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Had an off 2 weeks before holiday and must have smacked the front of my knee. A 10p sized scab and It was a bit tingly above the kneecap, painful if knocked and an intense pain if I pulled the flesh there or trousers did. BUT zero joint pain - I could ride and walk just fine.
5 days of uplifted BasqueMTB trip were fine, just had to be careful taking my kneepad off, but the end of the 5th day suddenly a shitload of fluid on there. reading around I reckon ive damaged the pre patella bursa.
so no more riding. The local medical centre drained c120ml from it on Sunday And I’ve spent a week in Ainsa sitting around taking it easy while K and others ride in superb weather (which has been glum).
the treatment seem to be RICE (and anti inflammatory drugs) and I’ve been mostly following that - no more than gentle walks (I’m doing the fat tourist car park - church thing) and the steps up to the old town a couple of times. It took me until last night to realise a 1.5L Evoc bum bag water pouch makes the perfect ice pack but I had some “ice spray” I was using before
it seems no better - I’ve got as much fluid on it now as I had a week ago, to the point it’s getting really uncomfortable and I’m going back to the medics.
anyone had this? How long did it take to improve? How do you know it’s better? (other than the fluid I could ride now - I don’t want to get nearly better and screw it up again).
The NSAIDS often work for mild cases but it doesn’t sound like they will do the trick for this. Find a Sports and Exercise Medicine Dr out there, they can satisfy themselves there is no infection or joint involvement and then if they feel appropriate, inject the bursa with a combination of corticosteroid and local anaesthesia. Usually recovers pretty quickly… hope it eases soon!
Thanks. assuming this is private? How do I go about that - haven’t done that before (I’ll be in London when I get home)
and pretty quickly means?
You can see your GP but they can occasionally be a bit hit or miss, saying that, my favourite SEM Dr was also a GP so if you do not have insurance or money is an obstacle then your GP will be your first port of call. There are lots of SEM Drs around London, one example:
https://www.londonsportsphysician.co.uk/information/what-is-sem/
They list fees but its also worth checking the cost of the injection before booking.
If its an infection, I would guess at 7-14 days with antibiotics and if its just an injection needed for a bursitis and nothing else then a couple of days of rest and gradual return to activity, the Dr will obviously give you the accurate information for exactly what you need to do and they are the one to listen to!
I had a very similar looking injury picked up early July last year, although I had quite a bit more bruising. Was a not terrible impact, I finished my qualifying run and 6 hours later it ballooned.
Was diagnosed as Pre-patella Bursitis on my return home, very painful, the hospital were more interested in my bruised ankle that caused no noticeable pain. The various uk doctors were very much of the opinion it’d sort it self out.
It showed no sign of healing for many months. An eventual MRI showed a 9cm Hematoma. Was able to start riding with a swing crank in January, which was challenging at BPW.
Its still healing now and full range of motion returning.
@jamesoz so yours wasn’t bursitis? How was it treated. What’s a swing crank?
Not Bursitis but diagnosed as such. I only posted because every doctor I saw was convinced it was Bursitis Until a scan was eventually sorted.
RICE was about it for treatment and generic knee exercises that just made it worse.
unfortunately being on SSP I had to balance paying the mortgage with savings against maybe shortening recovery with private care.
All the uk doctors I spoke to were reluctant to drain, due to infection risk.
A scan was difficult to get as they said all they’d see is the fluid.
A swing crank has an extra pivot so injured knee doesn’t have to bend as much. Also known as a mobility crank.
So this isn't fun. Still no improvement - it's been 14+ days since it blew up now. Yesterday was spent at Doctors and the 'Urgent Care' at hospital. X ray and blood tests normal but I waited another 4 hours thinking next step was Orth doc coming back to aspirate and send sample of fluid for testing. It turned out he wasn't coming back and I was just waiting for a prescription. And that wasn't for antibiotics as nurse told me but just for painkillers I don't need.
the visit summary letter just says 'bursitis', no advice on treatment, physio appointment in 2 weeks but I've not got restricted movement so I'm not clear what thats going to achieve.
That's crap, but it's what both myself and wife have experienced recently with broken bones. MrsF has just been given a massive box of 30mg codeine from the GP, no appointment, for her chipped bone in her foot (done 5 weeks ago). I didn't get half as much for my extensively fractured pelvis. Aftercare has been atrocious.
Keep mithering your GP, as that knee looks terrible.
Here's an up to date pic. It's really weird, other that some sensitivity to touch in the bit where I've circled theres no pain (and it's the weight of the fluid pulling on that bit that is painful from the fluid). I've got full mobility and strength. I took a lime bike to the hospital yesterday FFS. But the fluid isn't going.
It's not hot and no secondary symptoms so they've counted out infection. The blood test eliminated gout (which would have been a massive co-incidence). 
Glad you’ve got full strength and mobility.
Being actual Bursitis, unlike my pretend bursitis, certainly my local trust couldn’t be less interested until around the 2 months mark when with next to zero joint mobility they finally put me in for an urgent scan.
With good strength and mobility I wouldn’t hold my breath.
What you need is just a tap on the knee…
…sorry, my attempt at some levity, but maybe it does require draining, despite the apparent reluctance of the medics to do so. I understand their concerns about infection, but surely they have sterile surgical procedures that can be carried out, hospitals do operations every day, having an operation on my eyes involves surgery, so what’s the difference between eye surgery and draining fluid from a knee injury?
I find that odd too. No one worries about infection risk when you give blood. The doc had no concerns the first time in Spain, but when I went back a few days later saw someone else and they said can only drain every few weeks. (Couldn’t work out why). Thing is, the fluid is the body trying to protect itself so really want to deal with the source.
im hovering between trying to get a steroid injection or paying for an mri scan at the moment.
How about an ultrasound guided injection, it'll clearly show the swollen bursa then, with the probe in situ, they can aspirate it then inject the steroid. A couple of colleagues of mine would do that for you if you're in Essex
How about an ultrasound guided injection, it'll clearly show the swollen bursa then, with the probe in situ, they can aspirate it then inject the steroid. A couple of colleagues of mine would do that for you if you're in Essex
that’s what I’m trying for. I think there are some private physios near me in London that look like they do it (and it might be what the nhs physio would do in a fortnight)
Private physio/ ultrasound a few days back. NOT bursitis. A Morel-Lavallée lesion (MLL): a closed soft-tissue degloving injury where the skin and subcutaneous tissues separate from the underlying fascia, often due to high-energy blunt force trauma. Injury can lead to a fluid collection (hematoma, seroma) between the separated tissues, potentially causing complications like infection and delayed diagnosis.
Drained it guided by ultrasound (big needle, local anaesthetic) and then bandaged up tight so that hopefully the layers knit back together. After c72 hours it’s looking like at best only partial successful. 🙁
