Joe A Shaw PA-C - 9/26/2012

Question
QUESTION: Hi there I m a fifteen year old female and I play athletics. Recently I have notice my right knee pop, go stiff and there would be pain this have happened ever since a hurdling accident, also now I can't straighten my right leg when I stand my right leg is bent and my left is straight and is painful. Another thing my shoulder have popping noises alot it would be painful and stiff. I can't have full range of motion on my right shoulder I can't even put my arm out straight on the side without pain.  This was cause during a shot put accident. To add more detail I have went to the doctor and ER for my injuries but now its been getting worst. For my injuries they only did X-rays where my right knee has a fracture and my right shoulder I broke my clavicle and the end of the shoulder bone. I have been to Physio every week twice a week for two month now. Can you please give me advices on what to do, how can I manage the pain, stiffness and swelling. Thank you

ANSWER: Jenny,
I would recommend that you get an MRI of the knee and shoulder...xrays only give some of the story..ie bone..xray does not show cartilage damage,ligament,tendon or muscle tears. If the mri shows something you may need surgery (scope)..if you don't need surgery then cortisone injections are some times used to help with pain, stiffness and swelling...After 2 months of PT you have reached maximum benefit and cont'd PT may not really help..you can cont. with exercises at home though.

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QUESTION: Hi I have been to have MRI scans on my knees and shoulder it shows that I tore a bit of my mcl, acl in my right knee and on my left knee I have bruises on my bone and stress fractures also my shoulder my right one I don't know but they say that I tore a ligament or something. Can you please help they didn't recommend any crutches or surgery somehow now my knees are really painful it's gotten worst to which I can't walk anymore and it's swelling and so painful.my right shoulder they just put me in a brace. My doctors told me to do physio for two months but I have been to physio for a very long time. Can you please help me. Thank you.

Answer
You need to see an orthopedic surgeon,if you are seeing one then seek a second opinion if you are not satisfied. If you have partial tears or MCL or ACL PT is usually recommended..but if you have done PT for 8-12wks I doubt more will help much. You shouldn't need crutches?
If you have a tear in shoulder you may need scoped to repair. Im not sure but if Aust. has socialized med like Canada, they probably dont see these conditions too pressing? ie vs trauma, heart attacks etc..If knee is really swollen,you may need to have knee drained of fluid and try a cortisone inj.