Young school boy joseph in his living room

Joe, 11, keen footballer

Consultant: Prof Adrian Wilson

Knee ligament injuries

Paediatrics

Joe is back to football following rehabilitation with Ben Wilde under the care of Professor Adrian Wilson

A football injury and subsequent bike accident left Joe in need of a clear diagnosis to enable his knee to be treated effectively.

Joe sustained an injury whilst playing football in January 2020. His father Gary took him to a knee specialist who diagnosed a simple knee sprain. A few months later, Joe was racing his bike when he flipped and damaged his knee again. He was taken to A & E as he had also cut his knee and couldn’t put weight on it. Joe had a number of days off school and was on crutches.

Gary was worried this incident had aggravated Joe’s earlier knee injury and, as he didn’t feel completely confident with the earlier diagnosis, started researching knee specialists. He came across Professor Wilson online and was impressed by his experience, especially in children’s knee injuries.

Professor Wilson examined Joe’s knee and took MRI scans and diagnosed minor damage to Joe’s ACL, which had not been identified previously.

Whilst they discussed doing an exploratory arthroscopy to see what was going on inside Joe’s knee, they agreed that a course of rehabilitation would be less invasive and the first course of treatment. Gary explains: “My hope as a parent was that we could get Joe through non-operatively – back to football and all the sports he loved. Professor Wilson was very understanding, and he knows his stuff. He was supportive and gave opinions, but he didn’t try and force this upon us but gave guidance and support around it.”

Joe began a programme of rehabilitation with Ben Wilde from Physio & More. After an initial assessment and plan, they met weekly for Ben to review Joe and go through tests and check his progress. Gary says of Ben’s approach: “Very detailed, very personable, Joe really bonded with him. Ben is the best physio Joe’s ever seen, and he’s seen a lot as he is frequently injured. He felt very comfortable as Ben was really good at explaining, thorough, good with me. I have done a lot of sport and have a relatively good knowledge of sports injuries. Ben was patient and tolerant of all the questions I asked. He made sure I understood what would be done to make sure I was clear on what was going on. He was easy to contact by phone and email. I can be painful as I ask so many questions and he made sure I was comfortable.”

After this 8-10-week rehabilitation programme, Joe went back to see Professor Wilson. Gary says: “It was amazing in terms of what had been achieved and he was signed off to return to football. He plays in a local team, he’s a talented young player.”

Joe is now back to playing football after a 4-week training schedule, “like he’d never not played, and he hadn’t played for 5-6 months.”

Gary’s advice for parents with children with similar problems: “Find the right person who you personally trust. Don’t give up and make sure you stick with them. It took me a long time to find Professor Wilson and Ben Wilde who I trust with my son. Don’t be afraid to ask questions if you’re not sure. Professor Wilson and Ben are those people for me as they have the knowledge and understanding. You need to trust your specialist, but you also need to trust your gut instinct.”

He summarises his experience with Professor Wilson: “I can’t speak highly enough about Professor Wilson. He has been great with Joe and I. I can text him, call him and if he’s not around, he’ll get back to me within a few hours. He is the only specialist who will ever treat my son’s injuries now.”

Senior physiotherapist Ben Wilde explains how he progressed Joe through his rehabilitation: “Considering Joe’s movement when he came to see me and the restrictions in his knee, it was initially important to rebuild his confidence. To do this, we had to break things down into manageable blocks. We started with return of range and the beginnings of neuromuscular control around the hip and the ankle. It was a case of reintroducing him to safe ranges and the beginnings of strength patterns. Every two weeks we progressed him and introduced more challenging work. Moving forward we introduced multi directional exercises. At every point we were assessing Joe for flare up or reaction after the new load, and if there was none we were progressing again once that stage was complete. We then introduced plyometrics and straight-line run/walk programmes, both of which were on a staged progression. We completed his treatment with a return to play hop test and then additional sports specific drills at every point, assessing for detrimental reaction on the knee. In summary it was a matter of the appropriate exposure to loading and sports specific activities before a full return to activity.”

Professor Wilson concludes: “Joe has done extremely well. He is obviously now feeling fit and is doing all of his activities without any instability. He has worked very hard with Ben Wilde and his father to get Joe back to the sports he loves and he has completed all of his return to play assessments without any issues.”

September 2020