The patello-femoral joint :

skiing accident, bruised knee? - - Posted by tomscales (tomscales), 22 January 2005

Three weeks ago, I slammed my knee against a rock in a skiing fall.  I nailed it slightly right and up from the knee cap, on my right knee. It was incredibly painfull immediately after the accident, but the pain subsided significantly after about 15 minutes.  So I decided to keep skiing for the rest of the day, just less agressively.  I was telemark skiing, which means ever turn effectively involves dropping into a "lunge" position.  Dropping into the lunge position resulted in some pain, but otherwise it didn't seem too bad.  It was quite swollen the next day, and tender to the touch.  After three weeks of rest (and ice early on), the swelling is nearly gone, but it still hurts when I apply firm pressure.  Does not hurt while walking, or even after a jogging yesterday for the first time since the crash.  When I rub the sore spot, seems like I can feel some scar tissue.  Should I worry?  Might it be a bruised knee?  If so, what did I likely bruise?  The bone?  Or is there some important soft tissue in that spot that I might have bruised?  The bursa perhaps?  Should I see a doctor?  Perhaps a badly brusied knee just takes a while to heal?  Thanks so much!
Posted by hmaxwell (Heather M.), 22 January 2005

A badly bruised knee can take a while to heal.  However, I'd really recommend that you see an orthopedic surgeon who specializes in knees.  Because until you get a thorough evaluation, you don't know that a bone bruise is  'all' that you have (I say that in quotes because it can be a very painful and prolonged condition).

Where are you located?  Colorado?

Many ski towns have fantastic knee surgeons who specialize in treating skiiers, snowboarders, and others who do winter sports.  My surgeon is in Vail, and he's wonderful.  Amazing.  Every surgeon in the practice really knows how to deal with these unique injuries.  

If only for peace of mind and prescription anti-inflammatories, I would go see a doctor in a ski town.  Because you've given it three weeks and it's not feeling too much better--i.e. it's still causing you problems.  And in the meantime, consider RICE--rest, ice, compression, elevation.  This can help 'cool off' a traumatized knee while you wait to see a doctor.

If you want to post where you live, I'm sure people here can recommend a doctor that they trust to do a thorough consult.

In the meantime, I'm going to post the web page for my current surgeon in Vail.  There is a section that deals with chondral defects, which is what can happen after a severe blow to the knee.  It can also be the result of overuse injuries or worn cartilage when someone has poor knee mechanics.  A lot of times people have a condition where their knee mechanics aren't very good, and it only comes to light after a sharp blow or a series accident.  

On the other hand, lots of athletes give their knees a good jolt and manage to slowly heal and work their way back to their chosen sports.  But in order to do that, you need to get a proper diagnosis and make sure there is no fracture, loose body, or very series bone bruise and resulting damage.  Once these boogeymen are out of the way, you can get in touch with a good physical therapist and slowly work your knee back to the shape it was in before the skiing incident.  It's a very good thing that you were in great shape before the accident--that will only help you recover.

My surgeon's web page (Dr. Steadman): http://www.steadman-hawkins.com/

Information on chondral lesions or defects, which *can* happen after a blow to the knee.  I'm not saying this is what you have, it's just worth reading to become familiar with the anatomy and issues that can arise when there is trauma to the knee like you had.
http://www.steadman-hawkins.com/knee_chondral/overview.asp

Heather
Posted by tomscales (tomscales), 23 January 2005

Thanks so much for the prompt reply, Heather; I appreciate the advice and web references.  I'm in Portland, OR -- not exactly a "ski town" (especially this winter!) but I should be able to track down a good orthopedic knee specialist without too much trouble.   I did a "light" stair workout yesterday and it didn't really hurt...so that's a good sign, right??

Thanks again,
Tom

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