Question
Last Friday, I was skating a concrete bowl, which resembles a small pool.  I fell backwards and as I fell I could feel myself twisting my lower back.  I have had swelling on my lower left side of my back.  I also have a knot in that location.  It is located on hip bone, towards my spine.  I can still move my back and body and I can still lift things, but it hurts to do all of the above.  I am thinking that I bruised the bone badly, but I want to make sure that I don't need to go to the doctor for this problem.

Answer
Dear Eric,

I would agree that you may have bruised the bone here if you directly fell on the pelvis.  Knots can be due to inflammation/swelling or contusions within the soft tissue, or due to an actual callous formation over the bone from a fracture (however this takes time to manifest).  So you probably have a pretty good strain/sprain here and the possibility of a fracture.

I would suggest that you monitor your symptoms, and use ice for pain...20 minutes over the knot, and repeat every other hour.  this will stiffen you up a bit, but will lower inflammation levels and this will help to control pain.  You should see your condition improve over the next few days and your range of motion should become easier.  If the pain gets worse at all, or your range of motion does not improve, then schedule an appointment for an exam with either a chiropractic physician who is trained in sports injuries or an orthopedist.

Good luck Eric...make sure you wear protective gear next time you ride...helmet and pads please.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net