle as they predict 🤞🏻

@Whitecliffs87 I’ve got plenty of time on my hands now to bore you all senseless 😂Good call on finding a private physio that might recommend a place to get a private scan. I’ll definitely look into it if I’m not happy with how things are progressing (or, more likely, NOT progressing). If I have to take out a loan, beg, borrow, steal - I’ll consider it if it means I’d be potentially healing better and not being left with unattended-to issues that will affect my future mobility and quality of life.

@itsgettingweird I’ve never had to get a sick note before as I’ve done a lot of freelance stuff. I’m now in the public sector and my line manager was asking me when I wanted to start the 7 day self-certification. I think I have to contact the GP to get it extended if I feel the need to- I think it’s likely I’ll need another week or two. My main thing will actually be getting to work as I usually walk 25 minutes there and back. If I’m still hobbling on crutches I’ll need to taxi there and back which will be costly. I stand a lot in my job and carry stuff and crouch up and down putting things on shelves - I won’t do a decent job until I’m crutch-free or at least down to one stick. I won’t go back unless I’m happy I can move about well enough and do my job without knackering my knee again or setting back my recovery. Work might see it differently and want me back with adjustments ie. Staying seated but I can’t see how that’s practical in the space and role. Anyway that’s a future chat.

This was me last June!! I did end up with torn acl but this was only diagnosed after a scan. I was on crutches for 6 weeks. I was back running after 6 months and I opted not to have surgery as I didn’t have ant giving way or knee locking. I’m 55 but I think if you are younger then surgery might be suggested. Good luck xxx

Your boos likely asked you when you want to self certify from because some companies allow you to certify from day of injury and get the AL back.

You'll have no problems being off as you’re injured but worth speaking to your manager to check what dates you should self story from and the date you need for note from. The GP can backdate for notes if needed.

@sandycloud your story was very encouraging. I’ve just turned 60 myself. I’ll be grateful if I can get back to doing the 25 minute walk to work and back. Running after 6 months is amazing. How long after your injury did you get a scan and did you have to go private? I think they suspect I have tears in my meniscus and didn’t rule out I might have a very minor tear in one of my ligaments but said the treatment is the same. Rest. Heat. Elevate. Ibuprofen. And keep doing the exercises.

I’ve got a physio appointment in 10 days time. I’m continuing to do the exercises A&E gave me and am slowly feeling like my knee might actually work again. Were you working when this happened? Did you have much time off? I’m just trying to think of the practicalities of being in work on crutches as it’s not a desk job.

And thanks @itsgettingweird for the annual leave/self-cert advice. Very useful 🙂

I had to wait about 6 weeks for a scan. I did see someone privately for a consultation after the scan results as the nhs physio offered surgery but I wasn’t sure whether to have it. Nhs would not advise me as they said I had to decide. The private consultant said lots of people over 50 don’t have great meniscus as it goes during wear and tear. I had also torn my medial meniscus. My knee always felt stiff and didn’t really hurt or give way. I have torn my acl too. He felt I didn’t need surgery as I wasn’t in any pain. I’m also back playing tennis. Another friend from tennis has torn her acl skiing. She has private health cover and was offered a acl repair early on so she did. It hasn’t been great and the surgery was very painful. The surgeon also told me I have torn my acl so can’t do it again. He said a brace probably wouldn’t help me but might make me feel better mentally I wore one for a bit then got fed up with it especially when it was really hot.