 Poster: A snowHead
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Could our GPs and knee-specialist medio snowheads please help me!
(Sorry to post this here, but I don't want the bother of bothering my GP if there isn't anything she can (or won't) do)
As per previous posts, I banged my left knee good & proper in a spectacular fall on the local dryslope.
Did it late evening, RICED it.
Next morning massive purple bruising radiated a good hand-width all around the epicenter of the injury (which is on the muscle just before the knee joint and a bit toward the inside of the knee. According to Google it appears to be the bottom of the vastus medalius ??).
Kept on RICEING, and resting and to date I haven't tried to run.
For a few weeks the whole area swelled like a football and was stiff and painful to bend.
About 2 weeks after the event my GP checked my range of movement (which was pretty much ok by then, if somewhat stiff at the limits) and she thinks it's "just" deep bruising. She thinks that if I eventually regain full range of movement and have no clicking or pain in the joint when I exercise, then even if the numbness remains, it's probably not worth investigating further (i.e. arthriscopy).
Now 5 weeks on I can walk without problem and have full range of movement, but:
stairs sometimes cause twinges, especially going down them.
there's still a bruised colour at the epicenter of the impact.
in the muscle joining the knee I can feel nobbly bits where the blood's congealed.
there's also still fluid around the point of impact and my kneecap.
where the fluid is, still feels numb (but not as numb as previously).
I've never had a bruise this hellish or last like this before.
My question is this: Bearing in mind the bruising raidiated to include a fair proportion of the knee joint, should I be worried about the nobbly/fluid filled/numb bits?
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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Well I 'm no medical person but then again the GP isn't likely to be a knee specialist...
I would go to a physio who has a background in this type of injury. Seek out by reputation the one you want to see and you know has sorted out people with knee injuries.
I say all this reserevedly not to upset our medical people on here but just because it took me YEARS to find a decent back specialist and I tried loads and it cost me a lot of money. There are specialists and specialists IMV.
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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I'm not a medical doctor, I'm afraid, but I am in a not too dissimilar position, with a couple of bangs this year (23rd July, 8th Sept). Did a bit of the RICE thing, but probably not enough. First time around it took about 2 weeks before I could bend it enough to walk downstairs properly, and nearly another month before hill-walking was really comfortable (although skiing was fine). 2nd time there was much more bruising (back of leg from mid thigh to top portion of calf) and swelling but less pain - just as well as I had a trip walking across Corsica the following week!
Very similar story to you from the GP when I eventually went to see her on about 22 Sept. Diagnosis was "pre-patellar bursa", aka housemaids knee. It's swelling of the covering of the kneecap, the body reacting to protect it, and in my case feels like a gristly pad between the skin and bone. The week after the second fall it was definitely fluid filled, about the size of a softball and I was getting a tad concerned it might burst, but it's certainly still slowly reducing and firming up, and now I can pretty much feel the whole patella. I'm not too worried about creaks and clicks from the knee though, as that's been pretty much normal most of my life. She reckoned it would go down eventually, but if it doesn't to come back and she'd refer me to an orthopod - but I forgot to find out what "eventually" should mean in this context. It's certainly still reducing slowly. The swelling area was discoloured up untill a few days ago, but seems pretty much normal today, there are still some knobbly bits.
Numbness (pretty much surface only - interior of knee still has normal sensation) is still there, also fading slowly. GP says that nerves grow back at the rate of 1mm/day, provided the ganglia are not damaged. Not going quite that fast, so probably got a bit of permanent damage there.
Started running again a couple of weeks ago, gently at first, with no apparent ill effects (well - no more than normal).
Main things are a) don't kneel on the swelling, and b) (unlike me) don't do it again  . Other than that it sounds like just give it a bit of time.
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| GrahamN wrote: |
| Did a bit of the RICE thing |
Wot's that?
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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Something to serve with curried knee
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You'll need to Register first of course.
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Manda, not a GP, but just some observations from someone who has had various injuries before - including to inner quadricep.
- walking down stairs or a slope (eccentric contractions) puts loads more strain on the knee so symptoms persisted in these situations even after I was happy to run on the flat again
- Regarding lumpy bits - in muscle, scar tissue can last for ages. I got nailed in the back of my calf 2 years ago while getting onto one of those old 2 man chairs that doesn't slow down. I got distracted and got hit full on by a little metal booble which the bar would normally rest on at the base of the chair. That bruise lasted for about 3 weeks, but to this day there is still a 'bump' where that happened.
- I have had an osteopath who was working on me for an adductor strain comment on bits of scar tissue in muscle when working me over reminding me of blows I had received years ago.
I would agree with JT that you should try and find a good sports physio (try your local gym?) - I suspect they will know more than the average GP.
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Rest
Ice
Compression
Elevation
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rob@rar.org.uk, doh Rest Ice Compression Exercise, at least I think that's what it means, it could just mean standing arround in a paddy field
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You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
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| GrahamN wrote: |
Rest
Ice
Compression
Elevation |
Ta. Sorry for being thick! Is elevation above head height or above sea level?
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
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Frosty the Snowman,
That'll work..!!
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rob@rar.org.uk, sometimes means both! 
Thanks JT & GrahamN! GrahamN by all accounts your bruising and my bruising would have a lot in common to talk about as our symptoms are also most identical!! Was your fall skiing-related?
Google reckons "Treatment of prepatellar bursitis begins with avoidance of the aggravating activity" [$hit Shirlock, really???]. And "In some individuals, drainage or excision of the bursa may be indicated." Oh dear. I sense the posibility some additional therapuetic pain coming on .....
I'd already gathered that the nobbly bits are blood congealing and torn muscle repairing itself. Have previously had high impact injuries causing deep bruising (from hockey balls/sticks), in one instance above the inside ankle where the bruising calcified and had to be treated with ultrasound in order to break down the nobbly bits, but that was on the bone and not a joint.
Was worried that any hardening of the musclulature around my kneecap might end up causing problems!
My massage therapist has already provided gentle massage exercises for the injured area. He's a sports massager, and has a very good medical knowledge (probly has a better understanding of whats wrong with knee than my GP) but unfortunately he's not qualified to diagnose and treat medical conditions so I'll ask him to recommend a physio.
Thanks guys!
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You know it makes sense.
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Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
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Manda, yes, look back at your "Damn Dendix" thread.
Oh - and BTW my GP was pretty clear I shouldn't let anyone stick any needles in the knee to try and drain it. I would go down by itself fine, if it didn't it would only fill up again after draining, and needles would only introduce infection - or cause more damage if done badly.
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Poster: A snowHead
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GrahamN,
Agree with this, the fluid is there for a reason and unless you have team of people who will see a course of treatment through, ie a professional sports team etc, then it will go down when the body is ready. And if doesn't go down all of this is beyond our experience related knowledge and you should get referred...
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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Manda, I had had fluid withdrawn from within the knee joint. No infection, it was a lot easier to walk afterwards, and it looks a lot like urine. And yes, I did watch, and it's important to keep absolutely still. The procedure was carried out by a Dr who works only in Orthopaedics. If you want his phone number PM me.
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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Manda I am a GP working not far from you and have a bit of an interest in Sports Medicine.
It sounds to me like you may have a bit of "dead leg" (also known, strangely as Charlie Horse!) - which effectively means that those nobbley bits that you are feeling are actually small bits of bone forming within the muscle. This is a fairly rare problem but you sometimes hear of it especially in footballers who have collided with another player. It is similar to your hockey ankle injury, but the calcification is occurring in muscle not attached to bone.
The correct treatment of both the fluid and the lumpiness is to see a sports injury physio. Near you I could recommend David Newman (02380 330387) who works in Lodge Rd, Soton, or alternatively the Sports Injury Clinic at the Nuffield Chandlers Ford (02380 266377).
Don't worry about the numb patch, it will recover. With a heavy blow to a surface nerve the nerve fibres die but are able to regenerate along their myelin sheath (a bit like threading the copper wire down a piece of insulation).
If you are not exactly in Southampton but somewhere nearby, let me know as I may have alternative names to suggest.
By the way, I have no financial interest in any of the recommendations!
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You need to Login to know who's really who.
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That sounds nasty Manda, I remember when I twisted both my knees whilst skiing in Austria three years ago, very painful, I couldn't fully bend them for weeks. 
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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Nick L curiously, sometime between my and your posts I'd made an appointment to see David on Monday. 
BTW do you know whether there's an NHS sports injury clinic at SGH or RSH? Or elsewhere nearby in Hampshire? I searched the NSH website and but the Hampshire section is $hite for information about local services. I don't mind paying for private physio, but it seems a waste of my tax money if there are NSH services available to me - so long as they don't involve massive waiting times ...
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You'll need to Register first of course.
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Manda,
I think its more important to get the right person than the cheapest/nearest. I'm not so sure I would be getting a name out of a phone DIR if it were me, with all due respect to the medical profession.
Hopefully this will clear up ok and all this will seem a bit OTT
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Manda, I know nothing about knees, but I do know this:
1. You can not diagnose or treat knee problems by posting on a forum. The knee (and person attached) must be seen and examined by someone who understands ski injuries.
2. Few GPs understand sports injuries (Dr Couthard, where are you?) - even fewer understand skiing knee injuries. If your problems persist find a Sports Injury clinic.
Meantime for some pleasant bedtime reading try ski-injury.com. For fun (gruesome?) graphics try Michael Tuggy on the University of Washington site.
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Manda, With my state registered Physio hat on!! - Its very hard to diagnose without assessment, however from your description it could well be that the knee may need aspirating (fluid removing from joint). However there may have been a 'twisting' injury causing other damage which needs checking to just be sure it gets cleared up a quickly as possible.
But your first move should be contacting a registered Physiotherapist via a GP referral or find one from this link.
http://www.csp.org.uk/director/physiotherapyexplained/physio2u.cfm
Good luck and let me know how it goes.
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You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
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Thanks for the link lisach! Don't worry Jonpim I wasn't hoping for a diagnosis on this forum, only an indication of whether I should bother a professional (sometimes I get a bit hypochondrial....)
BTW yes, I noticed that GPs aren't necessarily clued up about sports injuries - it would be lovely to find a nearby dedicated NSH sports injury clinic (hint, hint), but doesn't seem to be one in Hampshire.
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Manda, most NHS physios, in my experience, are pretty clued up about sports injuries, but other than that you are unlikely to find a dedicated NHS sports injury clinic, as it's not a priority for NHS funding.
It is impossible for me to be able to make a diagnosis as to what's happening to your knee without examining it, however a good rule of thumb is that if things are improving by themselves, then an extra intervention is probably not needed. My experience has been that most people expect soft tissue injuries to improve over an unrealistic time scale, not realising that sometimes, IMO, it can take between 6 and twelve weeks for a soft tissue injury to heal. However if things stop improving in that time, or the injury is being particularly troublesome then seeking medical advice is adviseable.
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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Kramer yeah, am starting to wonder too if I'm just being impatient. No doubt I'll be sent home feeling a bit sheepish if the physio thinks I'm perfectly ok but for a bit more healing time.
Re: sports injury clinics, Cambridge NSH has a walk-in clinic, and Nottingham NHS has a Centre for Sports Medicine.
Would be great if one were down here too.
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And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
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| Manda wrote: |
| Cambridge NSH has a walk-in clinic |
Sounds like we need dedicated 'hobble-in' clinics
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Manda, I knew that we had a centre for sports medicine in Nottingham, but I didn't know that it had clinics that I could refer to. Thanks for that bit of info.
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You know it makes sense.
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Manda,
Sorry I haven't visited the forum for a few days.
NHS Sports Injury provision locally is..... Not good (understatement) and not likely to improve due to severe financial crisis in Hampshire Strategic Health Authority.
Glad that you have booked in with David. Your GP could refer you to an NHS physio but there is likely to be a considerable delay.
Hope your appointment goes well today.
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Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
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Where's the smiley for "looking sheepish"? Apparently I'm fit and healthy and my knee's just really really really bruised - the swelling/numbness over the kneecap's just blood, and (like Kramer already said...) deep tissue bruises take a loooooooooooong time to heal. I've also clearly killed a few nerve endings which (probably) will grow back in time.
Physio bent my knee everywhichway and concluded that structually the limb is absolutely fine, nothing wobbly, limp, or lax. He's done a bit of ultra-sound to help the bruising re-absorb, and recommended gentle stretching to encourage full range of movement.
Gentle exercise is ok (so no skiing, no rowing races, and no long-distance runs before xmas, grrrrrr)
Mind you, the consult fee was good value considering a) physio himself seemed to know his stuff, b) no waiting, and c) the peace of mind was included in the price. And I've feel smug for having contributed to the financial health of my local medical community
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Poster: A snowHead
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Jonpim, thank you, really useful links there's a lot of very helpful information on Dr Mike's site.
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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| Quote: |
Where's the smiley for "looking sheepish"?
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Will this do? 
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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Manda, I'm glad it's nothing more serious.
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You need to Login to know who's really who.
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maggi, it's perfect! How'd you get him/her?
Kramer yes, me too (my hypochondria is also very much relieved).
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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Good to hear that it's nothing structural. Great sheep Maggi.
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You'll need to Register first of course.
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FAQ
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Well Mr Employer I had to go to Les Arc when I was on the sick because the doc told me my bad knee needed elevation 
), although the resulting bruises were impressive. I have them on file somewhere, might post them up to scare the faint hearted 
