Signs A Knee Injury Is Serious 
By Dr. David Geier 

Knee injuries are among the most common injuries in sports and exercise.

Fortunately, most knee injuries do not require surgery. Maybe you injure your knee landing awkwardly from a jump playing volleyball on the beach on Sullivan’s Island. Maybe you twist your knee playing Mount Pleasant coed league soccer.

If you suffer a knee injury, how can you know if it is serious and worth seeing an orthopaedic surgeon? Or do you need to go to an emergency room or urgent care facility in the Charleston area?

This list is far from comprehensive, but here are some signs you have a knee injury that might require surgery or absence from sports or exercise.

You heard a pop. I don't mean a small pop like the one you feel when you crack your knuckles. I'm also not talking about the popping many of you feel under your kneecaps normally with knee motion. If you hear or feel a loud, painful pop during an awkward landing or when you get hit in the knee, you could have torn a ligament. Many athletes say that their teammates heard the pop when they tore their ACLs.

Your knee buckled or gave way. If your knee buckled when you landed from a jump or changed direction suddenly, you could have suffered ligament damage, such as an ACL tear. Alternatively, if you experience your knee giving out with twisting or landing movements in sports weeks or months after an injury, you should consider seeing a sports medicine doctor. True knee instability with activities can risk further damage to the meniscus or articular cartilage.

Your knee is swollen. It might not be a big deal for your knee to have a small amount of fluid present. On the other hand, if your knee swells up like a basketball in the first few hours after an injury, you could have an ACL tear or fracture.

Your knee is locked. Younger athletes can often tear the meniscus in such away that the inner, torn fragment can flip into the center of the knee and block motion. These bucket-handle meniscus tears often require surgery. The surgeon must push the meniscus back into place and repair it with sutures or anchors. Milder or more chronic forms of knee locking or catching also can suggest you have a meniscus tear.

You can’t bear weight. Extreme pain trying to walk is somewhat of a generic complaint. Many injuries can be serious enough to cause pain when you try to put pressure on the injured leg. It is still a sign you might consider seeking medical attention.

You cannot fully extend the knee. Pain, swelling, and inflammation after acute injuries can all make knee range of motion difficult. If a patient comes to my office days after an injury and I can’t straighten the knee, I get at least a little concerned. It can be a nonspecific finding, though. Regardless, I have often found ACL tears, acute meniscus tears, patellar dislocations, and more in these circumstances.

Your knee hurts in a very specific location. Patients with meniscus tears usually complain of pain in a very specific spot along the joint line rather than throughout the knee. Medial meniscus tears often hurt along the medial (inside) and posterior (back) side of the knee. Lateral meniscus tears often cause pain along the lateral (outside) and posterior aspect of the knee. Likewise, stress fractures usually cause localized pain on the bone at the site of the fracture.

I hope that this list is helpful. Again, it is by no means comprehensive. Also, please understand that it is not intended to replace the advice of your doctor of orthopaedic surgeon. If anything, I hope you would consider seeing your doctor sooner after injury if you have any of these complaints.