Knee and Quad Pain

[s24320]

Almost 3 weeks ago I was at my desk with my leg crossed over and leaning against the edge of the desk. I was showing someone how hard I hit something and not thinking hit my Vastus Medialis Quad muscle (the inner quad muscle to the inside of the knee) pretty hard. Over the next few days I didn't have much pain or discomfort but by the 3rd day I began to have pain in the Pes anserine Bursa below the knee. Then over the next week the knee started to get tighter and I started to to hear more popping and swelling around the knee. I also noticed that my IT band on the side of my knee will snap when I pivot or change directions. Over the past few days I had started to bike more and do some lunges and squats, stretches, etc. When i do this I notice that my quad that I hit is extremely weak and very sore. last night doing squats just with no weights as I didn't want to stress it i felt something in my quad move upward into my quad more, now today it is really sore in that spot and prior to this My quad never really hurt but it was what I hit. The area around my knee cap also hurts. I am just wondering how long it could take for a quad muscle to heal from a direct blow but with no bruising and if the weakness in the VMO muscle could cause my knee to pop and IT band to snap at times and cause pain in my pes anserine bursa. I did see a orthopedic who said he is not sure.  X-rays were negative but I have a high deductable insurance so I am trying not to get an MRI.  I just dont see how it could have done something as I just hit my quad muscle hard but my knee was against my desk so it had know where to go.

[s24320]

I went and got a MRI because I wanted to make sure.  The results cam back today saying every thing is intact with small joint effusion in the Patellofemoral Joint.  I havent had a chance to meet with the doctor.  I am just assuming this is fluid under the kneecap.  Is there anything that be done to speed this up or does it just take time for it to go away.  Would an ultrasound help to get the blood moving?

[Michael L Gross, MD]

Healing times vary, so I am hesitant to predict.  If you are concerned, PRP injections have been used  to accelerate the healing of soft tissue

[s24320]

How long could a contusion of the VMO take to heal?  Also could the pes anserine pain be due to weakness in the VMO?

[Michael L Gross, MD]

As im sure you know, the VMO is the major stabilizer of patella tracking. Therefore, the symptoms you are describing could all easily arise from a VMO contusion and secondary dysfunction.  I don think an MRI is needed at this time.  I would recommend a patella brace and a short course of physical therapy.