Need cycling-specific ortho recommendation

[cutter]

Anyone know of an orthopedist who either rides or has experience working with cyclists?  Not necessarily in Austin, I'd be willing to drive a ways to see the right doc.

I sustained a very unusual and potentially debilitating injury to the cartilage in my lower ribcage. Nasty situation, I don't care to share the gruesome details here. I am already seeing a good ortho and PT but I would like to get an opinion from a doc who "gets" cyclists and the specific physiology involved in the sport to make sure my rehab is focused properly.  I really need to make sure I rehab this properly.

Lots of interconnected muscles and other structures involved. Hoping to find a doc who has personal experience with the sport and speaks our language, who gets how it all fits together.

I have the same ask for a GP / PCP if anyone knows a local doc who rides.  Even a serious roadie or triathlete would have a better frame of reference.  My current family doctor is a lovely woman but she's way out of her depth on this one.

Thanks in advance for any help anyone can offer.

Edited September 5, 2023 by cutter
length

[throet]

I'm surprised that you haven't gotten any responses, as usually there are plenty of opinions on medical care here. However, this is a very specific request that understandably folks may shy away from. Hopefully you're already getting the care you need, but if I had to recommend somebody local, it would probably be this guy. Honestly not sure if he bikes at all, but I've seen him for a couple of different issues that have impacted my biking. I've never been disappointed. Good luck with your ailment. I know from experience that rib injuries are a drag. Treatment options are extremely limited though, and you may find that just giving yourself the rest needed to recover will let that soft tissue repair on its own. 

Matthew D. Driscoll, MD- Orthopedics | Austin Regional Clinic

Edited September 9, 2023 by throet

[cutter]

1 hour ago, throet said:

I'm surprised that you haven't gotten any responses, as usually there are plenty of opinions on medical care here.

Thanks man - I was starting to think that maybe I'm just not that well-liked 'round these parts.  But yeah, it's a super specific ask, I wasn't hopeful but I figured I'd roll the dice. The usual suggestions I have seen on here like Airrosti etc. are not gonna cut it.

I am seeing a very good ortho and PT and I am certain they're doing me right. I like them a lot. Not looking to change course on treatment, just want to make sure I get this one right.

Lots of things factor into this and I have several questions about how it all ties together, my riding style and position, bike fit, the fact that I ride a single speed, etc.. Stuff that another cyclist would intuitively grasp and perhaps have more informed suggestions or a sympathetic ear.  I'm honestly worried that I will have to give up MTB, or drastically curtail my riding style to the point where it's just not much fun.  The way I feel right now, I don't see myself riding trails for a long time, I can't put any power into the pedals or steer with my hips at all.  I am definitely not going to Angel Fire this fall as I had planned.  I am making progress but it's frustrating.

Cartilage injuries suck.  Stupid thing is, it's not exactly "painful" apart from all the muscle tightness around the injury, which ain't great but it doesn't hurt the way a fracture or a muscle or ligament injury would.  I can suck it up but it is extremely discomforting, it's messing up my sleep, can't sit in one place for long, can only do zone 1-2 gravel rides, no standing, all spinning.  I feel like if I move the wrong way my whole rib cage is going to rip open.  Obviously that's hyperbolic, but it **feels** scary as hell.  Like I said, frustrating.

[ssorgs]

Maybe not exactly what you're looking for but highly recommend Dr Chris Sellers at Performance Wellness.  He's a chiropractor and treats lots of athletes, including myself from time to time and a couple of friends who ride.  We all consider him a miracle worker as he's been great at diagnostics, especially, and treatment.  One friend was having knee pain that turned out to be from pelvic issues and weak core that no one else was able to figure out... YMMV of course.

[cutter]

On 9/10/2023 at 2:44 PM, ssorgs said:

Maybe not exactly what you're looking for but highly recommend Dr Chris Sellers at Performance Wellness.  He's a chiropractor and treats lots of athletes, including myself from time to time and a couple of friends who ride.  We all consider him a miracle worker as he's been great at diagnostics, especially, and treatment.  One friend was having knee pain that turned out to be from pelvic issues and weak core that no one else was able to figure out... YMMV of course.

Thanks man.  My PT offers most of the same treatments as those guys, apart from chiro.  Chiro will probably be my last stop on this journey, hopefully when/if my ribs stabilize somewhat and my muscles settle down, I'll check Dr. Sellers out then.

[dlstyley]

I’ll second both recommendations.  Driscoll was great.. not biking specific but a good ortho surgeon if you need it.  

But from your description, I’d recommend a visit to Sellers now.  He is excellent, and one visit is pretty low commitment.  Most PTs I’ve been referred to (well, all of them actually) don't provide much value.  They are just milking the insurance from the referral and going through the motions.  I was also highly skeptical of chiropractors having heard all the stories but having not actually visiting a good one, but as a serious chiro/PT, he has an excellent grasp of anatomy, biomechanics, and how that translates to a lot of athletic endeavors, including cycling.  My only complaint, which really isn’t, is that each visit you only spend a few minutes with him, but it’s amazing how quickly he diagnosed a really old shoulder issue and helped me understand the root cause and treatment.  Then he sends you to his PT room where less skilled people work you through his prescription.   Go see him once, and if you don’t find it extremely beneficial, then just don’t go back.  

[Cafeend]

On 9/9/2023 at 6:25 PM, throet said:

I'm surprised that you haven't gotten any responses, as usually there are plenty of opinions on medical care here. However, this is a very specific request that understandably folks may shy away from. Hopefully you're already getting the care you need, but if I had to recommend somebody local, it would probably be this guy. Honestly not sure if he bikes at all, but I've seen him for a couple of different issues that have impacted my biking. I've never been disappointed. Good luck with your ailment. I know from experience that rib injuries are a drag. Treatment options are extremely limited though, and you may find that just giving yourself the rest needed to recover will let that soft tissue repair on its own. 

Matthew D. Driscoll, MD- Orthopedics | Austin Regional Clinic

Dr Driscoll did my wife's surgery after a nasty broken leg incident. He was great. When my son sustained a leg injury and broken leg he is who we first turned to.

Highly second Matt.

 

[cutter]

On 9/9/2023 at 6:25 PM, throet said:

I know from experience that rib injuries are a drag. Treatment options are extremely limited though, and you may find that just giving yourself the rest needed to recover will let that soft tissue repair on its own.

What was your rib injury?

[throet]

8 hours ago, cutter said:

What was your rib injury?

I took an awkward fall off the bike and landed hard on my side. Right away I knew something was wrong because even breathing was painful. Xrays showed no rib breakage though. I never knew what exactly the injury was, but I recall having to be very still for a couple of weeks. Getting in and out of bed, in and out of the car, etc was very painful during the healing process. It was probably just a strain to the muscle or connective tissue surrounding my rib cage. You mentioned damaging cartilage though, which doesn't generally heal well on its own. So, I can understand why your situation is unique and potentially debilitating. Hope you are able to get things sorted out. 

[cutter]

3 hours ago, throet said:

I took an awkward fall off the bike and landed hard on my side. Right away I knew something was wrong because even breathing was painful. Xrays showed no rib breakage though. I never knew what exactly the injury was, but I recall having to be very still for a couple of weeks. Getting in and out of bed, in and out of the car, etc was very painful during the healing process. It was probably just a strain to the muscle or connective tissue surrounding my rib cage. You mentioned damaging cartilage though, which doesn't generally heal well on its own. So, I can understand why your situation is unique and potentially debilitating. Hope you are able to get things sorted out. 

Yeah, I wish this was just an intercostal muscle strain.  Those are painful but will usually heal eventually.  Cartilage, not so much, sort of the opposite, not painful because there are no nerves in the tissue, but also not able to heal because there are no blood vessels either.  It's God's little design flaw.

[cutter]

Just wanted to follow up and say thank you to @dlstyleyand @ssorgs for the recommendation of Dr. Chris Sellers.  Good call.

I am still uncertain whether I will have to give up MTB. My ribs are very unstable and even riding my gravel bike is torture, can't put any power into the pedals without my ribs going all Jenga on me.

But I went to see Dr. Sellers and I can definitely say he's awesome. He listens, he is skilled and knowledgeable, and his staff are genuinely nice and helpful.  He is finding and addressing issues that I kinda-sorta knew about but was tuning out, and it's helping in ways I did not expect.

Between his adjustments and body work, and the PT I am doing through my ortho's office, I am definitely starting to feel better.  Still not healed, may never be healed, but getting better.

Long road ahead.  Thanks y'all for the reco.