Knackered my knee...what to ask for?

[Lozatron]

So last week I embarked on a longish ride...after 20 miles my knee started aching and by 40 miles it became excruciating and unbearable. I should say that I regularly ride 40-60 miles and have not had any discomfort in my knee before...feet, perineum, neck and shoulders but never knees...

I was on an organised ride so got picked up by the broom wagon and got checked out by a doc (you need nurofen for the inflammation and san miguel for the morale) and briefly looked over by a physio (it's the lateral tendon apparently).

What SEEMS to have happened is that my left cleat slipped forward 2 cm or so while I was riding, which resulted in uneven load on my knees and this embuggerance.

I'm seeing my GP on Weds - any suggestion as to what treatment / referral I should be asking for? Is physio the right option or should I get it looked at more thoroughly? If so - what kind of specialist?

I'm actually kind of crapping myself as I love riding my bike and the thought of getting some injury which prevents that or makes it difficult is just too horrible to contemplate...

Your advice greatly appreciated!

 

[amaferanga]

Um I might be wrong, but I always thought it was the GP that decided whether or not a patient is referred.

 

[ohnovino]

My Dad's currently undergoing physio after a minor knee operation. He's been athletic all his life and knows a thing or two about sports injuries so he was sceptical about how useful a physio would be, but it turns out they've worked wonders with him: for a couple of weeks after the op he couldn't walk properly, but he was running again about 48 hours after seeing the physio for the first time.

BTW, I wish my spellcheck would stop trying to change "physio" to "puppyish"!

 

[rualexander]

GP is probably a waste of time, go and see a good sports physiotherapist and they will sort it out quickly.

 

[vickster]

IF you need a specialist, in the UK, it'll be an orthopaedic surgeon - the GP will decide whether you actually need an specialist, and will refer you either to physio or an ortho. You'll wait a while for either unless you have private insurance. Is the knee swollen - if so ice it, take ibuprofen and paracetamol, don't do any sport or exercise for a while, or indeed anything that hurts. Can you walk?

If you've not ruptured, torn or broken anything, it's unlikely an orthopod will be able to do anything as there's nothing to fix surgically, physio and rest will be far more beneficial

I am coming up for 2 years post knee, injury, have had 2 operations and LOTS of physio which is still ongoing. I don't expect you'll be referred yet unless you are totally disabled or very swollen - my knee got worse (i.e. more and more swollen) over the course of 2 weeks, couldn't walk really - I had torn the menicus, bruised the bone deeply anmd worst of all knocked a chunk of cartilage off the bottom of my femur

Fortunately, I have private insurance! To be honest, if you don't and don't want to wait months to see someone on the NHS, you would be better off finding a good sports physio locally now - initially consultation will be around £50 and follow ups around £40. Knee injuries are a bugger, the sooner you start rehab the better

 

[Lozatron]

Thanks guys

@ameferanga - in my experience going to the GP without a plan is not a recipe for success...even specialists need help and guidance sometimes, but that's probably for another post...

@everyone else - I am happy to pay, and indeed have private health insurance through work - the thought of not being able to cycle anymore terrifies me and I would happily forego cars, holidays or other pleasures for having my knee in working order...if physio is way to go I'll take it...I suppose I have a worry at the back of my mind that a physio *might* not be the right solution, but that if I went to one first they would happily take my money without necessarily helping. Is this a reasonable fear?

I'm lucky in that I don't have trouble walking and the pain is far from severe - a worrying twinge if anything - except when I get on the bike when it is EXCRUCIATING.

 

[vickster]

If you have insurance, you shouldn't have to pay for the physio (or is there an excess)

How it went with me - A&E afternoon of accident (came off my bike), GP a week later, GP another 2 weeks later, X-ray & bloods, ortho the following day (!), he recommended physio, MRI & another X-ray to confirm diagnosis, 4 months of physio, operation #1...I couldn't get on a bike for about 8 months!

Ask the GP to refer you to a specialist privately, get the imaging privately if recommended. I would not cycle in the meantime, RICE is usually the first port of call with any injury - the R being key

Good luck, knees are a bugger, although if you can bend and straighten ok, don't have lots of swelling and can walk, it is *unlikely* you have done anything fundamentally awful/structural!

Good knee forum if you need more advice 9although most do have negative experiences as is often the case with such thing) http://www.kneeguru....Etalk/index.php

 

[amaferanga]

@ameferanga - in my experience going to the GP without a plan is not a recipe for success...even specialists need help and guidance sometimes, but that's probably for another post...

Imagine how tiring it must be for a GP when every patient comes along self-diagnosed with the help of Google. GP's don't have all the answers, but they're very likely to know more about the best treatment than you do.

 

[MarkF]

Go to A&E, at least you'll get things moving on the system, be "assessed", and speed up the possibility of a quick MRI scan.

Imagine how tiring it must be for a GP when every patient comes along self-diagnosed with the help of Google. GP's don't have all the answers, but they're very likely to know more about the best treatment than you do.

I dunno, Google can be very useful in certain instances. My operation is this Friday, I had an accident last Monday night and early Tuesday googled up my injury, which was damage to things I'd never heard of before, it certainly speeded things up at the hospital.

 

[PK99]

IF you need a specialist, in the UK, it'll be an orthopaedic surgeon - the GP will decide whether you actually need an specialist, and will refer you either to physio or an ortho. You'll wait a while for either unless you have private insurance. Is the knee swollen - if so ice it, take ibuprofen and paracetamol, don't do any sport or exercise for a while, or indeed anything that hurts. Can you walk?

For internal damage to the knee: orthropod - the clue is in the surgeon bit!

For strains or overuse injuries to the external/supporting structures: Physio.

I was referred to an orthropod last year, who did an MRI scan and saw no problem. advised rest for a while. When i got back on the bike and the problem flared (with exactly the same symptoms) i went to a sports physio who diagnosed patellar tendinitis and solved the problem by an exercise program

Even without Bupa, i'd now happily pay the £40 to consult a sports physio.

to the OP: sounds to me like you need a physio. If the damage is out of their area they will refer you on to an orthropod

 

[albion]

You also need to be aware that the force exerted on the knee is an exponential of the speed.I'm sure it varies but a 20 mph flat terrain ride would exert something like 4 times the force of doing 10 mph flat terrain ride.Get to 30mph and its almost certain to be double again.

 

[Arsen Gere]

When you look at physio prices bear in mind thats what they will charge for someone using insurance. If you talk nicely to them they will reduce their price. Infact mine offered my half what he has on the pricelist without any haggling.

 

[vickster]

The OP has insurance May be worth paying depending on the excess though (I don't have one with my insurance, just a pretty generous annual limit of 1k)

I pay for mine, fax the invoice through and it gets paid by my insurers into my bank account - same price as without insurance

£50 initial consult (60 minutes), £42 for 30-45 minute follow ups, but those are SE prices! My previous physio was more expensive, but that was at the private hospital where my first surgeon practices

 

[Wardy]

I used to have pain in both knees then I started taking Glucosamine and now I have no pain at all.

 

[VamP]

GP's don't have all the answers, but they're very likely to know more about the best treatment than you do.

Making the mistake you are making in that assumption cost me two years out of the sport I love.

To the OP - you are absolutely right to educate yourself, plus it makes you a more rounded person