The Knee is a Tricky Joint

On, June 21st, round about 8pm, I was on the ice doing a warmup drill with our goalie. I was standing still in front of him when a teammate sent a puck towards me but behind me and to the right. I twisted around to receive the pass. Funny thing is, my left foot decided not to follow me, I think because it was caught in a rut in the ice. So as I pushed off the inside of my left foot to propel myself to the right, my knee was faced with a choice.... and the choice it made was not good. I heard and felt several loud pops as the knee gave out, and down I went.

Now, the first thing you think when this happens is, "I know that's not a noise that my knee is supposed to make", as you lay on the ice looking upward. A few seconds later, you start to feel the pain, which actually is not that bad at this point. After laying there for a minute and gathering my wits about me, I had some teammates help me to the bench where I removed my equipment and assessed the situation. At the time, I knew something was wrong because my knee didn't really want to move, but from the outside it looked well, more or less like my other knee. I hobbled around the rink gathering up my stuff, and (very) slowly made it out to my car.

Being my left knee, driving was not really impaired, and I drove home and hopped into the house. By that point, the swelling had started. I never got to the "grapefruit sized" swelling that many people experience, but the inside of my knee was quite swollen and sore. I immediately started RICE therapy (rest, ice, compression, elevation) and actually slept comfortably that night.

The next morning was a different story. As I got out of bed, the knee -really- did not want to support any weight, and I hobbled to the restroom 10 feet away. It's a really strange feeling to have a joint and a limb that you are used to walking, running and skating around on be completely useless. I think my brain had a tough time reconciling this, as my body was then overcome with an intense wave of nausea, the worst I'd ever felt. Good times! Thankfully, that lasted only 2-3 minutes, but enough time to convince me that a trip to urgent care was in order.

After a lonnng wait at the urgent care center (not so urgent, I guess), the doc took a look. An xray showed no fracture, so he sent me home with an immobilization brace, a followup appt. in a week, and a promise to have someone contact me about physical therapy.

Over the next week I went back to work, and with the immobilization brace it was pretty easy to get around. After a few days, the swelling went down, and what remained was a lot of stiffness and tenderness on the inside of the knee, indicating an MCL (medial collateral ligament, runs along the inside of the knee) injury. Day by day I gained a little movement back but still did not develop any "trust" in the knee - it still feels like it might give out, especially when not bandaged.

I was not impressed with the urgent care doc, and when no followup call about PT ever came, I cancelled my appointment with him and scheduled one with my regular UAB doc. Saw him on Friday, and he did another x-ray, which again turned up no fractures, but was interesting nonetheless cause my kneecap was out of place due to the swelling. The doc's comment was, "Hey, what's your kneecap doing way over there?" Just kinda interesting to see.

He ordered an MRI for me, which I completed this morning. As my first MRI, that was an interesting experience. It was easier since it was my knee and my head did not need to be in the tube. The noises were interesting, and LOUD... while laying completely still for 30 minutes I had lots of time to think about them, so I decided they broke down into three groups: sounds like machine guns, sounds like grinders, and sounds like futuristic laser weapons. Not sure why it needs to be so loud, but not really disturbing - the earplugs that were provided were a big help.

With the holiday, I won't have the results until sometime Wednesday, but what I suspect is at the very least, an MCL sprain. A sprain is when you stretch or tear one or more ligaments, and judging from the soreness right over my MCL, this seems like a likely outcome. The concern I have is that with the number of pops I heard, there may also be damage to the ACL and/or the meniscus. MCL injuries don't generally call for surgery, but ACLs often do, and meniscus injuries generally don't heal by themselves either, due to lack of bloodflow to the area. So, I'm not sure what's in store quite yet. The good news is that I can support weight and walk around with very little pain or discomfort, and the knee overall feels like it is becoming more stable. But, the knee is a tricky joint, and sometimes other ligaments or muscles can compensate for injuries.

In the meantime, I've also been fitted for a sports brace, which will allow me to ease myself back into hockey as the knee heals. I will wear it for at least the first year after the injury. I'm in no hurry to rush back, though. I'm looking forward to doing some PT to increase the strength and flexibility of the joint first. Right now, I'm just hoping to avoid surgery. I should know more later in the week.