Blown Knees

Knee pops on a rockover move.

By Dr. Julian Saunders | June 3rd, 2015

Heel hooks with the knee angled out put stress on the ligaments of the outer knee. Illustration by Steve Graepel.

This article appeared in Rock and Ice 206 (December 2012).


I got a heel hook, rocked up and tucked my foot under my pelvis, even camming my toe against the wall a little, when I felt something pop in my knee. Pain ran down the right side of my right knee into my calf and I jumped off. It was uncomfortable that evening. In the morning the knee greeted me with greater pain. I was able to walk all over the city the next day, but with some stiffness, and occasional acute pain related to lateral or twisting motions. Help! I have a Yosemite trip in two months and am in the middle of training.

—MtnZealot, via


I’ll try and be positive here by saying that you can go to Yosemite as long as you stick to slabs. Cracks, however, will aggravate your knee. I can’t say for sure because I refuse to climb things that hurt, namely cracks, and granite in general since climbing granite is akin to crawling across a parking lot strewn with broken glass.

Sounds like you snapped a small ligament that restrains the top of the fibular against the side of the tibia at your knee. As you rock over your heel, with your knee angled out, the top of the fibular wants to bust outward like a booby trap, the trigger being your ligament snapping. Twaaaang!

As you report, there is a little pain at first, but the next day your knee has a class-A hangover. Twisting motions, and in particular heel-toe maneuvers, will feel like the knuckle on the outside of your knee has instantly transformed itself, terminator-style, into hot liquid metal. This sensation will ease over the coming months, but don’t expect pain-free use this side of six months.

As a differential diagnosis, your lateral collateral ligament is also in the general area, positioned about an inch higher than the fibula head. A moderate injury to this ligament should repair in a month or so.

In terms of rehab, there is very little outside of complete rest or, for the more motivated, injury management. Translation: Avoid heel hooks and anything that fully flexes the knee. Sub-translation: Avoid pain.


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