TMBRA - Rider Board

[racerx68]

Doc,

Hi. Just over a month ago, my right foot came un-clipped from the pedal and I struck the thumb paddle of my rapid fire shifter with the inside, upper portion of my right knee. It actually didn't cause much pain initially, just a slight discomfort and it also left a small skin absarsion...no blood though.

I didn't think much of it initially but, as the ride progressed, the discomfort level intensified, mostly during the up(pulling) pedal stroke on the affected side. I finished my ride and for the next day or two, I could feel a slight pain, especially when climbing or descending stairs. It felt like a Charley Horse. After about 4-5 days the pain completly subsided until....... I rode my bike again!!! (about one week later) I was about 4 miles into the ride when I began to feel the same pain I felt the day I damaged it. At that point, I stopped the ride and decide to take a full, two week hiatus. Unfortunatley, two weeks later, another ride and the same issue!!!

Now, I'm really upset. I hate not being able to ride my bike. Anyway, after conducting a little research, I've come to the possible conclusion, I may have a damaged MCL. The mark on the inside of my knee is consistent with the area where the MCL is located. Does this sound correct? If so, does this sound like a bruise, or worse, a tear?
How long do these take to heal and what do you reccomend for diagnosis and treatment?


Thanks Doc



Joe

[Anonymous]

I dealt with the same problem in late sept and oct. I would have a horrible pain when I would pull up on the pedals. Yes I have MCL damage. Instead of surgery I am healing through prolotherapy. Look it up on the web. It is a great alternative to surgery and you can still ride and do whatever while taking it easy. If you have any questions pm me and I will talk with you.

[The Bike Doc]

racerx68:

Your type of injury and symptoms are consistent with an injury to the medial colateral ligament (MCL), the ligament along the inner aspect of the knee. It provides stablility to the knee from lateral forces that would force the knee inward. Treatment usually is non-surgical even for severe tears. You may benefit from a orthopedic and a physical therapy evaluation so a rehabilitation and prescription for a hinged knee brace may be provided to maximize your recovery.

Prolotherapy may or may not be of benefit for you. Most MCL injuries that are rehabilitated correctly do well with conservative therapy. Here is a summary of an article on Prolotherapy:

Clin J Sport Med. 2005 Sep;15(5):E376.

A systematic review of prolotherapy for chronic musculoskeletal pain.

Rabago D, Best TM, Beamsley M, Patterson J.

University of Wisconsin-Madison, Madison, WI 53715, USA.
David.Rabago@fammed.wisc.edu

OBJECTIVE: Prolotherapy, an injection-based treatment of chronic musculoskeletal pain, has grown in popularity and has received significant recent attention. The objective of this review is to determine the effectiveness of prolotherapy for treatment of chronic musculoskeletal pain. DATA SOURCES: We searched Medline, PreMedline, Embase, CINAHL, and Allied and Complementary Medicine with search strategies using all current and historical names for prolotherapy and injectants. Reference sections of included articles were scanned, and content area specialists were consulted. STUDY SELECTION: All published studies
involving human subjects and assessing prolotherapy were included. MAIN RESULTS:
Data from 34 case reports and case series and 2 nonrandomized controlled trials suggest prolotherapy is efficacious for many musculoskeletal conditions. However, results from 6 randomized controlled trials (RCTs) are conflicting. Two RCTs on osteoarthritis reported decreased pain, increased range of motion, and increased patellofemoral cartilage thickness after prolotherapy. Two RCTs on low
back pain reported significant improvements in pain and disability compared with control subjects, whereas 2 did not. All studies had significant methodological limitations. CONCLUSIONS: There are limited high-quality data supporting the use of prolotherapy in the treatment of musculoskeletal pain or sport-related soft tissue injuries. Positive results compared with controls have been reported in nonrandomized and randomized controlled trials. Further investigation with high-quality randomized controlled trials with noninjection control arms in studies specific to sport-related and musculoskeletal conditions is necessary to
determine the efficacy of prolotherapy.

Thanks,
_________________
Paul K. Nolan, MD
AKA: The Bike Doc