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Spring Trauma: Cycling Blog by Adrian Fairbank

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As a knee surgeon, I am often asked about pain in the knee, and this shall be the focus of the next few blogs.

Perhaps still the most common question I am asked relates to trauma. Even though the threat of black ice has largely gone, falls due to gravel or front wheel punctures remain common. This weekend a fellow rider landed heavily after losing the front wheel to gravel on a bend. Firstly we assessed them for head injury – and level of consciousness.

Should you be unlucky and have a fall and injure the knee, think first about your and your colleagues safety. Remove your self from the risk of secondary injury from motorists and other cyclists – get to the side of the road and away from corners. If the fall was due to ice or oil let other cyclists know with a warning shout.

Once you have ‘come to’ check the situation out with a rapid self-assessment of how serious the injury is. Are you in severe pain, can you weight bear? A fracture will usually be very painful, and often make it difficult to weight bear. In this situation, call an ambulance.

Should there be bleeding from lacerations, road grazes or cuts apply pressure to stop heavy bleeding. Pick out any large macroscopic debris. Once home wash the area with an antiseptic such as Savlon. This can ‘sting’ a little. Wash out the smaller debris and if heavily contaminated get to A and E – the wound might need to be cleaned under local anaesthetic. To be cleaned effectively the area would need to be numb.

Once clean, apply a dry non- adhesive dressing such as Melanin, cover this with a thin layer of dressing gauze, and then a firm (but not) tight crepe bandage. This should be changed daily until the area starts to heal and dries up. Antiseptic creams can help reduce infection but also keep the area supple and reduce risk of cracking skin.  Healing can take 10 days or more, and covering the wounds to protect from the rubbing of clothing can help.

If concerned get to see a medical professional. At our clinic we have a nurse who can see you if insured, but many GP practices have a nurse who can help you as part of the NHS treatment .

If you have persisting symptoms do get it checked out. I have come across many traumatic injuries to the front of the knee that have caused damage to the articular cartilage of the patella and these have warranted further assessment and treatment.  For further information click here.

Safe cycling.