09 Feb Dream acquired injury
Ever heard of someone being injured whilst dreaming…no…me neither!
Im sure anyone reading this will have had a dream about something which appears so realistic that it feels genuinely real. Well for one patient of mine this was the case. Only they were so engrossed in this dream that they actually injured themselves during it.
The said patient’s dream was of his nieces who were playing in the park. A park which has dog walkers etc strolling around minding their own business. Whilst his nieces were playing in the park (still dreaming) a pack of dogs started to attack them. This then led my patient to start thrashing out with the leg to kick them away and stop them mauling his wonderful nieces.
So for however long he was ‘kicking these dogs’ he was actually thrashing his leg around in the air which as you can imagine could have been rather forceful. He came into clinic reporting pain around the knee cap (patella) and around the inside and outside of the knee. I think it’s quite likely he had hyper-extended his knee so much that the front edge of the shin bone (tibia) and the front edge of the femur (thighbone) repeatedly met each other with force and caused trauma to the joint lining on each bone.
Having compressed these areas of the knee it is likely that there is an element of ‘bone contusion’ which is basically a bruising. This does heal with time with relative rest but it can be so contused that it fractures and requires a full cast and immobilisation. Its also likely that the muscles, used to thrash the leg around whilst he was dreaming have been contracted forcefully and for some time, have become tight after the event which is why potentially the front of the knee where the quadriceps muscles form a tendon (patella tendon) is painful.
What was the treatment?
Treatment for this was rest, gentle mobility work to maintain joint range of motion which was very good still and stretches. I wanted the patient to stretch the muscles he used to kick his leg (quads, hip flexors, tibialis anterior) as these were obviously exhausted and tight from all the thrashing. 3 days after we met the knee was much better and just needed time for the bone bruising to calm down and the muscles to relax properly. After this he was able to play football without any pain and was able to kick with up tp 80% full force or the knee would be slightly painful. The last piece of advice I gave my patient was to avoid eating strong cheese prior to sleeping – this apparently makes your dreams quite extravagant.