Severe knee pain: with history of menisci and ACL injuries


Q: I had an acl and maniskus surgury 2 years ago. i some what lied about the pain to play football the following year. after that season i went to the doctor to findout i tore another part of the maniskus. i've been through theropy, not taking it very serious about 6 months ago and now i have severe pain. i've always had a limp, but now its a limp with aching pain. it also has random times when laying down with intense pains, to the point where i'm considering it to be as bad as when i tore it. i'm almost positive i do not have any fractures but its constant pain. i spent a lot of time dealing with the pain until it went away and i completely regret it. please tell me what may wrong with my knee.


A:    Considering your past medical history of menisci and ACL injuries plus surgery and a new menisci injury, at this point you have to know about that Repetitive stress injuries (RSIs) are injuries that happen when too much stress is placed on a part of the body, resulting in inflammation (pain and swelling), muscle strain, or tissue damage, menisci and ACL in your case. This stress generally occurs from repeating the same movements over and over again, with no enough healing time so they are also called “overuse syndrome”. On the other hand, Knee pain is the most common presentation of patellofemoral syndrome. The pain typically is located behind the kneecap and often shows during activities that require knee flexion and forceful contraction of the quadriceps (ei, during squats, bicycle, ascending/descending stairs, jogging or pendants). Pain may be worsen by sitting with the knee flexed for a long period of time, such as while watching a movie, hence leading to the terms "theatre sign" and "movie-goer's knee." The causes are diverse: Overuse (repetitive use or activity), overloading, and misuse of the patellofemoral joint. The suggested strategy for conservative treatment should be as follows: Physical therapy program (exercises and pain control with TENS, ultrasound, ice packs after exercises), anti-inflammatory medication (i.e.: “Aleve”, “Advil”), education,  so  you understand which activities avoid because those can aggravate not only the patellofemoral syndrome but also your previous ACL and menisci injuries. It is very important, remark the need for extended adherence to the exercise regimen. The physical therapist should educate you about a home exercise program. Allow time for these conservative measures (ei: exercise program) to have an effect, usually 4-6 weeks is adequate for some resolution of symptoms.

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