Fearing The Worst - 16th Jan. 2013

48 Hours Later

ACL - Anterior Cruciate Ligament (referred to as ACL throughout)
PCL - Posterior Cruciate Ligament (referred to as PCL throughout)

October 15th 2010

You may be thinking that I've missed out October 14th if you've been closely following the dates on each post.  The 14th had nothing interesting going on, it involved no University, just me sitting at home and trying to keep myself mobile around the house while constantly racking my brain to what I could possibly have done.  Down the years I paid only a little interest in specific footballing injuries as personally I'd been lucky.  I had only ever suffered one injury while playing football and this was the fracture and breaking of my arm and wrist, both in the same action, and yes, that was painful too, but the impact of that on my life is far less significant to the story you are part way through reading.

I Googled each and every possible symptom, studied reports on footballers who had suffered knee injuries in the not so distant past and queried all sorts of people who themselves had experienced knee injuries while playing football (these people included my Dad, Uncle, Grandad and various other "sources").  Depending who I asked, it would sway my mood.  My Dad predicted some mild form of cartilage damage, which in my head I knew would be 3 or 4, maybe 5 months without football, that didn't feel good!  It was only a few weeks prior to October 12th that I was discussing with my friend Shane, how it would be horrible to suffer long term injury and the feeling of not physically being able to play football would be incredibly depressing, this conversation was a sign of things I was about to experience.

I returned to A & E, the 48 hours after I was instructed to.  The swelling had somewhat reduced, although my knee was still many times larger than it should normally be, which was worrying after basically 4 days had passed, this was definitely much worse than a twisted knee that I had earlier convinced myself of.  I saw the same doctor as 2 days previous and his facial expressions worried me from the start.  Not many doctors are happy, smiley characters, not around here anyway, but this man looked concerned, he had an element of pity and fear in his eyes, I could see right through him and what he was about to tell me wasn't what I wanted to hear.  He again prodded and pulled my leg, conducting various tests, one of these being the Lachman Test.  Most people won't have heard of this, I hadn't at the time, but since I have educated myself around the topic.  
The following explains in short detail what the Lachman test consists of;
"With the patient lying flat and relaxed, the examiner bends the knee slightly (about 20 degrees). The examiner then stabilizes the thigh while pulling the shin forward.
The test places stress on the ACL. Both the amount of movement (shifting) of the shin bone, as well as the feel of the endpoint of movement (how solid the ligament feels), offer information about the ACL. Knees with a damaged ACL may demonstrate more movement and a less firm endpoint during a Lachman test."
(http://orthopedics.about.com/od/kneeexaminationtests/g/lachman.htm)
While conducting this test, the doctor asked if I was in pain, although I think he could tell with my facial expression that the answer was clearly yes!  But, despite the anticipation of finally finding out what I had actually done, he still couldn't give me an answer.  The swelling was still too much as my bodies reaction to such injury was crazy, releasing tons of fluid to protect the rest of my knee, but, he did tell me it was possibly both a cartilage injury and some cruciate ligament damage, the latter I really didn't want to hear.  I knew through my passion for football and the knowledge i'd picked up over the years, that a cruciate ligament injury was massive, it would change my life and it would also mean at the very least 12 months without playing football, maybe even never playing again, this is when my brain went into overload.

The diagnosis of a possible ACL tear was my worst nightmare and when I curiously searched the internet upon my return home, I found all the typical symptoms for this to be the outcome.  Below is an image showing how an ACL tears occurs, this was the first picture I came across on my search and it somewhat confirmed, albeit unofficially, what I had done on Tuesday night.

The ACL, located in the centre of the knee, in front of the PCL but behind the knee cap

Although this wasn't a final diagnosis, I feared the worst.  Doctors never usually suggest something in diagnostic terms if there isn't a 50% or more chance of it being likely but I still remained hopeful that'd he'd be wrong, after all, nobody is correct all the time are they?  Upon leaving the A & E department, I gave more details about my GP to gain a referral to private healthcare, this would speed up the process of my rehab and put me in a better position to have my operation(s) brought forward.  This took a few days to clear and I was basically sat at home the whole weekend waiting for a phone call and/or letter to let me know when I'd be heading down for an MRI scan and it felt like an age to find out the news......

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