Dr. Timothy K. Durnin - 8/20/2007

Question
On 5/14 my 16 yr old son dislocated his Lt knee cap to the outside. He pushed it back into place.  X-rays were ok. Dr. said kneecap was stilling properly aligned and he was to rest 1 week--no Football--so he rested--10days later on 5/24 in sustained a severe blow to the Lt thigh resulting in a large hematoma in the quad muscle.x-rays and MRI showed no evidence of tears in the knee, only the benign ossifying Fibroma in the distal Femoral Metaphysis and probable mild quad tendinosis.he began physical therapy right away and has not done any running since the accident.  The thigh pain has resolved but now he still has swelling of the thigh just above the knee cap which is sore, the knee cap area is still very sore and the knee cap is sliding around to both sides-which really hurts when it happens and the knee is making a snapping noise.  Our Dr. says these sym are because the quad is now weak and the blow caused it to not yet do its job of stability and as he strenghten the quad the knee will stop moving around.  He has been doing strengh work outs at PT 3x/wk, and walking, swimming and bycycling for 3 weeks now with only slight improvemnt in the symptoms.  Does this explaination for the continued knee pain, and lack of stability sound correct to you, Are we just being impatient or should we be getting him a second opinion?  My son is hoping to get released to play football again come Monday 8/27, but he can't play if he can't run.  Thank You--Susan

Answer
Hi Susan,

Sorry I wasn't able to get back with you immediately but we have severe flooding here in the midwest and in our house.

Your doctor is correct, the tracking of the knee cap is contingent on the strength of the inside leg muscles. 2 weeks is not long enough, going back to contact sports prematurely has ended many careers early. He needs time to bounce back, it may cost him a few more games but the flipide is a lost season or worse. He shouldn't listen to the PT, only the Ortho should give the release to football, icing it everyday will be a big help also.


I hope this answers your question Susan!

Dr. Timothy Durnin
drs.chiroweb.com