Knee Injury Symptoms: Numbness in Calf and Foot Explained

After a knee injury, there may be a sensation of numbness in the back of the leg and the foot?

Hello, doctor.
Over a month ago, I experienced persistent pain in my knee and sought treatment through massage therapy.
However, during the session, it seems that the treatment was not handled properly, and I ended up getting injured.
At that time, the therapist instructed me to lie down and keep my right knee straight while applying pressure on my patella.
Suddenly, I heard a popping sound in the knee area.
Although I could still walk afterward, I felt something was off with my knee, and it has been problematic ever since.
1.
When standing, my right knee seems unable to fully extend.
For instance, when I stand and engage my quadriceps, I can visibly see my right patella moving upward.
2.
When lying down with my knee straight, I feel numbness along the back of my right knee, extending down the outer side of my calf to my foot, even affecting my big toe and second toe.
Additionally, the muscles behind my knee feel tight.
3.
Squatting causes pain in my knee, and the numbness persists, making it difficult to stand up directly.
4.
After sitting for a while, I also experience numbness, and when I stand up, I feel weakness below my knee.
5.
My walking feels abnormal, and I can hardly run or jump.
Furthermore, my right thigh near the knee appears to have shrunk, possibly indicating muscle atrophy.
6.
When sitting, if I move my right leg side to side, I feel a sensation along the front of my thigh to the outer side of my patella, as if a tendon (or ligament?) is twitching.
Could you please explain why I am experiencing these symptoms? Which area is likely injured? Is it possible that I have a tear in my anterior or posterior cruciate ligament? Additionally, can an MRI reveal any nerve compression or damage? Thank you.

Lin Xiansheng, 20~29 year old female. Ask Date: 2016/07/05

Dr. Shi Guozheng reply Orthopedics

As you described, the pressure is unlikely to cause a rupture of the anterior cruciate ligament, but it is possible that the lateral nerve of the knee joint is being compressed.
This nerve is called the common peroneal nerve, which innervates the outer side of the calf and the foot.
For now, avoid performing the same movements and rest to see if there is any improvement.
If there is no improvement, then consider getting further evaluation.

Reply Date: 2016/07/05

More Info

Based on the symptoms you've described, it seems that you may be experiencing a combination of knee instability and possible nerve involvement following your injury. The key symptoms you've mentioned include difficulty fully extending your knee, numbness radiating down your calf and foot, pain during squatting, and a sensation of tightness in the muscles around your knee. These symptoms can be indicative of several potential issues, including ligament injuries, nerve compression, or even muscle atrophy.

1. Knee Instability and Ligament Injuries: The sound you heard during the manipulation of your knee could suggest a possible injury to one of the ligaments, such as the anterior cruciate ligament (ACL) or the posterior cruciate ligament (PCL). These ligaments are crucial for stabilizing the knee joint. If the knee is unable to fully extend and the patella (kneecap) appears to move abnormally, it may indicate a ligamentous injury or even a meniscal tear, which can also lead to joint instability and pain.

2. Nerve Involvement: The numbness you are experiencing in your calf and foot, particularly along the outer side of your leg and into the toes, could suggest that there is some form of nerve compression or irritation. The common peroneal nerve, which runs near the knee, can be affected by swelling or structural changes in the knee joint. This could explain the numbness and weakness you feel when standing or after sitting for a while.

3. Muscle Atrophy: The observation that your thigh appears smaller near the knee could indicate muscle atrophy, which often occurs when a muscle is not being used effectively due to pain or instability. This can further contribute to the weakness and difficulty you are experiencing when trying to stand or perform activities that require knee stability.

4. Diagnostic Imaging: An MRI is a valuable tool in assessing soft tissue injuries, including ligaments, tendons, and cartilage. It can also help identify any nerve compression or damage. If there is concern about potential ligament tears or nerve issues, an MRI would be a prudent next step. It can provide detailed images that can help your physician determine the exact nature of your injury and guide appropriate treatment.

5. Next Steps: Given the complexity of your symptoms, it would be advisable to consult with an orthopedic specialist who can perform a thorough physical examination and review your symptoms in detail. They may recommend imaging studies like an MRI to assess for ligament injuries, meniscal tears, or any signs of nerve compression. Depending on the findings, treatment options may range from physical therapy to surgical intervention if significant injuries are identified.

In summary, your symptoms suggest a possible combination of ligament injury and nerve involvement, which can lead to instability and pain in the knee. An MRI would be beneficial in clarifying the diagnosis and guiding treatment. It is essential to address these issues promptly to prevent further complications and to facilitate a proper recovery.

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