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Question:
I sprained my knee (again)in January and have not been able to fully extend it since then. I have no pain involved with jumping or walking (i have a slight limp now)I can jog at a slow pace but when I open up the stride I feel pain. I am 6 years post op left ACL (patellar tendon graft)and really wrenched it in July while stepping in to a HUMVEE during a training exercise. My job requirements have not allowed me time to go to physical therapy and I have only been seen once by a Ortho Doc in November. I guess the bottom line is why wont my knee straighten out?
Question submitted by:
Robert Beuerlein - ebobtanker@aol.com
| Dr. Golden |
Dr. Golden is an orthopedic surgeon and the author of the "Knee Pain" chapter in the upcoming "Manual of Pain Management". He has presented numerous scientific studies at orthopedic conferences. In addition, Dr. Golden is a member of the American Academy of Orthopaedic Surgeons (AAOS),the American Medical Association (AMA), and the Arthroscopy Association of North America (AANA).
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Answer:
There are many reasons why the knee may not completely extend. An effusion (fluid in the knee joint), scar tissue (from the previous surgery), sprains or strains, or muscle weakness may contribute to the inability to completely straighten the knee. If the knee cannot fully extend yet, whatever the reason, when you reach full stride, you increase the extension of the knee and cause pain. So the initial answer is to modify your activity. Activity that does not cause pain is usually safe. Having the knee re-evaluated by an orthopaedist is reasonable to check the integrity of the graft you had previously. If there is stability and no acute issues that will not most likely resolve, then physical therapy (PT) may help get the range of motion back. But be sure that PT is the correct method by asking your doctor. A compressive stocking and ice with an anti-inflammatory medication (if you are able to safely take them) may help for the time being. If the knee was able to completely extend previously, after your original ACL reconstruction, then hopefully, you will attain that range once again.
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