Knee Pain And Hematoma In Vastus Lateralis After Trauma. Tendon Injury?

Hi


7 weeks ago I hit the area above my left kneecap on a metal box.

I thought it was the knee at first but seems it was slightly above this on the Vastus Lateralis tendon insertion?

It seemed to settle after a day or so but then after 6 or 7 days it really started to flare up. I went to a sports doc who said I had a small hematoma in the lower VL and to do some one leg squats.

I still have a lot of pain in this knee, upper kneecap area that radiates into the lower VL and slightly to the side of the knee that really burns at night. I have also started to experience similar pains, minus the burning, in the right knee i presume due to some compensation going on.

Any thoughts on this - could it be tendonitis or something more? What can i do to treat it ?

thanks



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Joshua Answers:

Hi there nameless.

You bet I have thoughts! :)

So let's see.

1. Doesn't sound like Tendonitis, though you may have had some pre-existing something that got irritated with the walking into hard objects activity.

See: What Is Tendonitis?


2. If it's showing up on the other side, I too would think that the body is just mimicing the pain for balance. The body like to be in balance, but it's not very smart sometimes.


3. Unless you have more information to give me, from what you've said, hematoma and an ACUTE Process of Inflammation makes sense and fits.


4. I'm guessing that you've done some one legged squats...and that it hasn't helped. True/False?

I guess it could....it would get things moving, put some beneficial stress on the area. Except, if that stress irritates it even more.....


You have inflammation. And if it's on tendon, ligament, or the connective tissue close to the bone, ESPECIALLY the connective tissue close to and wrapping the bone, then it is expected to have the pain you describe. That will last for a good while unless you help it go away.

And if you actually bruised the bone....OUCH! Bone bruises hurt. A lot. And for a long time.

Again, unless you help it get better.


Were I you, I would spend a SERIOUS 3-7 days Icing the heck out of that spot/area.

Ice pack 5 minutes on, 5 off. As many times per day as possible. Really.

And towards the end of the day, instead of ice packing, you can get something like a frozen water bottle and start massaging the painful area. Gently at first, push in as you can. Literally you will be massaging the bone (depending on where you hit it).

As things start to feel better, do more ice massage and less ice packing.

The ice cold may feel like a deep hurt/ache in the knee/bone. Respect this, and don't push it too much. You won't actually be damaging yourself, but it hurts in a special way...you'll know what I mean.

Point being, Ice and massage (and ice massage)

Partly you want the 'squeezing the sponge' of the (ice) massage, and you also want the ciruclatory benefits of cold. The area you describe doesn't have a lot of direct blood flow, so you have to force it.

Possibly I read where you described hitting yourself as a bit lower than you did. Still, the same icing and massage applies.


When the doc said hematoma, did he mean that you had bleeding/brusing deep in there and it turned hard? Or just that there's swelling in there?


I don't know that I'd call it 'tendon injury'. Let's just call it a painful bruise.

Regardless, there's only one thing to do about it. Old stuff out, and new stuff in, and that makes everything better.





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Joshua Tucker, B.A., C.M.T.
The Tendonitis Expert
www.TendonitisExpert.com
















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Comments for Knee Pain And Hematoma In Vastus Lateralis After Trauma. Tendon Injury?

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Dec 15, 2009
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PART 2 - Follow up - Knee Pain And Hematoma In Vastus Lateralis After Trauma. Tendon Injury?
by: Tom

"Hi there nameless."

Hi - Sorry Tom here :)

"2. If it's showing up on the other side, I too would think that the body is just mimicing the pain for balance. The body like to be in balance, but it's not very smart sometimes."

OK - well seems i have something biomechanical going on this side as when doing a 1 leg squat my right knee wants to fall inwards towards the left. Maybe gait is all messed up since injury?

"3. Unless you have more information to give me, from what you've said, hematoma and an ACUTE Process of Inflammation makes sense and fits."

Nothing more to give really apart from the issue that 'pressing' into the area that 'hurts' does not actually hurt. There is a spot thats slightly more tender than the surrounding area and this seems to be the tendon that attaches the VL to the patella but its not really painful as such but more a bizarre thickened numbness feeling, although its not really numb either. A bit odd and hard to describe. Having said that after deep tissue work into this area i can really 'stir' up the burning acheing feeling once stopped, although not really during.


"4. I'm guessing that you've done some one legged squats...and that it hasn't helped. True/False?"

I have and they have not helped - they dont seem to have hurt either although sometimes they cause a bit of minor increased pain when on the upward motion.

"You have inflammation. And if it's on tendon, ligament, or the connective tissue close to the bone, ESPECIALLY the connective tissue close to and wrapping the bone, then it is expected to have the pain you describe. That will last for a good while unless you help it go away.

And if you actually bruised the bone....OUCH! Bone bruises hurt. A lot. And for a long time."

Would these type of things hurt when pressed on? Just that as i mentioned the area does not really hurt as such just feels a bit thicker, achey and irritated.

"Were I you, I would spend a SERIOUS 3-7 days Icing the heck out of that spot/area.

Ice pack 5 minutes on, 5 off. As many times per day as possible. Really."

OK lots of icing it is - shall i do this as well as deep tissue work?

"When the doc said hematoma, did he mean that you had bleeding/brusing deep in there and it turned hard? Or just that there's swelling in there?"

There was a black blob on the ultrasound he said was bleeding within the muscle. It was not calcified though apparently.

"Regardless, there's only one thing to do about it. Old stuff out, and new stuff in, and that makes everything better."

thanks - will try my best!!!

Tom

Dec 17, 2009
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Part 3 - Knee Pain And Hematoma In Vastus Lateralis After Trauma. Tendon Injury?
by: The Tendonitis Expert

Joshua Comments:

2. It's unlikely your gait is messed up from that. It's more likely it was already set up to fall inwards like that, unless you were doing that previously and it didn't act like that.


3. 'Stirring up the burning sensation' makes sense. Irritant and pain enhancing chemical getting pushed out into the surrounding tissue.

4. yes, bone bruise would hurt, ligament probably would, tendon maybe would, depending. I was thinking it was more on towards hard tissue and less in the muscle. SOunds like it's primarily in the muscle.


Ice pack and Deep tissue. If you practice and learn the ins and outs of it, you can use ice massage as deep tissue massage.


Keep at it.

Ask questions.

Update me on what's happening. We'll fine tune as necessary.



Jan 04, 2010
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PART 4 - Update - Knee Pain And Hematoma In Vastus Lateralis After Trauma. Tendon Injury?
by: Tom

OK so i have been trying to work at it as you say but found it hard to dedicate the time over the holiday period plus i have the added benefit of an 8 month old child who is poorly at the moment so no free time and not that much sleep time!

I also got an MRI conclusion is....

"Mild thickening and hyper intensity of lateral patello-femoral ligament as it approaches patellar bone suggestive of a low grade strain or tendinosis of this structure. However, gap, defect or rupture is not seen.

There is a small tear of the posterior horn of the medial meniscus with a mild increase in joint fluid."

So - should we change anything or shall i carry on and work on the ice massage?

tom


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Joshua Comments:


Yeah, time is certainly a factor.

Might want to get a Vitamin D level on your child. Check out the Vitamin D pages on www.Easy-Immune-Health.com.

If I had a kid, enough Vit D would be one of the main things I would make sures/he had enough of as a basis of overall health. Vit D is pretty crazy necessary when you start looking into it.


Ok, so MRI. Do you have pain with that torn meniscus? If you don't, don't worry about it.

If you do, meniscus injury is a special kind of pain.

I had just a bruised/ground up/irritated medial meniscus, and one day I could run, the next I could put NO weight on it for 4 days, then was seriously favoring it with a cane for a month, then managed it for another month as it healed.

No fun.

And it doesn't sound like what you were first describing.

More to the story?



Jul 15, 2016
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Follow up
by: Fil

Hello Tom.

I know it's several years later, but i was wondering how your injury ended up going? I seem to suffer from the same ongoing problem and its a pain to deal with.

Did you have any luck in resolving the problem?



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