13 year old schoolboy. Played rugby for years. 4 weeks ago had left knee forced into adduction and pressed to ground during a tackle. Knee immediately swelled . Mother is GP—got him an MRI scan and this showed no damage but “ blood going into the bone”

She was worried and confused since there was no further explanation. According to Cyriax this is common during trauma.

My examination showed normal tension in quads, hamstrings and right calf—but massive contracture in lest lateral gastrocnemius—the calf. Also the knee was still moderately swollen and had lost 20 degrees of flexion. I checked hw he looked standing and his left knee was slightly “ knocked” which may contribute to trouble in future. I removed the contracture from the calf, massaged strongly the fluid from the knee and then gently stretched the knee into flexion to gain half of the lost range. Two days later I saw him and all the pain had gone and he was walking normally-the second session finished off the work on the calf and I gave his father instruction in how to massage the knee until there was no return of fluid.

Given hamstring stretches to do--unlikely to do anything else and this is primary problem--no return after 6 months and the mother reported the boy back to normal sport within a few weeks with no signs of difficulty