Sports Injuries: Knee and Abdominal Pain Management

Please inquire about sports injuries and rehabilitation issues?

1.
Knee area: Five years ago, while playing badminton, I fell after my right foot couldn't move forward while trying to save a shot.
My knee started to hurt.
After resting for nearly a month, I had no issues with movement or running.
At that time, I didn't think much of it, so I didn't pay attention.
Recently, I started learning Aikido, which requires frequent turning and defensive movements, and I felt the same issue with my right knee reoccurring.
The first traditional Chinese medicine practitioner I visited indicated cartilage fibrosis and recommended heat therapy and electrical stimulation.
The second practitioner suggested it might be tendonitis.
The condition remains inconsistent, with periods of improvement and worsening.
I'm unsure what to do.
Please help clarify my confusion! Pain description: The lower edge of the cartilage in my knee feels sore when moving.
There is soreness on the right side behind the knee.
When sitting, I feel tightness in the front of the knee.
When standing, there is tightness on the right side behind the knee.
When I turn using my right foot, the lower edge of the front of the knee feels sore.
2.
Lower abdomen: The cause is related to the aforementioned defensive movement issues.
The so-called defensive movement involves standing with feet together, bending the knees to squat down, allowing the buttocks to touch the ground, and then rolling backward while extending the legs and lifting them up before getting back up.
I had a previous arm fracture and hadn't done abdominal exercises for nearly a year.
After performing the movements, I experienced muscle soreness throughout my body for three days.
However, on the fourth day, only my lower abdomen remained sore.
Eager to improve, I attempted the movements again and felt a tearing sensation about 8 cm below my navel and 15 cm to the right, which was very painful, prompting me to rest immediately.
The next day, I noticed bruising in my lower abdomen.
The following day, I also had bruising on the skin beneath the penis and on the right half of the scrotum.
The first traditional Chinese medicine practitioner indicated inflammation and recommended heat therapy, electrical stimulation, and herbal powder treatment.
The second practitioner from the Department of Rehabilitation at China Medical University suggested it was a sports injury and recommended heat therapy and muscle relaxants.
The third practitioner from Renai Hospital's rehabilitation department had a similar assessment and prescribed SZULEN (AZULENE) and NIMED 100MG (NIMESULIDE), along with heat therapy and electrical stimulation.
I am currently undergoing electrical stimulation at Renai Hospital for one week.
The bruising is slowly fading, but the pain remains.
I apologize for the lengthy description of my issues.
I would like to ask the following questions: 1.
Regarding the knee, could it be a ligament or meniscus tear? Which specialty should I consult? Which hospital should I go to? How should I rehabilitate and recover? Is complete healing possible, and how long might it take? 2.
Regarding the lower abdomen, could I have injured my kidneys or other internal organs or muscles? What are the other related concerns?

aaron, 30~39 year old female. Ask Date: 2004/09/18

Dr. Yang Zhengfan reply Orthopedics

Dear Arron,
1.
After reviewing your description, it seems there are no issues with the cartilage or ligaments in your knee.
If you need further confirmation, please consult an orthopedic specialist nearby; I believe you will receive a comprehensive answer.

2.
A strain in the lower abdomen can also occur.
The diagnosis from the rehabilitation department is valid.

Reply Date: 2004/09/18

More Info

When it comes to managing sports injuries, particularly knee and abdominal pain, it's essential to understand the underlying issues and the appropriate steps for recovery and prevention. Based on your description, it seems you are experiencing two distinct problems: knee pain likely related to previous injuries and abdominal pain possibly linked to recent physical activities.

Knee Pain Management
1. Understanding the Injury: Your knee pain, which has been persistent since your badminton injury five years ago, could be attributed to several factors. The symptoms you describe—pain around the knee joint, tightness, and discomfort during specific movements—suggest possible issues with the cartilage, ligaments, or tendons. The mention of "soft cartilage fibrosis" and "tendonitis" by different practitioners indicates that there may be inflammation or degeneration in the knee joint.

2. Recommended Specialists: For knee-related issues, it is advisable to consult an orthopedic specialist, particularly one who focuses on sports medicine. They can perform a comprehensive evaluation, including imaging studies like MRI, to assess the condition of the ligaments (such as the ACL or MCL), meniscus, and cartilage.
3. Rehabilitation and Recovery: Depending on the diagnosis, treatment may include physical therapy focused on strengthening the muscles around the knee, improving flexibility, and enhancing joint stability. Recovery time can vary significantly based on the severity of the injury, ranging from a few weeks to several months. Adhering to a rehabilitation program is crucial for a full recovery.

4. Long-term Management: To prevent future injuries, consider incorporating a regular strength and flexibility training program into your routine. Proper warm-up and cool-down exercises, along with using appropriate footwear, can also help reduce the risk of re-injury.

Abdominal Pain Management
1. Understanding the Symptoms: The abdominal pain you describe, particularly the tearing sensation and subsequent bruising, raises concerns about potential muscle strain or injury to the underlying structures. Given that you experienced a bone fracture in the past and have not engaged in abdominal exercises for a year, your core muscles may have weakened, making them more susceptible to injury.

2. Recommended Specialists: For abdominal pain, it may be beneficial to consult a gastroenterologist or a sports medicine physician. They can help rule out any internal organ injuries or complications. If the pain persists, imaging studies like an ultrasound or CT scan may be necessary to assess the abdominal organs and muscles.

3. Rehabilitation and Recovery: Treatment may involve rest, ice application, and gradual reintroduction of abdominal exercises as tolerated. Physical therapy focusing on core strengthening can be beneficial once the acute pain subsides.
4. Long-term Management: To prevent future abdominal injuries, consider a gradual return to physical activity, emphasizing core stability and strength. Engaging in low-impact exercises initially and progressively increasing intensity can help your body adapt without overstraining.

Conclusion
In summary, both your knee and abdominal issues require careful evaluation and management. Consulting with the appropriate specialists will provide you with a clearer understanding of your injuries and the best course of action. Rehabilitation is key to recovery, and implementing preventive measures will help you maintain your physical activity levels while minimizing the risk of future injuries. Remember to listen to your body and allow adequate time for recovery, as pushing through pain can lead to further complications.

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