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What Causes Difficulty In Bending Knee Backwards And Knee Pain?

Posted on Thu, 10 Mar 2016

Question: one of my players is 16 years old,bending knee backwards fully is difficult,a bit painful from the back of the knee,sometimes on different spots around the knee

Answered by Dr. Aashish Raghu (3 minutes later)

Hello. I just read through your question.
It is possible that he may have hyperextended it at some point recently. the fast way to heal is to rest the knee.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Aashish Raghu (3 hours later)

Well he fell awkwardly 3 months ago, he had swelling and pain, he had an MRI, it was suspected to have ACL tissue damage, no tear in the miniscus or ACL though, he rested for a month, we worked in the pool for rehabilitation and strength for another month, and started strength and flexibility training for the quads, hamstrings and knee ligaments. The patella was very loose in comparison with the left, now it is much more stable and on standing, only seems to be very slightly looser than the left patella. There is no pain, even while sprinting or jumping, but the only complaint is pain behind the knee when stretching backwards (the heel touching the glutes) it doesnt bend all the way, and there is, as mentioned earlier, bareable pain behind the knee.

Answered by Dr. Aashish Raghu (5 hours later)

Brief Answer:
Could be a meniscus tear, MPFL tear

Detailed Answer:
Hi there.

Thanks for the query.

Could you please detail the MRI Report please?

Has your player ever had a twisting knee injury?

This appears to be a classical Meniscus cartilage tear associated with possible lateral patellar subluxation.

It is advisable to keep strengthening the quadriceps and hamstrings which will provide worthy rehabilitation. The pain needs to be looked into, most probably a meniscus tear which should have been given in the MRI Report.

A diagnostic Arthroscopic procedure or key hole surgery can be undertaken after a complete knee Exam to look for small tears in the meniscus cartilage and also repair the Medial patellofemoral ligament if there is lateral patellar subluxation.

I hope I have answered your query.

I will be available to answer your follow up queries.

Regards,

Dr. Aashish Raghu

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Aashish Raghu (9 hours later)

Please find attached, these are 2 months old MRIs. As I said, no pain, only when bending foot backwards

Answered by Dr. Aashish Raghu (17 minutes later)

Brief Answer:
There is compete ACL tear

Detailed Answer:
I have reviewed the MRI Report.

Yes, There is complete ACL tear which is very evident in the scans. Compete ACL tear usually cause no pain but is a forerunner to early appearance of knee arthritis such can explain pain.

Also there is damage to outermost aspect of the knee over the lateral femoral condyle.

These can cause the knee to be unstable and increased chance of knee arthritis at early age.

He needs Arthroscopic reconstruction of the ACL as soon as possible to avoid premature arthritis which can cause severe pain and restriction is knee movement.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Aashish Raghu (4 hours later)

He is 16 years old, would you really suggest suregery at this point? Wouldnt the ACL be able to heal at this stage of his life? There is no swelling currently in and around the knee, he can train football specific drills and can do sprints. These MRI's where 3-5 days after the injury. Would there be another diagnosis that might be possible?

Answered by Dr. Aashish Raghu (1 hour later)

Brief Answer:
ACL tear confirmed. Needs surgery if he wants to continue sports and athlet

Detailed Answer:
ACL will not heal by itself. It requires surgery. He won't be able to do most high demand knee movements like pivoting, squatting, running without feeling instability and sometimes pain. He requires surgery. No other diagnosis.

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Aashish Raghu (22 minutes later)

How long would the rehabilitation take usually after the arthroscopic reconstruction? And when can he resume collision sport? Will he need to spend a night at the hospital or would he need crutches to walk afterwards?

Answered by Dr. Aashish Raghu (6 hours later)

Brief Answer:
Please follow the Answers in details

Detailed Answer:
After ACL reconstruction, he won't be able to bear weight on the operated limb for about 6 months. So he will have to use a walker for moving around. He can return to collision sports within 1 to 1.5 years after surgery.

Hope I've solve your doubts. Any further clarifications are most welcome.

Regards

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Arnab Banerjee