Sports Related Knee Injury


Q: I am in my mid teens and when I was around 12, I was playing soccer and I dont know what happened but my left knee just snapped. It made a 'cracking' noise and the next thing I know, I was on the ground. It caused me so much pain but I was still able to bend my knee and walk (slowly). I did not visit the doctor and the pain eased away after 2 days. Then I began to notice that there was something different with my knee as everytime I would bend or do lounges it would make a 'carcking' noise, however I do not feel any pain. Also, I should mention that weeks or months after the injury, whenever I would tilt my left knee a certain way while exerting force to it, I would hear the cracking noise again and feel the same pain as I did when I first got the injury (this has happend more that once since i got the injury). However this time, it only takes an hour or 2 for it to heal and I am back on track. I quit playing soccer after the injury as I am not confident with the conditions of my knee. SOmetimes when I run very fast, my left knee feels unstable or 'wobbly' and then I simply slow down. As of now, I have started playing tennis and I haven't experience any knee injury as a result of it. But I really want to be able to play field sports again, do you have an idea what may be wrong with my knee? and what i could do to fix this problem? thank you


A:   Direct blows to the knee or twisting/ rotational movements may produce injury of the ligaments, menisci, bones or capsule, but if there is no significant swelling or deformity, and no limitation on the active movements (flexion, extension), a fracture or dislocation can be ruled out. Also if there is no instability or locking a menisci lesion may be ruled out.
The menisci are C-shaped wedges of fibro cartilage located between the tibia and femur, and very close related to knee ligaments and attached also to the joint capsule. They are susceptible to get injured with leg rotation movements or rotational forces applied to them, and the lesion produced can be partial or complete tear. Meniscus injuries are common in young males who are involved in sporting or manual activities. Locking is a common symptom after a menisci lesion develops. Locking usually occurs at 20-45° of joint extension. If a torn fragment has been trapped within the joint, extension may feel limited against a rubbery resistance.
Joint inflammation or capsular involvement also may resemble locking. A more reliable indicator of menisci lesion is a click or snaps after the joint unlocks, it can be or not associated with pain. A sensation of giving way may occur when the loose fragment becomes lodged for a moment in the knee joint, causing a sense of buckling. This finding should be distinguished from the sensation of giving way due to joint instability (e.g., ACL tear) or buckling secondary to decreased activity of the quadriceps femoral muscle.
Given the description you did about the problem of your knee, and if you had previous history of a knee injury that you can remember, it could be important to rule out a Meniscus lesion.

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