OpenHealth Q&A

Concerns Regarding My Pain Sensitivity

I am a 27-year-old male weighing 330 pounds, and recently, during a dance with my partner, I injured my leg while attempting to lift her overhead. The experience was accompanied by a loud popping sound, and since then, I have felt a noticeable weakness in my knee. Following this incident, I underwent an MRI, and here are the findings: **ACL:** There is a complete tear of the proximal anterior cruciate ligament (ACL), with the distal section horizontally aligned. There is mild swelling of soft tissues, indicating that the ACL injury is in a subacute phase. No anterior tibial translation was observed. - **PCL:** Intact - **MCL:** Intact - **LCL:** Intact **Medial Meniscus:** A complex tear in the posterior horn is noted, characterized by a prominent horizontal tear visible across four sagittal images. This tear affects zone 1 and zone 2 and connects with the lower meniscal articular surface. Additionally, there is a vertical peripheral tear in the posterior horn. **Lateral Meniscus:** Intact **Extensor Mechanism:** Both the patellofemoral retinacula and the iliotibial band remain intact. **Tendons and Muscles:** - Quadriceps muscle-tendon unit: intact - Patellar tendon: intact - Semimembranosus muscle-tendon unit: intact - Popliteus muscle-tendon unit: intact **Posterolateral Corner:** Intact **Posteromedial Corner:** There is a small, multi-septated popliteal cyst measuring 6 cm that contains low-intensity debris. **Knee Joint**: There is a moderate-sized effusion present. **Bone:** - **Medial Tibial Plateau:** A subcentimeter cyst at a subchondral fracture, likely incomplete, is found in the posterior corner of the medial tibial plateau, accompanied by bone marrow edema-like signals. The surrounding articular cartilage is undamaged. - **Lateral Tibial Plateau:** A small area of bone marrow edema-like signal is noted in the posterior corner; the covering cartilage remains intact. **Cartilage:** - **Patellofemoral:** There is fissuring of the patellar cartilage, but no full-thickness defects are observed. The femoral trochlea’s cartilage is intact. - **Medial:** No cartilage defects. - **Lateral:** No cartilage defects. **Tibiofibular Joint:** Congruent. **Muscle:** Normal mass and signaling. **Neurovascular Structures:** Normal configuration, size, and signaling. Currently, I experience minimal pain, with only the occasional discomfort. I am active at work, engaging in walking, bending, and crouching as usual. Occasionally, I wear a brace to provide additional support to my leg, and I find that by maintaining stability in my knee, I can walk without difficulty. Historically, I have had a high tolerance for pain. However, based on the feedback from those familiar with similar injuries, they express concern over my ability to manage daily activities with such minimal discomfort. Even during intimate activities, I don't face significant issues—perhaps just some mild cramping. At this juncture, I am anxious about the possibility of further knee damage or if there might be underlying nerve issues that warrant a visit to a neurologist.

Answers (1)

8/25/2025, 6:12:19 AM

OpenHealth AI

It sounds like you've experienced a significant injury to your knee, and while you’re managing some discomfort, it's understandable to feel anxious about potential long-term effects. Your MRI findings indicate a complete ACL tear and a complex meniscus tear, which typically requires careful management to prevent further damage.

Main Points:

• You have a complete ACL tear and meniscus injury but are currently experiencing minimal pain and functioning well.
• Concerns about future knee stability and potential nerve issues are valid, especially with the complexity of your injury.

Explanation:

A complete ACL tear can lead to instability in your knee, which might not always be accompanied by significant pain, especially in the early stages. The meniscus tear adds another layer of concern, as it can impact joint function and may lead to more pain or stiffness over time if not monitored. Your occasional use of a brace suggests you are being proactive in supporting your knee, which is a positive step.

Regarding your concern about nerve issues: While nerve problems can occur, they are less common with knee injuries like yours unless there's a direct impact causing nerve entrapment. Your MRI results appear normal in terms of neurovascular structures.

Next Steps:

1. Monitor Symptoms: Keep a close watch on any changes in your knee's stability, strength, and any new pain in varying activities, particularly high-impact or twisting movements.

2. Physical Therapy: Consider consulting a physical therapist who specializes in sports injuries. They can provide specific exercises to strengthen the muscles around your knee and improve stability, which is crucial given your injuries.

3. Use the Brace Wisely: Continue using the brace during activities that require additional knee support, especially during high-impact movements or when you feel any instability.

4. Modify Activities: While you’re currently active, be mindful of the activities you engage in. Avoid activities that put excessive stress on your knee, like jumping or heavy lifting, until you get further guidance from a healthcare professional.

5. Stay Informed: If you notice increased weakness, swelling, stiffness, or new symptoms, it would be beneficial to follow up with an orthopedic specialist. They can assess your knee and help determine if surgical intervention or additional treatments are needed.

Taking these steps can help you maintain your current level of function and minimize the risk of future injuries. It’s good to hear that you’re managing well, and with the right steps, you can continue to do so. If you have more specific concerns or if your symptoms change, feel free to share!