Answering questions about knee pain

I figured I would just do a post and a video of this because there’s a lot going on here. I received a question from a member of the Goalie Training Lab on Facebook about knee pain so here is my response. You may find it easier to watch the video here for visuals! >>



So when he flared with his right leg and felt a sharp pain on the left of his kneecap, so on the outside. After going to a butterfly a few more times, it started hurting in that spot every time he went down. Woke up the next day, the pain was sort of above his knee, any idea of what happened?

When he flared out or put his right knee out, he felt the pain on the outside. You MCL is on the inside. Now, again, it can get injured more often when somebody falls on it or if it’s really awkward position, but he had pain on the outside and the outside of his kneecap.

So I think one of two things. One is did he sublux his kneecap a little bit? Some people and it’s not actually that uncommon, but some people there’s a lot of force. My quadricep muscles come down, they make a quadriceps tendon at the top. My kneecap is actually engulfed in the tendon and then they attach at the bottom. And this part is called the patella tendon. Muscles pull in straight lines, not around corners.

If I’m a little bit like bent in and getting a strong contraction of my quadricep, well then it’s trying to pull my kneecap around the corner and where is it going to want to go? It’s going to want to make a straight line. So my kneecap is going to get pulled to the side. Sometimes, it’ll actually frankly dislocate. A lot of times, it just subluxes, it gets pulled out or its groove and then it slams back in. That doesn’t feel good.

That is the first thing that I thought, the way you described it. Especially since afterwards you’re like oh and then I was sore above my kneecap because you would’ve caused some trauma also to those tendons and those structures.

The other thing it could be is when my knee is bent in a little bit, I’m compressing this joint space, this lateral compartment of my knee and sometimes that will pinch a meniscus. Now, that’s usually more a real pinchy thing, like ow. When you get in the right position, it’ll give you another ouch. I wouldn’t expect it to be so achy, be more like jabbing. So my money would be on a little patellar subluxation.

Then, well there’s a little talk about strain, sprain, yatta yatta. A strain is to a muscle and there’s grade one, two, three. Grade one strain is, yeah, there’s some fibers torn, but it’s not that bad. It’s sort of a very mild strain. A grade two is, yeah, there’s a definite fiber disruption. You can feel a gap in the muscle where the tear actually occurred. Then, grade three is, like no, this thing is completely torn, which is really, really bad. You don’t see very many of those.

Same thing goes with a sprain. A sprain is a ligament. You sprain your ankle, you strain a muscle. The same thing, it’s tears and there’s grade one, two, three. One is a little bit, but it’s not really lax. It would be like if you just mildly rolled your ankle. Grade two is you’ve actually really torn part of it, but not completely torn, obviously a little more serious. Then, grade three is, no, your ACL is gone. Grade two and three, you’ll have instability, a little bit bigger deal. Grade three, if it’s in your ACL or something, he might be very well looking at surgery, that kind of thing.

That’s that. This is fun. This is another good question. Then, someone had some ideas about changing equipment and that kind of thing, which you already are using house straps.

Maybe see a doctor that has experience dealing with sports injuries. Because sometimes, and bless them, they have to diagnose everything and probably they’re much more about missing a really bad illness or something like that in a patient than misdiagnosing a knee sprain. If they’re like I think you probably sprained your knee, that’s like what does that mean? That’s pretty wishy washy.

If it’s like here’s some anti-inflammatories and just don’t do anything for a while, take a week off or two weeks off and then go back. Again, that might be fine to let it settle down. I don’t think if they prescribe some anti-inflammatories or something, probably not a bad idea to help it settle down that inflammation.

I would probably be looking for a really good sport physiotherapist who actually has the tools to do a really good assessment and they would’ve seen probably in the last month, they’ve seen five knees just like this and they have an idea of what’s going on and what you should do next.

There is a very long winded answer to a rather simple question. Gang, have a great day. Catch you later.