kneecap bruising, stack injury

[Norco Maniac]

not really asking for advice so much as anecdotes of similar injuries. i'm wondering if what's happening in my knee is a normal result of a stack injury.

last wednesday was the last points round of Retro for this round. i'm last in the field, usually, but one of the few consistent riders so although i'm trailing i give it all i've got, you know? so i came out of the start gate, feeling pretty good despite a double-header two-class weekend previously and hit the doubles at good speed, no worries.

next thing i know, i'm left knee, right elbow and right temple/helmet driving into the track then beartrap pedal scrape up the back of the left leg, bang to the left shin and bang on the left back of the helmet from the rear wheel of my bike. i've tried to stand up but the left leg wouldn't bear weight and so the first aid takes me off track to patch me up.

despite Thor Static elbows and Raceface Flank leg armour (i choose soft padded armour for a reason) my right elbow is bruised, left back of calf bruised and sliced open by the beartraps, i have tyre marks in my helmet, a wrenched neck and a bruise on my back where the bike hit. the biggest problem, however, is the left knee. first point of impact but with a good inch of soft armour. i have a peppering of 20c piece-sized bruises all over the knee and surrounds but i cannot for the life of me stand even a sheet scraping over the kneecap. it's a nasty sharp sting rather than a bruise feel, and if i knock it (which of course i have a few times these last few days) it's like the first hit all over again, tears to the eyes and all.

those of you who know me also know i can take a hit. i'm treating it with Hiruidoid ointment, massage and Arnica plus the occasional Nurofen when i have to ride. i can't kneel on it, knock it, or bear full weight and am very reluctant to fully bend or straighten it. i've done a couple of rides since but no racing and not happy to do so. there's some swelling but no more than maybe a cm or two.

so yeah. is this stinging sensation on contact normal? is there more bruising to come? and how the hell did i do this with armour on?

 

[Laura_Renno]

Just a thought?

not really asking for advice so much as anecdotes of similar injuries. i'm wondering if what's happening in my knee is a normal result of a stack injury.

last wednesday was the last points round of Retro for this round. i'm last in the field, usually, but one of the few consistent riders so although i'm trailing i give it all i've got, you know? so i came out of the start gate, feeling pretty good despite a double-header two-class weekend previously and hit the doubles at good speed, no worries.

next thing i know, i'm left knee, right elbow and right temple/helmet driving into the track then beartrap pedal scrape up the back of the left leg, bang to the left shin and bang on the left back of the helmet from the rear wheel of my bike. i've tried to stand up but the left leg wouldn't bear weight and so the first aid takes me off track to patch me up.

despite Thor Static elbows and Raceface Flank leg armour (i choose soft padded armour for a reason) my right elbow is bruised, left back of calf bruised and sliced open by the beartraps, i have tyre marks in my helmet, a wrenched neck and a bruise on my back where the bike hit. the biggest problem, however, is the left knee. first point of impact but with a good inch of soft armour. i have a peppering of 20c piece-sized bruises all over the knee and surrounds but i cannot for the life of me stand even a sheet scraping over the kneecap. it's a nasty sharp sting rather than a bruise feel, and if i knock it (which of course i have a few times these last few days) it's like the first hit all over again, tears to the eyes and all.

those of you who know me also know i can take a hit. i'm treating it with Hiruidoid ointment, massage and Arnica plus the occasional Nurofen when i have to ride. i can't kneel on it, knock it, or bear full weight and am very reluctant to fully bend or straighten it. i've done a couple of rides since but no racing and not happy to do so. there's some swelling but no more than maybe a cm or two.

so yeah. is this stinging sensation on contact normal? is there more bruising to come? and how the hell did i do this with armour on?

Hey,

Sorry to hear about your fall.

Just a thought maybe you should go have an X-Ray and MRI to assess any damage?
I had a fall out riding 4 weeks ago and ended up with 2 fractures in my patella.
I managed to ride home with it. I didn't even fall hard. Never ever imagined i'd fracture it.
Couldn't weight bear or bend either. Sharp pains like you too.

Your GP can refer you for an MRI you will just need to have it done privately (~$100-200).
Hopefully some imaging can rule out or in something for you?? You definitely need a plain X-Ray though.

All the best

(Just saw you weren't looking for advice, it's a similar injury though so hopefully helps)

 

[Mywifesirrational]

Hows it going a week later?

Basically even with knee armor on the patella has been compressed (obviously under significant load) into the sub patella articular cartilage, this will have caused bruising and inflammation 'inside' the knee - this will primarily be what is restricting end range movement - the regards to the nasty sharp sting, you have gone to the Dr's to have it checked out as Laura has suggested? there may be a minor fracture in there and/or cartilage, menisci or ligament damage?

Depending on the level of trauma you have caused, it actually may get worse over the next week or two - if an osteophyte forms in the area where the cartliage is bruised/damaged it will result in significant and sharp pain on pressure to the patella. When I did something similar along with a patella fracture it was a long time before i could kneel on it without significant pain - it was a really shitty injury that dragged on for a long time, worse than a clavicle or femur fracture.

 

[mars mtb]

Hey there,

Firstly bad news on the crash, they are not fun.

As the others have said, definitely seek medical attention. Re the X-ray and MRI make certain you are referred to a place that knows what they are doing. The MRI takes different views of layers and shows the internal damage to layers, but it must be done properly by a skilled examiner. Eg. The first place I was sent to after a crash years ago showed all clear, a month later another MRI undertaken by an alternate place showed massive damage and hence was the reason for not healing well through rehab. In particular deep bruising not only on the inside of the patella but also on the top of the tibia. Like your knee it was mega painful to light touch.

I was then locked in to have surgery and was turning the legs over in a month.

So yep go get checked ASAP don't try and tough it out as it may potentially delay the fix it may need.

Good luck.

 

[shakes]

Depending on the level of trauma you have caused, it actually may get worse over the next week or two - if an osteophyte forms in the area where the cartliage is bruised/damaged it will result in significant and sharp pain on pressure to the patella. When I did something similar along with a patella fracture it was a long time before i could kneel on it without significant pain - it was a really shitty injury that dragged on for a long time, worse than a clavicle or femur fracture.

I think you just explained why I couldn't kneel for a good part of my teens and 20's

Would that show up on an x-ray?

 

[Mywifesirrational]

I think you just explained why I couldn't kneel for a good part of my teens and 20's

Would that show up on an x-ray?

Not unless they were looking for it / got lucky and/or the scans were done a week or two after the injury so the calcification was occurring to show up on xray - it may not having anything to do with the knee pain in this case, but I would think it needs to be investigated / ruled out.

Because the sub patella space is essentially surrounded but bone and xray will struggle to show and clarity in this case (any radiologist on here confirm that?) a CT or MRI would be needed I think - although I only read the radiologists reports once people are ready for rehab - so there methods and abilities are a bit of a mystery to me.

Its a bit like when you smack you shin into something hard - you 'crack the periosteum layer and it heals much like a normal fracture but you get a calcified lump, bone remodelling takes years so the lump lasts for years, if that occurs under your patella it would explain the trouble kneeling. Unfortunately, it also most likely predisposes you to a very high chance of osteoarthritis (or you could have stayed on the couch your entire youth and died of heart disease... so oh well).

 

[Norco Maniac]

hiya gal and guys, and thanks for all the replies and info.

ok. nearly two weeks on, and i didn't train or race last week because i couldn't stand the pressure of the armour on the kneecap. i'm fairly certain there's no breakage (i'm a health care worker myself) but i think you're right, MWI, in saying that the patella being forced down on top of the femur and tibia ends has created a lot of internal bruising in the joint, and probably inflammation in the joint capsule itself. that would explain why it felt like there was rubber stopper preventing me from fully straightening the knee. i do know i had a minor medial meniscus tear in that knee in about 2002 that resolved itself after a few months.

the nasty sharp sting seems to be bruising on the top of the patella itself, which is slowly getting better but i still can't kneel on it. on palpation it's still relatively soft, there's actually not a lot of bruising visible at all, but internally it's still pretty tender. it tends to ache a lot at night, especially on the medial side of the end of my femur and i'm having trouble finding a comfortable position without a pillow between my knees.

i've been on the bikes for my usual commutes and shopping runs and i managed to ride a training session last night but i might skip Wednesday night's fun night at racing in favour of the 30 year celebrations at Gawler on Sunday - normally i'd ride both - but we also have the last round of the State Series the next weekend (two classes) .... it looks like i may come out of that with good points yet.....

thanks again being over here in SA without access to the practitioners i've known for 20 and more years is a bit unsettling to say the least!

 

[Sic]

At the start of this year I had a pretty minor OTB incident at slowish speed but managed to break my fall with my left knee straight onto a rock. I didnt hurt too badly at the time, finished the ride figured i'd be sore for a few days and that would be it. Not so much.

There were no visible signs of bruising but my knee swelled and was very sore the next day, I couldnt load bear on it very well, couldnt bend it and nearly cried if I tried to kneel on it. This went on for quite some time...I could ride ok but everything else was problematic and it felt like it was grinding. After a few weeks I started to think I had done something very wrong so I went to see a doctor, he refereed me to get an MRI.

Got the MRI ($300 and no sir your comprehensive private health cover doesnt cover any of that expense thankyou very much....) and they found nothing......

So I kept putting heat and ice on it (heat pack at night to get comfy) and just took it easy. Eventually it came good but it took a few months for things to be back to normal, keep in mind though that im 37 and things take longer to heal at my age!

So after all that there doesnt seem to be any long term damage and my knee function is back where it should be and now I use Fox Launch knee pads on all my rides, even the bog standard cross country ones that arent too long. I figure the sweat and looking over dressed is worth it in the long run.

 

[shakes]

Not unless they were looking for it / got lucky and/or the scans were done a week or two after the injury so the calcification was occurring to show up on xray - it may not having anything to do with the knee pain in this case, but I would think it needs to be investigated / ruled out.

Because the sub patella space is essentially surrounded but bone and xray will struggle to show and clarity in this case (any radiologist on here confirm that?) a CT or MRI would be needed I think - although I only read the radiologists reports once people are ready for rehab - so there methods and abilities are a bit of a mystery to me.

Its a bit like when you smack you shin into something hard - you 'crack the periosteum layer and it heals much like a normal fracture but you get a calcified lump, bone remodelling takes years so the lump lasts for years, if that occurs under your patella it would explain the trouble kneeling. Unfortunately, it also most likely predisposes you to a very high chance of osteoarthritis (or you could have stayed on the couch your entire youth and died of heart disease... so oh well).

Makes alot of sense, thanks. I couldnt not kneel, it was just very uncomfortable, I put it down to crashing lots, local country doc couldnt see squat on the xray. My shin's are very lumpy too funily enough.

Sorry for the hi-jack.

 

[Norco Maniac]

no worries, shakes. i did ask for anecdotes of similar injuries!

went for a couple of rides yesterday, probably only 30k in all, hardtail and race cruiser. bumped the knee on my saddle lifting the leg over the hardtail, still brought tears to my eyes and it's very tender today. one more club points round Wednesday, then a two-day two-class weekend coming up for Gawler's birthday celebrations and to finish off the current State Series.

the knee two weeks later below, the external bruising has disappeared now at almost three weeks but as i said it's still pretty sore. very glad i was wearing armour when i did this.

my apologies for the British tan