Physical Rehabilitation Medicine/Knee injury


Left knee injury after 5 days
Left knee injury after  
Hi Rachel, I fell off my road bike (whilst doing 24mph) 5 days ago hitting my left knee on the kerb/verge. I sustained a puncture wound which resulted in 3 stitches & a considerable amount of road rash that was scrubbed clean. The wound subsequently became in infected but it is responding well to antibiotics.

I have been resting, icing & elevating my knee but have no idea what else or when I should start to improve mobility. I am currently unable to bend the knee, when I stand there is considerable pain, predominantly below & on the knee, as well as an increase in swelling. I am also getting lots of ache in my quad.  An X-ray showed no break but I'm a triathlete & wondered if you could give me some advice about rehab? I don't want to just sit & rest when mobility is the key. Also I have a large area of redness towards the back of the knee & sensation is quite different to my non- injured knee. Is this normal or could this indicate nerve damage?

Many thanks

Dear Jane,
Ouch! That's my response to the picture.  Did you have toe clips on at the time you struck your knee?  That would add in more complications.

Good news is no fracture.  You still traumatized your knee joint.  The cartilage and ligaments at the knee may have been strained as well.

It would take an MRI to show if you tore a meniscus...that won't show on an x-ray.  You can take a few weeks (2-4) to slowly work back to some bending.  Let pain be a guide.  However, that being said you are a triathlete and that takes overcoming a certain amount of pain regularly.  So believe your body's signals that tell you to go slowly.

You may also need some help from a PT to gently help the kneecap regain the extra glide patterns called accessory joint mobility as part of recovering.

I am not sure about the altered sensation you are having in the back of the knee.  If there is anything that feels urgent to you, respect that and follow up with a PT or a doc.  Follow up if the knee isn't progressing in 4 weeks.  Otherwise give it some time to lose the swelling and ease back into motion.

Good luck and healing.

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Rachel Katz, PT, SEP


I have expertise working with recovery from car accidents, RSD/CRPS, neck and back pain and chronic pain. I can answer questions about pain that is not responding to expected patterns of recovery. I can address pain issues that are associated with traumatic events, and veteran associated pain issues. If you have had abuse or periods of significant stress in your life, your pain issues may be more complicated. I authored A Consumer Guide for Recovery from Car Accidents which discusses many aspects of injury recovery as all as specific detail about PTSD, traumatic brain injury, and protective involuntary muscle spasm. The link is: I can't answer questions regarding pain medications, or some specifics related to surgical interventions.


I have over 30 years experience as a Physical Therapy clinician. I taught swimming in Michigan and skiing in Aspen. I have experience in analyzing movement patterns and muscle control. I treat all areas of pain in the body including headaches, neck pain, back pain, shoulder injuries, plantar fasciitis, nerve compression, and knee pain. I have had personal experience with chronic pain, RSD, car accident injuries, PTSD, and traumatic brain injury (TBI). Muscle spasm and pain is a common component of injury and response to traumatic stress. Posture patterns and habits of how your body is often used can also contribute to pain. Restoration of movement and the senses that enable you to feel it are key. Rachel developed and implemented a stress reduction program for inmates within the Boulder County jail's drug and alcohol recovery program in 2005-2006 based on trauma healing principles from Dr. Peter Levine.

Rachel holds a BS in PT from the University of Colorado Health Sciences Center. She has over 30 years experience as a clinician. She has over 1500 hours of post graduate continuing education in many Manual Therapy and Exercise approaches. She completed her training in Somatic Experiencing under Dr. Peter Levine in 2000. This 3 year program trains therapists in treating traumatic stress conditions. Rachel has developed a body of work integrating her training and unique insights into complex pain issues. She is the developer and instructor for Sensory-Motor Manual Therapy, which is a State approved 2 day work shop for Massage Therapists through the Boulder College of Massage Therapy.

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