Doctor – Should I go to the emergency room?  I hurt my knee really badly !

A knee injury is among the most common sports related injury – when in pain, often the first thought is ‘should I go to the emergency room’ ?  There are some injuries that should be seen right away and some knee injuries that can wait a few days.  Let’s review some of the differences.  Remember, this post is not specific medical advice for your situation.  Always rely on your own orthopedic surgeon for guidance.

I can’t bear any weight on my knee

If you’ve hurt your knee and now you cant walk at all, this is likely a sign of something significant.  This could be a fracture of one of the bones in the knee:  the femur, tibia and patella.  It is always a good idea to be seen and get an x-ray.  With fractures near the knee, the joint will usually swell up quite a bit – this is called and effusion, and it can also be hard to bend your knee.  I tell my patients to get that x-ray to assess their knee injury.

I feel numbness in my foot – I feel coolness in my foot

This can be an incredibly devastating knee injury to either a nerve or a blood vessel in your leg.  Blood vessel injuries start a time clock ticking  – usually about 6 hours  – before permanent damage can be done to the leg and foot.  Muscles start to die and you can become quite sick.  NEVER wait to be seen if you think you can’t feel a pulse in your foot or if you have no blood flow to the foot.  Similarly with nerve injuries – this is most commonly a stretch to the nerve that goes to your foot.  Be seen quickly if you think you may have a nerve injury.  Fortunately, these are very rare.

I can see my bone !

Severe traumatic injuries can sometimes break the bone in such a way that it comes through the skin.  If you see a puncture wound or the tip of a bone, you should go directly to the emergency room.  This is called an ‘open fracture’.  These always require urgent surgical treatment.
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My knee pain is severe – I can’t handle it

This is the obvious one.  Even if the injury itself doesn’t require emergent treatment or surgery, you may need to go in to the emergency room just because the pain is too much.  A lot of factors play into this – the severity of the injury, any pain medications you were taking before the injury, and your tolerance.

Something in my knee is out of place

Dislocations of the kneecap happen with all kinds of sports and are very common.  Usually if your straighten out your leg, it will naturally go back into place, but this doesn’t work, this is a good reason to be seen right away for your knee.  Also, if you think your entire knee is out of place, its best to get an X-ray and have an emergency room physician evaluate your knee.

These situations are rare, but are important to recognize.  Whenever worried, it’s best to be seen and evaluated for possible serious injury.