Knee Injuries and Nerve Issues: When to See a Specialist

Knee injury and foot numbness issues?

Hello, Doctor.
I apologize for bothering you again.
This is Mr.
Lin, who asked a question yesterday.
After I sustained an injury during a massage over a month ago, I haven't returned for any treatments and have not exercised during this time.
However, my condition has not significantly improved.
If I want to get checked out soon, should I still see an orthopedic specialist? You mentioned that it doesn't seem like a cruciate ligament issue, so would it be more appropriate to see a rehabilitation specialist for physical therapy? However, since you indicated that there might be nerve damage, should I see a neurologist instead? My foot numbness is not to the extent that I can't walk or have no sensation; it's more of a slight tightness.
Do rehabilitation specialists also perform nerve conduction studies? Thank you.

Lin Xiansheng, 20~29 year old female. Ask Date: 2016/07/06

Dr. Shi Guozheng reply Orthopedics

You can schedule an appointment with the Rehabilitation Department, which also performs nerve conduction studies.

Reply Date: 2016/07/06

More Info

When dealing with knee injuries and potential nerve issues, it is crucial to understand the nature of your symptoms and the appropriate specialists to consult. Given your situation, where you have experienced persistent discomfort and potential nerve involvement following a massage injury, it is advisable to take a systematic approach to your healthcare.

Understanding Your Symptoms
From your description, it seems you are experiencing ongoing issues related to your knee, possibly compounded by nerve involvement. Symptoms such as tightness and mild numbness can indicate nerve irritation or compression, which may not necessarily be severe but still warrants attention. The fact that you have not engaged in physical activity since the injury could also contribute to stiffness and discomfort.

When to See a Specialist
1. Orthopedic Specialist: If you suspect that your knee injury may involve structural damage (like ligaments, cartilage, or bones), it is wise to consult an orthopedic surgeon. They can perform a thorough evaluation, including physical examinations and imaging studies (like MRI or X-rays), to determine if there are any significant injuries that need surgical intervention or specific rehabilitation.

2. Physical Rehabilitation Specialist: If the orthopedic evaluation suggests that your injury is not severe and primarily involves soft tissue or muscular issues, a referral to a physical therapist or rehabilitation specialist may be appropriate. They can develop a tailored rehabilitation program to strengthen the knee, improve range of motion, and address any muscular imbalances that may have developed due to inactivity.

3. Neurologist: Given your concerns about potential nerve damage, consulting a neurologist could also be beneficial. They can perform nerve conduction studies and electromyography (EMG) to assess the function of your nerves and determine if there is any significant nerve injury that requires treatment.

Diagnostic Pathway
- Initial Consultation: Start with an orthopedic consultation to rule out any major structural issues. They can provide a comprehensive assessment and guide you on whether further imaging or tests are needed.

- Physical Therapy: If the orthopedic doctor concludes that your injury is manageable with conservative treatment, they may recommend physical therapy. Physical therapists can also assess nerve function and may perform specific tests to evaluate nerve integrity.

- Neurological Assessment: If there are persistent symptoms of nerve involvement, such as tingling or tightness, a neurologist can help clarify the situation. They can determine if the symptoms are due to nerve compression or another underlying issue.

Conclusion
In summary, the best course of action is to start with an orthopedic evaluation to assess the knee injury. Depending on their findings, they may refer you to a physical therapist for rehabilitation or a neurologist if nerve involvement is suspected. It is essential to address these issues promptly to prevent further complications and to facilitate a return to normal activities. Remember, early intervention often leads to better outcomes, especially in cases of musculoskeletal and nerve-related injuries.

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