The Kneedle and The Damage Done

June 4, 2008 9:32 AM

How long after injury to wait before seeing an orthopedic surgeon? Details inside.

So, I screwed up me knee a bit this weekend - Overdid it with running, hiking and playing tennis. I'm 28, have never had a knee/leg issue before. I can't pinpoint the moment this started. Somewhere between the hiking and the tennis playing I think. There was no snap, crackle or pop, but bending my right leg at the knee started hurting. Pain is on the lower front part of knee, but also a bit lower down on the muscle on the outside of my leg (shin splint?). The next day was better, I could walk fine, but going up or down stairs was painful on that right knee.

I've been icing it, and taking ibuprofen occasionally (even though that is unnecessary for daily activity). There is no locking or snapping when I bend it. Three days later (today) walking up stairs there is no issue. Walking down still hurts my right knee when I put my left foot forward and the weight is on my right foot. Fearing a torn meniscus. Ug. Father and brother in-law are urging me to go see an orthopedic surgeon sooner than later, but shouldn't I give it a bit of time to rest (like a week to see if it's just a strained muscle?) before going to someone?

If the answer is go see one now, anyone have recommendations for a knee guy in NYC?

posted by zackola to health & fitness (12 comments total)

Maybe see someone who can work on soft tissues before you decide to go surger route. Physiotheraphy sounds like a good plan.
posted by aeighty at 9:39 AM on June 4, 2008

Ibuprofen (or naproxen or aspirin) and ice early and regularly for the first 48 hours after an injury. Even if you have little or no pain, these drugs will reduce inflammation and thereby reduce damage. Your chance of longterm problems will be greatly reduced. (Use caution with NSAIDs if you have poorly controlled blood pressure or a stomach ulcer or are very old (80+).)
posted by neuron at 10:08 AM on June 4, 2008

If you're concerned, go see your internist or family doctor first. They should evaluate you and decide whether you need a) more rest and ice and NSAIDS b) physical therapy c) imaging or d) a referral to a orthopedist.
posted by gramcracker at 10:13 AM on June 4, 2008

There's not a lot orthopedic surgeons can do in this situation, IME.

I tore something bad about 5 years ago one morning, the surgeon guy just took an x-ray and that was it.

Welcome to middle-age, I guess.
posted by tachikaze at 10:33 AM on June 4, 2008

Definitely see an ortho, as soon as possible.

WARNING FOR THE FAINT OF STOMACH: STOP READING NOW!




My barely-related anecdote: I ripped my biceps tendon clean off my radius. Because most of the strength in elbow pronation (i.e., what you do during so-called "biceps curls") actually comes from other muscles*, after a night of RICE, I was able to convince myself & my doctor (an internist specialiast - not an intern, FYI!) that I had only torn muscle.

Just to be on the safe side, he sent me to an ortho, who sent me for MRI before even seeing me.

Turns out that if you wait more than 10 days to perform reattachment surgery, it becomes much more complex. As it was, I waited 5 days (Xmas intervened), and the surgeon still reported my muscle had begun retracting, making it harder to do the work.

* Little known fact - as evidenced by the fact that even my fairly competent internist didn't know it! The brachialis anticus actually does most of this work. The biceps is more important for pronation - rotating the wrist inwards.
posted by IAmBroom at 11:09 AM on June 4, 2008

Insofar as your health insurance (or private caches of golden doubloons) will allow, I would recommend seeing an orthopedic surgeon if you decide to seek medical attention for this injury -- I have had bad experiences with repeated misdiagnoses which were cleared up in instants by an orthopedic surgeon. (He cured it with physical therapy, so they're not necessarily too eager to dive right into the surgery).
posted by Comrade_robot at 11:52 AM on June 4, 2008

ASAP. It's not going to get cheaper if you wait, either.
posted by sondrialiac at 12:09 PM on June 4, 2008

To get into physical therapy you will need a prescription. Usually it is the orthopod who writes the scrip. If it were me, I would wait a few more days before going to the doctor, just to see if all the inflammation goes down by itself with rest and ice, but it is not too soon to see a doctor either.
posted by caddis at 12:26 PM on June 4, 2008

I had lots of knee problems (acl tear from soccer) and a piece of bone knocked off my knee cap.

If you wait things will get worse.
posted by majortom1981 at 1:53 PM on June 4, 2008

Also, the inflammation can go down but that doesn't mean it's ok. Ask my friend with the torn ACL whose leg felt/looked pretty much okay a few days after the fact.
posted by sondrialiac at 2:00 PM on June 4, 2008

Well, I'm going on Tuesday. Earliest appointment I can get. =[
posted by zackola at 7:40 AM on June 5, 2008

Happy to report that Doc thinks it's just Runner's Knee. Thanks to all.
posted by zackola at 11:22 AM on June 12, 2008