13 minutes ago, paco said:

Getting old sucks.  It looks like I (hopefully partially) tore my Patellar tendon on Thursday simply by bending down and picking up a box.  Wasn't even a big box, just one of the items I was loading into my super pantry. Just bent down, heard a pop and instant pain.  Tried to work through it and install an outlet after I was done and it was excruciating every time I kneeled down to get to the outlet.  Bend with your knees, my ass.

 

Schmoopie just ordered me an immobilization brace for my knee.  I'm hoping wearing it for 6 weeks will fix it and I can avoid a doctor trip

You should really make sure its only partial before you try non-surgical treatment. If its a full, complete retracted tear, and you waste those 6 weeks it might not be reparable because it'll atrophy too much in that time. 

If you dont want the expense of an MRI, Ultrasound is perfectly capable of evaluating the integrity of the patellar tendon and is a cheap enough test to pay for out of pocket. 

3 minutes ago, HazletonEagle said:

You should really make sure its only partial before you try non-surgical treatment. If its a full, complete retracted tear, and you waste those 6 weeks it might not be reparable because it'll atrophy too much in that time. 

I didn't realize this.  Thank you.  We are going to call my family doctor tomorrow and go from there.

 

 

Or I can drive up to see you if you also do butt stuff.    Deshaun Watson!!!

3 minutes ago, paco said:

I didn't realize this.  Thank you.  We are going to call my family doctor tomorrow and go from there.

 

 

Or I can drive up to see you if you also do butt stuff.    Deshaun Watson!!!

I added this to the post above:

If you dont want the expense of an MRI, Ultrasound is perfectly capable of evaluating the integrity of the patellar tendon and is a cheap enough test to pay for out of pocket. 

I have Ultrasounded butts before. If youre concerned about a high hamstring tear, or you want me to check out your piriformis.

10 minutes ago, HazletonEagle said:

I added this to the post above:

If you dont want the expense of an MRI, Ultrasound is perfectly capable of evaluating the integrity of the patellar tendon and is a cheap enough test to pay for out of pocket. 

I have Ultrasounded butts before. If youre concerned about a high hamstring tear, or you want me to check out your piriformis.

Also... I was thinking it *could* be Patellofemoral pain syndrome.  If so, how long do I need to immobilize, ice, and take anti inflammatories for it to subside? 

 

Reason I think (hope) it might be this is there were times when I was pushing myself on the peloton (not recently) I felt soreness in the same area.  The only reason I think it may be a tear is the pop I heard and the instant pain after. 

 

On Friday I rested it and it was good until I started bending it.  Saturday I did some rest but did some stuff around the house.  Again, once I bent it, it started to act up, especially going downstairs.

 

The timing of this sucks too

6 minutes ago, paco said:

Also... I was thinking it *could* be Patellofemoral pain syndrome.  If so, how long do I need to immobilize, ice, and take anti inflammatories for it to subside? 

 

Reason I think (hope) it might be this is there were times when I was pushing myself on the peloton (not recently) I felt soreness in the same area.  The only reason I think it may be a tear is the pop I heard and the instant pain after. 

 

On Friday I rested it and it was good until I started bending it.  Saturday I did some rest but did some stuff around the house.  Again, once I bent it, it started to act up, especially going downstairs.

 

The timing of this sucks too

If it is a partially torn patellar tendon, 6 weeks is about right for immobilization. 

If its patelofemoral pain syndrome, you shouldnt immobilize it. Go about your activities, only limitation is by pain tolerance. Unless youre really extreme on your bike maybe back off intensity a little bit for a while. Look for a different kind of brace. Sheidls brace/J-brace, or the DonJoy reaction brace is pretty good for it and probably the most low profile one out of all the options. KT-Tape can also do the job if youd prefer to start with that as the cheapest option first.

 And youd want to do quad strengthening, especially focused on the vastus medialis obliquus muscle. Thats the fix. Other stuff just helps manage the pain until you can properly balance the muscle strength in your quads.

Thank you.

 

If I immobilize it for a few days and then try normal (non bike) activity, if it is a partial tear do I undo any good I have done by immobilizing it?  Is there risk of making it worse?

 

I'll say this.  This am it felt good.  I made an effort not to bend it.  So far today, no pain, but I'm not bending it either.

DMX had a heart attack and is on life support  

22 minutes ago, paco said:

Thank you.

 

If I immobilize it for a few days and then try normal (non bike) activity, if it is a partial tear do I undo any good I have done by immobilizing it?  Is there risk of making it worse?

 

I'll say this.  This am it felt good.  I made an effort not to bend it.  So far today, no pain, but I'm not bending it either.

Potentially you can undo any good youve done. You want the torn part to scar down and weave itself back together. If you break those new adhesions, youre kinda back at square 1. And of course, considering you have something similar to a partially frayed rubber band, yes you can make it worse and fully tear it more easily.

However, 6 days wont put you beyond the window of opportunity for fixing it, so if you wanted to try that to see how you feel, I guess you can do that and 6 days isnt really the end of the world.

 

 

To be honest, Id not expect a torn patellar tendon from your injury mechanism. Thats more likely to happen with a strong contraction of the quad muscle. While you do have an eccentric contraction of that muscle when squatting down, its not likely to be such an extreme contraction that should injure the tendon. Its more likely to happen with that kind of contraction if you were jumping and landing from a height.

 An injury with deep knee flexion is more likely to be either meniscus or ACL, or just some arthritis where you felt some bone on bone grinding when you felt the pop.

Thank you, this really has been helpful especially considering I'm only going by google and don't know squat when it comes to these things.   

 

So given only what I told you (since obviously you haven't seen anything) you think its less likely a tear and more likely Patellofemoral pain syndrome.  (I will say, it was extremely painful when I bent down immediately after it happened).  Or I tore my meniscus or ACL somehow?

1 minute ago, paco said:

Thank you, this really has been helpful considering I'm only going by google and don't know squat when it comes to these things.  So given only what I told you (since obviously you haven't seen anything) you think its less likely a tear and more likely Patellofemoral pain syndrome.  (I will say, it was extremely painful when I bent down immediately after it happened)

Its really impossible for me to determine from here whether PFS, or patellar tendinitis, or arthritis, and/or torn meniscus is more likely.

I can type some extremely lengthy posts of things to look for/try to rule things out and narrow it down but of course even that has major limitations to how accurate it can be. 

I think a torn patellar tendon though possible, is probably the least likely. Of the major injuries that can happen with kneeling as you described its more likely to be meniscus or ACL. Patellar tendon rupture would make the list of differential diagnosis, but Id probably have it last on the list.

10 minutes ago, paco said:

Thank you, this really has been helpful especially considering I'm only going by google and don't know squat when it comes to these things.   

 

So given only what I told you (since obviously you haven't seen anything) you think its less likely a tear and more likely Patellofemoral pain syndrome.  (I will say, it was extremely painful when I bent down immediately after it happened).  Or I tore my meniscus or ACL somehow?

Have you tried walking it off, or rubbing dirt on it?

1 minute ago, HazletonEagle said:

Its really impossible for me to determine from here whether PFS, or patellar tendinitis, or arthritis, and/or torn meniscus is more likely.

I can type some extremely lengthy posts of things to look for/try to rule things out and narrow it down but of course even that has major limitations to how accurate it can be. 

I think a torn patellar tendon though possible, is probably the least likely. Of the major injuries that can happen with kneeling as you described its more likely to be meniscus or ACL. Patellar tendon rupture would make the list of differential diagnosis, but Id probably have it last on the list.

Gotcha, and I totally understand.  Sorry for asking so many questions, just trying to gauge both how serious it might be but also how likely it is that is serious.  Without going into too much detail, I'm on the clock to get a lot of physical work done around the house in a short amount of time, so I'm trying to figure out if I can just rest it for a bit and then I'm good to move forward or do I need to go to the doctor ASAP.  Only reason I'm considering trying home remedies first is that if it needs surgery, I miss my window no matter what

4 minutes ago, The_Omega said:

Have you tried walking it off, or rubbing dirt on it?

Well, after it happened I did get down on my hands and knees to wire an outlet to our new downstairs office, worked on the bedrooms Saturday and today spent a good couple of hours turning the condo around for our next renters

3 minutes ago, paco said:

Well, after it happened I did get down on my hands and knees to wire an outlet to our new downstairs office, worked on the bedrooms Saturday and today spent a good couple of hours turning the condo around for our next renters

Here’s Paco playing through the pain baby!

17 minutes ago, paco said:

Gotcha, and I totally understand.  Sorry for asking so many questions, just trying to gauge both how serious it might be but also how likely it is that is serious.  Without going into too much detail, I'm on the clock to get a lot of physical work done around the house in a short amount of time, so I'm trying to figure out if I can just rest it for a bit and then I'm good to move forward or do I need to go to the doctor ASAP.  Only reason I'm considering trying home remedies first is that if it needs surgery, I miss my window no matter what

I dont mind the questions.

I dont know what you have going on and the importance of meeting your timelines. But I can say an unrepaired patellar tendon is a lifelong handicap. There is only ONE extensor mechanism in your knee. There is nothing else to substitute for the patellar tendon to extend your knee for you. If thats torn, you need to have it fixed before it atrophies and cant be anchored back in place in order to have a functioning knee.

Ill tell you this- if you are keeping your knee fully extended without a brace locked in full extension, that means you have at least some patellar tendon intact. Because thats the structure that controls that motion/position of the knee. You cant extend the knee if that tendon is gone.

 However you can live with a torn ACL and function with that to do your work, and delaying treatment of that would be less damaging.

 

 

 

 

8 minutes ago, HazletonEagle said:

I dont mind the questions.

I dont know what you have going on and the importance of meeting your timelines. But I can say an unrepaired patellar tendon is a lifelong handicap. There is only ONE extensor mechanism in your knee. There is nothing else to substitute for the patellar tendon to extend your knee for you. If thats torn, you need to have it fixed before it atrophies and cant be anchored back in place in order to have a functioning knee.

Ill tell you this- if you are keeping your knee fully extended without a brace locked in full extension, that means you have at least some patellar tendon intact. Because thats the structure that controls that motion/position of the knee. You cant extend the knee if that tendon is gone.

 However you can live with a torn ACL and function with that to do your work, and delaying treatment of that would be less damaging.

 

Yup.  No problem doing that.  

 

I'm also sharing pain stories with my buddy who has been through multiple knee surgeries and he agrees with you it may be meniscus (and is betting against ACL)

Just now, paco said:

Yup.  No problem doing that.  

 

I'm also sharing pain stories with my buddy who has been through multiple knee surgeries and he agrees with you it may be meniscus (and is betting against ACL)

yep. 

Now, with meniscus if you have locking (not stiffness, but actually knee getting stuck in a bent position) that's likely indicative of a bucket handle tear which needs to be fixed, and is pretty urgent. Like during covid when surgeries were completely shut down, we would still operate on bucket handle meniscus tears. So- thats important.

But just about any other meniscus tear you can work through. You may opt for a cortisone shot which is very likely to take away your pain. If youre seeing your family doctor tomorrow some family doctors offer them.

You can wear a hinged knee brace. Even one that locks at a certain point so it prevents you from very deep knee flexion. So blocked at about 110 degrees...

 

I think its very unlikely that you need to immobilize your knee. And that causes you other issues like joint stiffness, and muscle atrophy. Likely, completely unnecessarily causing other side effects. 

 

No locking whatsoever.  Just cracking\popping and pain.  (not today, but then again, I've been trying hard not to bend my knee).  I don't have an appointment yet, I was holding on hope this was something temporary.  Schmoopie did get me a brace which is arriving Wednesday, and I think it does allow minor bending.  (It was a cheaper model, so I don't know how deep or if I can set it.)  Edit: found it, doesn't look like it does

 

Again, thank you for taking time out on your Easter weekend to talk through this with me

2 minutes ago, paco said:

No locking whatsoever.  Just cracking\popping and pain.  (not today, but then again, I've been trying hard not to bend my knee).  I don't have an appointment yet, I was holding on hope this was something temporary.  Schmoopie did get me a brace which is arriving Wednesday, and I think it does allow minor bending.  (It was a cheaper model, so I don't know how deep or if I can set it.)

 

Again, thank you for taking time out on your Easter weekend to talk through this with me

No problem at all. 

Good to hear you can extend it. Good to hear no locking.

With that, can pretty much rule out patellar tendon rupture and bucket handle tear. Your most urgent potential issues are low on the list of possibilities. Good news.

More likely just arthritis, and/or possibly meniscus.  Things you can put off any major treatments for. Things that are also helped by injection and/or bracing.

Its pretty safe to say you are ok to complete your work without causing yourself any further damage.

Thats my very unofficial EMB medical opinion.

 

Thank you and I really appreciate you taking time out.  It sounds like I can continue with my plan of rest (sort of), but not go overboard.  I'll continue to rest, ice, and advil it for the next week and then see how it goes.

22 minutes ago, HazletonEagle said:

No problem at all. 

Good to hear you can extend it. Good to hear no locking.

With that, can pretty much rule out patellar tendon rupture and bucket handle tear. Your most urgent potential issues are low on the list of possibilities. Good news.

More likely just arthritis, and/or possibly meniscus.  Things you can put off any major treatments for. Things that are also helped by injection and/or bracing.

Its pretty safe to say you are ok to complete your work without causing yourself any further damage.

Thats my very unofficial EMB medical opinion.

 

@paco had a bucket handle tear in my meniscus with my ACL tear... I didn't have any pain in the or locking in the knee cap area once I got over the initial issues from the torn ACL. I delayed surgery for 3 months because my wife was about to pop with our first kid when I tore it, so I waited until we had a couple of months to settle into a routine with the newborn. Never had any locking issues with the knee, but the doctor had strict conditions on allowing me to to delay surgery that I had to verbally agree to get the surgery right away if conditions worsened including any issues with locking or instability. 

2 minutes ago, Imp81318 said:

@paco had a bucket handle tear in my meniscus with my ACL tear... I didn't have any pain in the or locking in the knee cap area once I got over the initial issues from the torn ACL. I delayed surgery for 3 months because my wife was about to pop with our first kid when I tore it, so I waited until we had a couple of months to settle into a routine with the newborn. Never had any locking issues with the knee, but the doctor had strict conditions on allowing me to to delay surgery that I had to verbally agree to get the surgery right away if conditions worsened including any issues with locking or instability. 

yeah. When the meniscus gets flipped over and causes the knee to become locked thats when it becomes urgent.

9 hours ago, paco said:

DMX had a heart attack and is on life support  

it's ruff ruff being a gantsta.

15 hours ago, paco said:

I didn't realize this.  Thank you.  We are going to call my family doctor tomorrow and go from there.

 

 

Or I can drive up to see you if you also do butt stuff.    Deshaun Watson!!!

you should sign up for the healthcare I had when I was working in California. re-injured my knee about 7 months after my ACL replacement surgery and my MRI to see if i re-tore it was $50 co-pay. That was 100% of all costs/billing/charges I had for everything out there. Was awesome. 

Ok, I'll go do that.