# Knee and Tibial Plateau Injury



## jtrink (Oct 27, 2010)

I commented in another thread about my injury, but figured I would start my own thread if anyone is interested. Last Sunday I was competing in my last CAT 3 XC race of the season at Bear Creek Mountain in PA. WIth about two miles left, I was descending down an extremely rocky switchback. I lost my balance on the turn and kinda barrell rolled, still clipped in, off the turn. It was a left hand turn and I believe my right knee struck a rock pretty hard. I was in pain when I got up, but nothing extreme. It just felt like I banged my knee a bit. I hiked back up to the trail and continued on my way. I didn't really notice any difference in my pedaling and actually finished the race in 2nd place (3rd overall in the series!). About 15-20 minutes after I stopped riding I was walking with a pretty good limp. I had pain in the bone right below my knee when I touched it and my knee felt wobbly when I tried to walk on it. I could put weight on it while standing without any pain as long as I didn't push off on my toes. 

I had an X-Ray and the doctor noticed nothing wrong but some 'slight loosening' in the tibial plateau region. I looked at the X-Ray and saw no visible cracks anywhere. So I got a CT scan of my leg and am currently awaiting the results. The swelling in my knee has gone down a good bit and I have full range of motion. The area that struck the knee doesn't really hurt either. I guess I'm more worried about the ligaments, tendons, and cartilage in my knee. It still feels really weird and unstable. When my leg isn't elevated my foot turns a slight purple color too. 

I should get the CT scan results back today and will update the thread when I find out more. I'm pissed because I was supposed to start Cross season this week too. IF this is really serious, I might just switch to racing road next year and just do MTB as a hobby. My brain doesn't have a switch to go slow! :madman:


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## jtrink (Oct 27, 2010)

The CT scan came back with a bit of good news. There is no fracture and no dislocation. Supposedly they were able to tell that the ACL, MCL, and PCL were still intact. I have pain whatsoever in my knee or tibia, and have absolutely no swelling. However, my knee feels unstable and at times weak. I go back to the doc August 20th to see if things tighten up on their own. In the meantime I'm able to walk without crutches and the immobilizer. I'm hoping I just strained the ligaments and nothing is torn.


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## kinsler (Sep 13, 2011)

You need an MRI to really see the ligaments in the knee


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## OMZ (Jul 15, 2012)

I believe it would be very hard to break your tibial plateau with an impact. The most common way to fracture a tibial plateau (and the way I did it) would be to hyper extend a leg so badly that the bottom of your femur essentially rolls on top of it and fractures it from above.

A good orthopedic should be able to have a pretty good idea if your ligaments are in tact as well just by testing the knee.


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## OMZ (Jul 15, 2012)

The only ligament in the knee that is commonly injured from impacts is the PCL. You can tear that one with a hard enough impact just below the joint. The PCL resides just behind the ACL and limits your tib / fib from being able to move back in the joint. Again, a good doctor should be able to feel that when testing the knee. The movement in the joint would be obvious and similar to an ACL injury. You wouldn't necessarily be in a lot of pain.

PCL injuries are most commonly found in auto accidents when a person with a bent knee strikes a dashboard below the joint.


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## DenverPoke (Apr 19, 2011)

OMZ said:


> The only ligament in the knee that is commonly injured from impacts is the PCL. You can tear that one with a hard enough impact just below the joint. The PCL resides just behind the ACL and limits your tib / fib from being able to move back in the joint. Again, a good doctor should be able to feel that when testing the knee. The movement in the joint would be obvious and similar to an ACL injury. You wouldn't necessarily be in a lot of pain.
> 
> PCL injuries are most commonly found in auto accidents when a person with a bent knee strikes a dashboard below the joint.


As one who tore their PCL (Grade 2.5) and had a TP fracture... My ortho initially misdiagnosed which ligament was torn. He thought ACL/MCL, but MRI confirmed it was an isolated PCL/ and Meniscus. This was misdiagnosis was partially due to the fact that he was not able to do a good physical test with my knee at the time.


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## OMZ (Jul 15, 2012)

DenverPoke said:


> As one who tore their PCL (Grade 2.5) and had a TP fracture... My ortho initially misdiagnosed which ligament was torn. He thought ACL/MCL, but MRI confirmed it was an isolated PCL/ and Meniscus. This was misdiagnosis was partially due to the fact that he was not able to do a good physical test with my knee at the time.


Sure, because like I said the symptoms for a torn ACL and PCL are nearly identical. But, your doctor knew something was torn and it required a more in depth look with a MRI.

If a good orthopedic doctor torques on your knee and feels the ligaments doing their job, then he/she can be fairly certain there isn't a complete tear. Now, that doesn't mean you may not have a partial tear or meniscus damage, those types of things can only be seen with a MRI.


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## jtrink (Oct 27, 2010)

Yeah I go back on Monday so the doc can run some physical tests on my knee. It actually has tightened up a little bit more. 

If you were to lay down press the insides of you two feet together, the inside of your knee should hold in the same position with little movement. The inside of my injured knee feels like it shifts a little more than my good knee. But not by much. I'm very tempted to go for a run on it, but don't want to do more damage.


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## jtrink (Oct 27, 2010)

Well I jogged 3 miles on it at a 9:24 pace. I didn't sprint or anything. I had zero pain but it just feels really funny. Quads got a decent workout.


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## jtrink (Oct 27, 2010)

I rode 30 miles last Saturday on the knee. Strength feels good but still having some discomfort. It still feels lose and weird so im scheduled for an MRI on Thursday. I figured it's better to be safe than sorry before I start Cross season.


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## bballr4567 (Mar 12, 2006)

Honestly, Id take it easy until you get the results. If you do have a partial tear you can rupture the ligament with the slightest misstep. If you can, see if you can get the MRI done on a 3T (tesla) machine. It will give you a better image to see smaller tears.


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## jtrink (Oct 27, 2010)

bballr4567 said:


> Honestly, Id take it easy until you get the results. If you do have a partial tear you can rupture the ligament with the slightest misstep. If you can, see if you can get the MRI done on a 3T (tesla) machine. It will give you a better image to see smaller tears.


I'm not doing anything too crazy yet. I rode 15 miles last night with 1,500 ft of climb, but it was all road rides. I haven't been on the trails since I injured it.

The knee doesn't really hurt though. It just has a really weird loose feeling and it clicks/pops more than it used to. I have an MRI tomorrow morning, so hopefully it shows I just strained some ligaments or something.


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## kinsler (Sep 13, 2011)

Some light road riding is probably fine- cycling is great exercise to rehab your quads and quad strengthening would be the focus of any rehab for a partial ACL injury (or complete for that matter).


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## tedlove (Jun 23, 2011)

OMZ said:


> I believe it would be very hard to break your tibial plateau with an impact. The most common way to fracture a tibial plateau (and the way I did it) would be to hyper extend a leg so badly that the bottom of your femur essentially rolls on top of it and fractures it from above..


OMZ, just curious - how did you sustain a TPF? I just did it a couple months ago after colliding with a guy on the outside of my knee (as you described, femur caused the fracture). Anyway, I'm just starting to be able to try walking on it now - 2 months post-op. Was just wondering how bad your injury was and what your recovery time was like? Unfortunately, I think I won't be on my mt bike until next year...


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## tedlove (Jun 23, 2011)

jtrink said:


> I have an MRI tomorrow morning, so hopefully it shows I just strained some ligaments or something.


Any word on the MRI results?


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## jtrink (Oct 27, 2010)

tedlove said:


> Any word on the MRI results?


Nope, not yet. I had the scan Thursday morning so I might hear something today or on Monday. I rode 65 miles this week so far - all road riding though.


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## Wankel7 (Jan 5, 2006)

OMZ said:


> I believe it would be very hard to break your tibial plateau with an impact. The most common way to fracture a tibial plateau (and the way I did it) would be to hyper extend a leg so badly that the bottom of your femur essentially rolls on top of it and fractures it from above.
> 
> A good orthopedic should be able to have a pretty good idea if your ligaments are in tact as well just by testing the knee.


I earned a tibial plateau fracture by landing on the flat of a big ass jump on my snowboard. Fun.


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## bt (Nov 24, 2007)

op you're fine


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