[Closed] Bad knee, doctors or physio?

Rest and see your Doctor before you do more damage and retire from riding.

Trouble with doctors is they don't seem to interested in sports injuries. Unless your limb is hanging off, they just tell you to rest it.

Rest will probably sort it out, but a physio might give you some more pro-active stuff to do along with the rest.
Presumably you have tried icing it regularly to get the swelling down? Ibuprofen gel/tablets?

That was my thought that the doctor will just say rest it and not really bother looking at it properly, the Physio I thought might give it a proper examination and I am already booked in to see one.

I can get the swelling down but it comes back.

I did 6 ibuprofens at the race yesterday but it didn't have any effect, I have tried the gel as well and that wasn't much use, Deep Freeze and elevating seems to work though.

Dr to make sure there's no damage and keep your Physio appointment.

Don't over exert it but don't rest it as it will increase the swelling, knees need to kept moving, no impact sports or any that involve running, if you cycle then use flatties if you can. When resting if possible keep you leg elevated.

Ibuprofen if you can take it and follow the guidelines on the packet.

I was thinking of doing some light spinning on the road bike high post and saddle take the body weight of the knee where as on the BMX it's got to take my weight as wel as the pressure through the cranks.

dont over do it on the 'brufen. i know several people with stomach ulcers from taking too much. particually bad on an empty stomach.

Use your normal seat height and position though don't alter that, not sure what the difference between pedalling a road bike and BMX would be.

Well on a BMX you are standing the whole time where as on the road bike you are sat down.

Let pain be your guide. If it hurts during or after then stop.

Generally your GP is a generalist and he is interested in your physical well being but in my experience he/she will err on the side of caution and insist on rest. This is good advice however if you are an athlete you will probably spend most of your competitive career experiencing some level of injury/discomfort/pain at all almost all times. He may understand this but I would expect him not to support you continuing to train/race and possibly causing more damage.
In my experience given the availability of information on the net and of course a vested interest I have been able to investigate my own injuries to such an extent to only require my GP to confirm my findings! So unless you are unsure I would go straight to a sports physio.

[i]Well on a BMX you are standing the whole time where as on the road bike you are sat down. [/i]

DOH!

Having been off the bike for 8 months now with knee problems (4 ops and counting). I would recommend trying to find a good sports physio ideally one that has been recommended.

I have had mixed experience, including one that was unable to recognised ruptured ACLs in both knees which could have saved me 3 months of unnecssary rehab.

Would also keep Doc appointment and ask about a consultant appointment, particularly if you feel you are not getting better.

Doctor might not be very interested, but will at least prescribe you some better painkillers. Maybe an anti-inflammatory like diclofenac.

rest and get it sorted asap via doctor's [b]referal to the hospital.
i injured mine and left it for years as the swelling slowly went down and i did the "im alright now" thing.
every time ive been in to be seen by anyone the main question they ask is
"is it giving way?" if yours is you will get seen asap as this must mean something bad.when i used to say no, then they wernt so botherd.

Second the diclofenac, i used some diclofenac gel for the 85k merida having hurt my knee hiking the week before. Zero discomfort, and surprisingly no discomfort today either.

Docs,

tell them it was 'x weeks ago'* and youv'e been resting, and using ibuprophen, ice, elevation, compression bandage etc since. This way you bypass the "come back in 3-4weeks" stage.

*insert believable lie timeframe of choice here.

My knee is much better for sleeping with a tubigrip on it every night, will be going back tot he docs in a couple of months to ask to see a consultant again.

Go see your Doc, twisted knee and subsequent knee giving way may be an indication of ligament damage, if the bike is causing the knee to swell, keep off the bike until you get some indication of what is wrong, you risk doing more damage if you try and over-do it.

Docs can be unsympathetic to sports injuries, just make it clear how much activity means to you and usually they come around. A good GP should check for ligament/cartilage damage with some simple manipulation and should then recommend you for a course of physio, maybe for NMR scan and referral to a knee specialist (interpretation of these is quite hard for knees) or maybe even an x-ray (but this tends to be a check for any signs of arthritis and you sound too young for this to be likely). You should get some indication of severity of any injury from this and can make a judgement of what you can and can't do from there.

Kinda what a few others have said..

Go to the doc first to get in motion getting a specialist referral through the nhs - you might need an arthroscopy to see what's going on, whether it's ligament or cartiliage damage. In addition, see a physio/sports injury bod anyway, there's gonna be some waiting time with the nhs route.

Don't overdo it now - you might be hurting the chances of a better recover later if there is some damage that needs fixing.

Cheers guys, I will give the doctor a ring shortly and try to get an appointment. From reading up on the net it sounds like and ACL problem, but then again I am no doctor, so hopefully it's not.

everything sounds like an ACL problem when researched on t'internet................

Ha ha ha

Knee giving way is a major symptom of ACL damage. Sorry to say but your symptoms sound like a list of my problems with a snapped ACL.

For a diagnosis you will need a very good physio or ideally a specialist and a CAT scan. GPs aren't much use in themselves, but a good quality referral letter will help you see a good consultant.

If you really want to get back to your best you need an accurate diagnosis. You can't really make an informed decision without one.

both - physio will be able to help short term, and gp can put you on the list to get a specialist to look at it. my gp is a runner and so approachable on the injuries front and when i injure myself, i go to private physio for diagnosis. both times my physio (as well as helping with acupuncture, massage, exercise etc) told me to go to the gp and ask to see xx consultant for mri etc etc.

Right I went to the doctors this morning, she said that they normally leave it quite a while with knee injuries and was umming and erring about referring me to a specialist, they way it has been left is give it another 2 weeks rest and if it's not better then I am going to an orthopaedic surgeon for some surgery for a poke around with a camera and an MRI scan.

So can I still spin a road bike on the flat, does that count as rest?

hmm seems very strange to give it 2 weeks rest and then recommend SURGERY. Two weeks before referral to an OS seems reasonable, it seems to be pre-supposing what they are going to do.

I would not spin on a road bike if I were you. If you are going stir-crazy the last activity of choice always seems to be bloody swimming, though not, of course, breast stroke.

good luck

2 weeks rest and if it's not beeter they will refer me to have a camera put inside my knee, so surgery for a poke around, not surgery to fix it.

Ouch def not breast stroke, I might use a pull buoy and just do my arms.

Rest is dependent upon your pain levels.

If you can manage something without too much pain or swelling, do it - spin on a road bike, use a cross trainer, kick with a kickboard in the pool, lift weights, etc. The more you can build up the knee the better, whatever your eventual outcome. If you do need surgery the muscle will waste off your leg, you're better to start as strong as possible.

Exploratory surgery does sound unusual, I've only ever heard of MRI or CAT scans for diagnosis, certainly as a first option.

[i]hmm seems very strange to give it 2 weeks rest and then recommend SURGERY[/i]

It does but investigations don't which is what the GP recommended.

To be honest as a GP and with your history of your knee swelling up after exercise and giving way i would place my money on a meniscal cartilage tear. remember you will see the orthopods 1st and they may arrange an MRI or may proceed to an arthroscopy. Sounds like you probably need an MRI to me to find out whats causing the prob

Cheers for that, well I guess I will find out eventually if it doesn't sort it self out after 2 weeks rest and then have to wait god knows how long for my referal.