The WAITING ROOM => GENERAL KNEE QUESTIONS and comments (good for new threads) => Topic started by: Tamas on May 01, 2011, 03:57:11 PM

Title: My GP sent me to physiotherapy without diagnosis
Post by: Tamas on May 01, 2011, 03:57:11 PM
I had a hyperextension injury about two years ago, strain only, no dislocation. It took three weeks to get well enough for me to walk on it again, and about 8 weeks to get back to close to normal. I went to A&E at the time, where they ckecked for tears in the tendons (physical), but no x-ray was done.

I had the dull aches after light excersise and very slight swelling at weather fronts since, but nothing troublesome.
I started working out properly a couple of months ago, and since then it's progressively getting worse. At first it was a pain behind the kneecap, as if there was something sharp behind it. It felt slightly wobbly after running, but maybe because I was limping, and felt like it was going to give in during long cycle rides (no problem with the other knee).
It feels swollen all the time now and the joint is a different shape than the healthy one to the touch. It doesn't hurt as much during cycling now, but I try not to strain it and I stopped running. There's definitely something wrong, and it's not getting better.

I had to register with a new GP, my old one wanted to refer me to have an x-ray done, but he couldn't since I moved to another part of London.
The doctor I've seen at the new surgery have not gained my confidence to say the least... He ruled out an x-ray straight away, saying that it was "useless", but didn't offer any alternative, suggesting that the problem did not affect the "quality of my life" enough to warrant an expensive examanation. After him saying that a proper injury cannot be sustained from the accident happened to me, I sort of gave up, but he refered me to a physiotherapist at the end.

At this point I have the option to wait for the appointment or go to another GP (which I will eventually), and I could do with some wisdom from someone more experienced in the ways of the NHS. Can a physiotherapist treat me without knowing the problem, diagnose, or refer me to x-ray, orthopedist, etc.?

I am worried about this, as I never had problems with my joints before, and I know the sooner it gets treatment the better... I want to know what's the problem and I don't want to wait for it to get worse so a diagnosis can be made.
Title: Re: My GP sent me to physiotherapy without diagnosis
Post by: iain on May 01, 2011, 04:39:43 PM
to be honest I'm not surprised.  Referral to a physio treatment first is twofold.

  Firstly is can weed out those patients that don't actually need to see a specialist surgeon so taking pressure off orthopaedic outpatient lists by building up muscle strength and correcting imbalance and sometimes resolving the injury.  Whats the point of seeing a specialist registrar only to be referred to a physio...

And secondly the triage can help to prepare a patient for the rigours of surgery if eventually thats the way that is required.

Don't discount what physios can do - it is a form of treatment - and they should be professional enough to refer you for imaging or a specialist if they think they can't improve matters.
Title: Re: My GP sent me to physiotherapy without diagnosis
Post by: gooner on May 01, 2011, 10:21:44 PM
Agree with all of Iain's points, spot on.

Luckily my physio is great and I have learned a great deal from her. Physiotherapists have a range of established tests to perform and they can probably give you a good idea of the nature of your injury if you have one or possibly point to work needed on the muscle groups that support the knee.

Most importantly check that they will report back to your GP which gives them something to go on for further referrals treatment etc.

All the best.

Title: Re: My GP sent me to physiotherapy without diagnosis
Post by: Tamas on May 02, 2011, 01:05:23 PM
Thanks for the answers, I guess the best is to wait for the Physio.
This is not my first injury, and it was strange that no x-ray was done, since it seems they did one on other occasions, even if there was a remote possibility of fracture. It's good to know, however that the physio can refer if they see the need.
Title: Re: My GP sent me to physiotherapy without diagnosis
Post by: ExTra on May 03, 2011, 10:34:35 PM
When I went to see my physio for my torn ACL, she knew nothing about all the pervious dicussions I have had with the orthopaedics. She did the same set of tests as the docs and I had to tell her everything again.  To be honest, I think my physios ( my own one and her colleagues) talk more sense than the docs. My opinion is if you need a surgery then you need a doc, if you don't need surgery then all you need is a good physio. My doc told me to go the a gym and do something, that was all the advice I have had.