Sprained MCL in October - Still in Pain

I am fairly new to T-Nation so I am not sure if there are any guidelines for posting injury related things.

Long story:

I sprained my MCL a year ago in April 2010 and then again in jiu jitsu October 30, 2011 when my knee popped out during some sparring. I went to an orthopedic and was told that it was just a sprain. There was swelling and a lot of pain but nothing came up on the MRI as abnormal. I didn’t go to therapy, wore a brace and did some simple exercises at home. BW squats, foam rolling, etc. 5 months later and now both of my knees are in a lot of pain whenever I squat, kneel, bend, twist and now even when I sleep on my stomach. The ortho said that I have patella alta, meaning my patella tendons are too long making my whole knee instable but I have never had any knee pain before.

I am creating this thread to ask if anyone has had a similar experience and can hopefully tell me that it will just take a long time to heal and that I should be patient or should I get a second opinion on a different cause of the pain and discomfort?

Short story:
Sprained MCL twice, still having a lot of pain after 5 months when squatting and kneeling.

Thanks in advance for your help and suggestions!

~Disco

[quote]DiscoDani wrote:
I didn’t go to therapy, wore a brace and did some simple exercises at home. BW squats, foam rolling, etc. /quote]

First mistake. Although I don’t know what you did for your self-prescribed rehab, but based on the fact that you still have pain 5 months later and now it is in both knees, you probably would significantly benefit from some manual therapy.

It doesn’t necessarily mean your patellar tendons are too long, though they may be excessively lengthened. It usually means your hip flexors/quads are too tight/restricted and are pulling your patella superiorly, placing additional, undue stress on your patellar tendons.

When was your MRI? After the first or second injury?

[quote]LevelHeaded wrote:

[quote]DiscoDani wrote:
I didn’t go to therapy, wore a brace and did some simple exercises at home. BW squats, foam rolling, etc. /quote]

First mistake. Although I don’t know what you did for your self-prescribed rehab, but based on the fact that you still have pain 5 months later and now it is in both knees, you probably would significantly benefit from some manual therapy.

It doesn’t necessarily mean your patellar tendons are too long, though they may be excessively lengthened. It usually means your hip flexors/quads are too tight/restricted and are pulling your patella superiorly, placing additional, undue stress on your patellar tendons.

When was your MRI? After the first or second injury?
[/quote]

I know it was bad to not go to physical therapy but unfortunately I couldn’t make it in time. I work full time and occassionally work a second job while also going to college and the PT office closed at 4.

I actually got an x-ray on my knees that showed my patella tendons are two inches longer than they need to be. And had symptoms of patella alta.

My MRI was after the second injury because I think I had more damage that time. After the first time, there was no pain even right afterwards.

[quote]DiscoDani wrote:
I actually got an x-ray on my knees that showed my patella tendons are two inches longer than they need to be. And had symptoms of patella alta.

My MRI was after the second injury because I think I had more damage that time. After the first time, there was no pain even right afterwards.
[/quote]

Sorry, an x-ray won’t show any soft tissue damage or alterations. It will only show bone structures (for the most part). They radiologist/physician MAY have been assuming that the patellar tendon is “too long” based off of the positioning of the patella on the x-ray, but again, it is most likely due to tight hip flexors/quads causing a superiorly positioned patella.

Since the MRI was taken after the 2nd injury and it came up without any abnormalities, I would assume that the knee is structurally okay unless you have any another incident of injury. MRI’s are not 100% accurate, but based off of the information you’ve given, I’d assume you have some fibrotic tissue around your knee causing some discomfort and likely probably some technique issues during weight lifting and some mobility and stability deficits plaguing your lower extremities.

You make some good points. My orthopedic is the one who claimed the abnormal tendons and he did it based on the x-ray. Do you think I should go see a different doctor? Is it possible they missed a meniscus tear? I’ve heard sometimes that goes undiagnosed because it cannot always be seen in an MRI.

And I appreciate your time and help!

Before going for a second opinion, I would first say start with some formal therapy. If things don’t improve with therapy, then I’d say it may benefit you to get another MRI and/or 2nd opinion.