My MCL saga - it was probably a small tear. In the beginning. Lots of snow and ice and I am sure I torqued it at the barn, but there were plenty of other things going on and so while it hurt, it didn’t hurt that bad. Until a few days later when I went to yoga and could.not.do.anything.
I thought it might be Lyme arthritis, because that knee had been the most problematic of all my joints last summer. Went to the rheumatologist, she did a workup but said right off the bat it was an ortho consult. But it took 2 weeks (so now 3 weeks out) to get the MRI. And it kept getting worse.
MRI showed minor chondral damage (at my age, surprisingly little), plus a great deal of inflammation in specific places (one right where the MCL tear was…hmmm…). But these tears are not so easily seen on an MRI.
Went to an ortho I had seen before for other issues, some years back. Except now the practice is huge, and the only appointment in this century was with his physician’s assistant. Who told me I had arthritis and I would get over it. Did not do any physical tests (cough, like the one that would have spotted the MCL tear). I kept insisting it was getting more and more unstable and painful. She finally relented and gave me a cortisone shot (which did nothing, and thus should have served as a red flag). She also gave me a brace (not the hinged kind for the MCL). I was surprised to find out that the brace helped.
For a while. It got worse. And worse. I would try and get up out of a chair and often go splat. It had now been weeks since I could go up and down steps in any any approaching normality, and I couldn’t sleep through the night since the pain would wake me up. I could not go down the hall without it catching at least a few times. I gave up not cursing for Lent. Got another cortisone shot, and some fluid drained. No help. Tried mounting my horse for the first time since his injury and thought I would pass out from the pain of trying to swing my right leg over his back. Anti-inflammatories were helpful for pain, but not inflammation (1 g naproxyn/day).
At this point, since the PA told me “I should be over this by now” I went elsewhere - to a rehab specialist. Except by this point I’d pulled my patella out of whack, and my IT band was apparently the tightest he had ever seen, so he assumed this was secondary to …you guessed it…arthritis. Sent me to PT. They sent me back immediately, realizing there had to be other issues. Rehab guy sent me for a surgical consult.
Surgical consult did not do the MCL test. He looked at the now quite old MRI, injected me with lidocaine, apparently was deaf to the fact that two cortisone shots had done nothing, diagnosed me with arthritis and told me to get on an extensive physical program. Well, that would be fabulous. In fact, it’s what I used to do! And if only I could have done it then!
Are you still with me in my saga? So after a bit more PT, they said, “Have you gotten another MRI?” and “Maybe you need to make an appointment with your MD again.”
He was willing to do hylaronic acid injections, and I responded, “Can we entertain the formal possibility that this is not arthritis?”
Second MRI: definite MCL tear (I think now in two places). Way more inflammation than before, and now, for real! I have damage to the meniscal cartilage and the cartilage that was a grade 2 is now a grade 3/4. Apparently this is what happens with bad knee articulation.
So all that took from January through late May. I got the hinged brace with directions to wear 24/7 for 4-6 weeks. Did enough PT to give me strengthening exercises. Went back 2 weeks ago and was told in 2 weeks (like, now) I could take the brace off at night and then in another 2-3 start weaning off daytime use.
I will try and start riding by the end of July, using the other brace. No stirrups, every other day or every 2 days. And build up slowly. That, apparently, is key. S-L-O-W.
Think of this as a suspensory injury. I am now off stall rest, and can do some walking out of the stall (last night I went almost normally up and down the stairs without my brace, 1st time in 6 months). In a few weeks I can walk under saddle.
As far as the meniscus - I was told that was fairly simple surgery (depending of course on the severity of the injury).
What I did to keep my horse going: free lunging with not very much good transition work at first (hard to lift off my right leg). And long reining. Lots of long reining. No in hand, because I couldn’t walk backwards or sideways. It kept him going though! And my PT would just roll her eyes. I still can’t walk in the outdoor as that footing is more problematic for me (think: suspensory).
I am so sorry you are going through this. Hopefully yours was caught early and it will be a quicker fix. But - as Jan says - be religious about your pT. hat will make an enormous difference.
And ice!! Buy the neato ice bag in fabric form Walmart and use every night.
