Knee Pain After a Fall: Causes and Solutions

Knee stiffness while walking?

A month ago, I fell from a height of 1.5 meters and my knee was extremely painful at the time.
I didn't think much of it and used a regular adhesive bandage, but there was no improvement.
Since the fall, I've been experiencing a clicking sensation when walking, which seems to be getting worse.
I went to the hospital for an X-ray, and the doctor said everything was fine.
However, the clicking sensation continued to worsen, so the doctor ordered an MRI.
The results showed that my meniscus appeared normal.
I then visited another orthopedic clinic for an X-ray, and they diagnosed me with patellar malalignment, recommending physical therapy.
The clicking sensation is very distressing for me.
I don't feel pain when going up or down stairs, and I can squat without issue, but I experience a clicking sensation when I walk straight or when I extend my leg.
Why is this happening? I'm in so much pain.

Quan Kai, 30~39 year old female. Ask Date: 2016/04/05

Dr. Shi Guozheng reply Orthopedics

The difficulty in walking may be related to a knee joint injury.
It's advisable to rest and see if it improves, as recovery typically takes two to three months.
If the MRI shows no issues, then consider undergoing rehabilitation.

Reply Date: 2016/04/05

More Info

Knee pain following a fall can be a complex issue, especially when the initial imaging studies, such as X-rays and MRIs, do not reveal any significant injuries. Your experience of feeling a "catching" sensation in your knee, particularly when walking or extending your leg, suggests that there may be underlying issues that are not easily visible on standard imaging.

Possible Causes of Your Symptoms
1. Soft Tissue Injuries: Although your X-rays and MRI did not show any abnormalities in the meniscus or bones, soft tissue injuries such as sprains or strains in the ligaments or muscles surrounding the knee may still be present. These injuries can lead to instability or abnormal movement patterns, causing the knee to feel "catchy" or painful during certain activities.

2. Patellar Malalignment: The diagnosis of patellar malalignment (or patellar tracking disorder) suggests that your kneecap may not be moving smoothly within its groove on the femur. This can lead to pain and a sensation of catching, especially during activities that involve bending or straightening the knee.
3. Knee Joint Effusion: Sometimes, even if no significant injury is detected, there can be mild swelling or fluid accumulation in the knee joint (effusion) that can cause discomfort and a feeling of tightness or catching.

4. Chondromalacia Patella: This condition involves the softening and breakdown of the cartilage on the underside of the kneecap, which can lead to pain and a catching sensation, particularly when the knee is under stress.

5. Tendinopathy: Overuse or strain on the tendons around the knee, such as the quadriceps or patellar tendon, can also lead to pain and dysfunction.

Recommended Solutions
1. Physical Therapy: Since your doctor has recommended physical therapy, this is a crucial step. A physical therapist can provide targeted exercises to strengthen the muscles around the knee, improve flexibility, and correct any movement patterns that may be contributing to your symptoms. They can also use modalities such as ultrasound or electrical stimulation to help reduce pain and inflammation.

2. Activity Modification: While you may not experience pain when going up or down stairs or squatting, it’s essential to listen to your body. Avoid activities that exacerbate your symptoms, particularly those that involve repetitive knee extension or high-impact movements.

3. Ice and Rest: Applying ice to the knee can help reduce any swelling and alleviate pain. Resting the knee and avoiding activities that cause discomfort will allow for healing.

4. Knee Bracing: A knee brace may provide additional support and stability, especially if you have patellar malalignment. However, if wearing a brace causes discomfort, it may be worth discussing alternative options with your healthcare provider.

5. Medication: Over-the-counter pain relief medications, such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs), can help manage pain and inflammation. However, consult your doctor before starting any medication, especially if you have any contraindications.

6. Follow-Up Imaging: If your symptoms persist despite conservative management, further imaging studies, such as a repeat MRI or ultrasound, may be warranted to assess for any subtle injuries that were not previously detected.

7. Consultation with a Specialist: If your symptoms do not improve with physical therapy and conservative measures, consider seeking a second opinion from an orthopedic specialist who focuses on knee injuries. They may recommend further evaluation or treatment options, including injections or, in rare cases, surgery.

Conclusion
Knee pain after a fall can stem from various causes, and it’s essential to approach treatment holistically. Engaging in physical therapy, modifying activities, and following up with your healthcare provider will be crucial in managing your symptoms and improving your knee function. Remember, recovery can take time, and patience is key. If your symptoms persist or worsen, do not hesitate to seek further medical advice.

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