How Ascent’s Acute Knee Clinic Can Help You – Dr. Fisher |DC

  • Posted July 27, 2019

Did you know we offer Acute Knee Injury services?  Following a knee injury, an accurate and timely diagnosis is critical to setting up the right course of action for management, referrals to specialists (if necessary), rehabilitation and return to full function. I (Dr. Fisher) know from personal experience how true this is.

Let me tell you a story.

I was mountain biking in Canmore this past May down a trail called Reclaimer.  Following a friend down a tricky part of the trail I hesitated while dropping over a rock, tapped the breaks – and entered full superman mode over the handlebars and landed on some gnarly sharp rocks.  I felt banged up, had a few cuts, but generally felt lucky.

Until I finished the ride.

I could tell I was hurt – but figuring out to what extent took a team of people who took their time, followed up and actually cared.

Day 1- Crash

Day 2 – Assessed by Ascent’s Dr. Menta, Sport Specialist and Mark Austin, PT.  Referred for X-Ray and ultrasound.

Day 3 – Got ultrasound and X-Ray

Day 4 – Radiologist report came in.  No fracture noted.

THIS PART IS KEY: We looked at the images ourselves and did not agree with the report.  Dr. Menta immediately called the radiologists for another look and they agreed that there was something suspicious at the location of pain and tenderness on my patella (knee cap).

Key questions remained: if there is a fracture, is it stable?  If it’s not stable than urgent surgery is required and I should not be weight bearing.  If there is no fracture, more aggressive rehab should begin immediately.  If  it is a stable fracture – weight bearing is okay, but not aggressive rehab until it heals.

Specificity in a diagnosis leads to specificity in management.  Uncertainty leads to mismanagement.  

Day 5 – Certainty was needed.  Went in for an urgent CT scan and to have blood & fluid drained. This speeds recovery by weeks. Initial report from resident said no fracture (but made no mention of the patella either way)

Day 6 – Early that morning I received a call from senior radiologists – confirmed there is a fracture at the suspected site by Dr. Menta, Mark and myself

Day 7 – Obtained images of CT scan – a very clear fracture was noted – it just took someone who knew the full history and took the time to investigate thoroughly

Day 8 and on: A clear and precise management strategy could unfold, including:

  • Temporary bracing for support while weight bearing: We stock Bauerfiend Genu Train (semi custom) and Don Joy Custom braces
  • Pain and inflammation control through modalities, mobility exercises, patella mobilizations
  • Rehab included: Progressive retraining of quad (thigh) muscles, regaining ROM, hip and core stability training
  • Guided return to tolerable physical activities

1 month post accident I was able to get back on the bike and compete in the 25 km Rundles Revenge Mountain Bike Race.  The race was my second time back on the bike after the accident. Although the strength was not fully back, and there was soreness involved – we knew we were not causing further damage (thanks to an accurate diagnosis) – only to my pride as I rolled in 37th place out of 41 in my category 🙂

Some pain and discomfort during activity is good for healing

On day 2-6 above, I thought my summer plans of hiking, biking, paddling, backpacking were over.  Through the persistence of a great team, I’ve been able to modify slightly and keep active outside.

Ascent offers Acute Knee Injury clinical management including: a thorough history and orthopedic examination, imaging referrals, Sports Medicine and Orthopedic referrals when necessary, custom knee bracing and comprehensive rehabilitation and return to play programs.

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