Is my knee injury serious?

So you are out and about having a nice hike and all of the sudden – you step into a hole and twist your knee. Ouch! Once the initial frustration subsides, you are probably going to ask yourself “Crap! Is this going to get better on its own? Do I need to go to the doctor? Do I actually have a knee injury? What do I do?”

Here are a few indications that you should go to your doctor — and note, I say doctor because I am based in Colorado and am familiar with our laws. In Colorado you can self refer to a physical therapist but unfortunately, insurance will not pay for it. But “technically”, you could do this. Otherwise, you need to go through a physician who sends a referral to physical therapy. It’s a ridiculous system because MD’s are not trained in physical therapy, but it is this way for most non-primary care issues.

Anyway…..

Here is a (non-exhaustive) list of indications to see your healthcare provider sooner rather than later for your knee:

If you heard a “pop” you likely have a knee injury and not just irritation.

Not always, but usually when someone tears their ACL they hear/feel a ‘pop’. If you think you felt this, go directly to your healthcare provider to discuss your options. If there is a complete rupture of the ligament and you are trying to return to high level sports like soccer or skiing, you will *probably* need surgery. There may also be other damage in your knee, such as a meniscus or additional ligamentous tear. If you felt a pop and now your knee hurts a lot, is swollen, and feels unstable, your ACL is probably torn. This type of knee injury may require surgery.

If your knee pain isn’t improving, you may have a more serious knee injury.

Let’s say you planted your leg and you had a sharp pain, felt weak, or just felt like something was “off”. Several weeks have passed and it’s not really getting better. This is a sign that some damage may be done. I would like to note that it’s also possible not to have any damage at all! Sometimes the way you move during your activities irritates your joint, but all the structures are intact. This can be the case with intermittent pain on the inside of your knee or on the front of your knee. Either way, you will probably benefit from physical therapy to address these issues.

How is your range of motion?

After your injury try to bend your knee all the way – can you bend it the same amount as the other side? Can you straighten it all the way? Sometimes you can tweak your knee and it’s a little sore while doing this, but after a few days it feels fine. This is usually harmless. But if your knee is stuck in a slightly bent position and you can’t bend it more/straighten it all the way, something may be wrong inside.

So, is your knee injury serious? Here are a few things to ask yourself.

Is your knee injury serious? It really depends. Ask yourself:

1. Can you bend/straighten it all the way?
2. Can you walk without crutches or help? If not, I suggest immediate consultation with a physician.
3. Can you perform a squat?
4. Has this improved at all over the course of 1-2 weeks?

If the answer is “no,” make yourself an appointment with your physician and then go from there. If you answer “yes” to all of these, it doesn’t necessarily mean that you’re in the clear.

Sometimes the condition is still not considered “serious” and is very manageable if you do have an injury, but only an examination can really reveal that. There are many nuances in a PT examination – to cover all of these would be impossible and very confusing to the reader. So please, keep in mind that I’m limited in how much detail I can provide because there are so many possibilities.