(Surprising and confusing) MRI Results

Sorry I’m just getting this up so late on a Friday. I spent Thursday afternoon processing and then Thursday night I had one of the most acute bouts of insomnia that I can remember. I didn’t fall asleep until after 3am and woke up at 4:45am. I slept for another 45 minutes after that, but today was really rough after just 2.5 hours of broken sleep.

My MRI results were surprising and confusing. The email in which she “explained” them to me was as hard to read as the actual report issued by the technician. I sent an email requesting some clarification and asking some of the most pressing questions like, what does this mean for daily life, working out, martial arts, etc and she got back to me much later in the day, which I ultimately appreciated.

So the MRI showed:

  • Minimally displaced cortical fracture of the posterior lateral aspect of the proximal tibia (so a hairline fracture on the top of my femur bone?)
  • High-grade sprain or partial tear of the ACL (ligament inside knee that stabilizes it laterally)
  • Grade 1 sprain of the MCL (ligament on inner side of knee)
  • Grade 2 sprain of the LCL (ligament on outer side of knee)
  • A large cyst on my ACL tendon (this is evidently very common, so I’m ignoring it)

So yeah, quite a few things going on in there. And I have to admit, I’m really surprised and confused because my knee does not hurt, and has never hurt, since the moment I injured it. It doesn’t hurt when I stand, walk, sit, sleep, nothing. I’ve looked up all of these injuries and “not weight bearing,” “swelling,” “acute pain,” are present in pretty much every thing I read. And yet I’ve had none of that. I’m seriously flummoxed that I could have done so much and yet feel nothing.

And I’m so confused on how to proceed if I can assume that my knee will continue to give me zero feedback as to how my injuries are progressing. If I’m having no pain now, less than two weeks out from the injury, how will I know what I can and cannot do in the future? Usually with an injury you try exercises, and see how you feel in the moment and later. Usually the injuries let you know if you’ve pushed too hard by HURTING. How am I supposed to know how to keep my knee safe if it’s giving me no indications of what it can handle?

I am truly so confused.

I talked some to my uncle, who is a retired orthopedic surgeon who specialized in knees. He was similarly baffled by my lack of pain. He told me that it might not hurt now, but once I start trying to exercise I’d surely feel it. When I explained that I’d already been on the elliptical twice, and once I actually pushed up the resistance a little so I could work up a sweat, he was very surprised that my knee didn’t respond in any way. I’m not taking my Rx (or any other kind of) NSAID (I haven’t been since last weekend) and I only ice it 1-2 times a day, mostly out of habit and what I thought was obligation (at this point I guess you only ice it when it hurts?) so I’m sure I’m not medicating the pain away.

My uncle conceded that, in the absence of feedback from my injuries, I’d have to be very careful. He suggested I wear a brace always when I’m out of the house, to ensure I don’t overdo it (and to protect my knee in cases of tripping). I agreed. He also suggested I use only a stationary bike for at least a few weeks, to be sure I didn’t push it too hard.

I got a really nice, $200 brace last night, because I know I’m going to want to be doing things that require lateral stability and I wanted something that was guaranteed to give that to me. I also ordered a cheap stationary bike (also $200) so I could start with that and then switch between it and the elliptical later on.

The good news is that nothing if fully torn, and my doctor said my knee felt pretty stable when she saw me. She feels fairly certain that if I let these injuries heal I won’t need surgery. My long term prognosis is very good.

Short term, I suspect I’m going to make myself a little crazy trying to figure out what is appropriate and what is pushing too hard.

I have a phone appointment with my doctor on Friday and a PT appointment the next Wednesday.

In the meantime I’m just going to do more research and take it slow.

Oh, and actually sleep tonight. I’m definitely going to do that.

5 Comments

  1. Be very careful. Which you are doing. Sounds very confusing and like it could be quite easy to overdo too soon and then need operation. Tough.
    Had wondered as you had not written and I was guessing the results were less than fully decisive about how to be moving forward. Hope it gets clearer over this next week!
    THANK YOU FOR THE UPDATE!!!!
    Trust you are sleeping tonight and that the weekend allows you some extra rest.
    BEST WISHES!

  2. Thinking of you. So so hard to have these open questions!! Amazing that your uncle has that specific expertise – maybe he can recommend someone he really trusts? Definitely be careful. ❤️❤️❤️

  3. As of Sunday, 10th, DSTime is HERE! and Ides of March are almost upon us. Talk about disruptions. Sympathy for all of us!

  4. Hmmm! I’m sorry that I missed the early parts of this story. But honestly, with all the injuries I’ve had, none of them involved my knees so I don’t have a lot of experience with this. I do know people who have torn ACLs and avoid surgery just by strengthening the area. It sounds like ACL sprain (tear?) is the main problem. The other two sprains are mild, and the fracture- the tibia is the large bone in your shin btw- sounds kind of like a stress fracture (?) and those heal up on their own in 6-8 weeks. I’m surprised you’re not having any pain from that though, and also from the ACL issue. I agree, these results are confusing. I’m guessing you would feel it if you jolted your knee to the side, which you’re obviously avoiding. Well, anything you can do that doesn’t hurt will help the healing, so the bike sounds good.
    Btw I read back a few posts, and the last time my daughter had a stomach virus, she also threw up in the bathroom sink…. NOOOOO…. why, why, why??? Ugh.

  5. I’m so sorry, that it’s so confusing! We’d never think that a lack of pain as a bad thing normally but in the presence of injury, it’s definitely more confusing than having pain. I hope that they’ll actually MRI you again in some reasonable period of time to confirm whether those injuries have healed.

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