so all you knee injury experts

[sue123]

I was just stroking today, and somehow my toepick hit the ice, I went flying. My knee doesn't hurt as a bruise, but I can't bend it at all. I can put weight on it, no problem, but even bending it a tiny bit sent me whimpering. I couldn't even get in my car, I had to push the seat all the way back and do some weird contorsonism thing to get in and drive home. I drove back, one hand on the wheel, one hand on my knee to stop it from moving.

It hurts more in the back though. I'm not much of a knee expert, my specialty tends to lie in the ankle area. But it seems pretty swollen on the sides. Anybody have any clue? I really don't want to see a doctor. I'm bad about it, I practically have to be on death's door to get me to willingly see a doctor. Otherwise, I go kicking and screaming. I'm hoping I just twisted it, and by tomorrow, it'll be better. :)

[Debbie S]

If it's swelling, put ice on it now! And I would try to get a doctor to see you today. With the holiday weekend coming up, you won't be able to see anyone until Tuesday unless you go to the emergency room, where you would likely have to sit for hours to be seen. I had a bad fall on my knee once, like you are describing, and I waited overnight to see a doctor (fall was on a Sunday) and by late Sun night, the knee area had swollen so much I couldn't move it at all. I won't go into details about what the doctor had to do to relieve the swelling - it's lunchtime.

Then again, I've fallen on my knee at other times and have only had short-term pain and some bruising w/o the bad swelling, so it's hard to know exactly what will happen with your knee, but I would play it safe and get to a doctor now.

I hope you feel better soon!

[Mrs Redboots]

Sorry, Sue, but I agree with Debbie - get it seen to NOW! It may be only a minor twist, but if you've damaged it, the sooner it's seen to, the better. Yes, I know, it's Friday and you don't want to spend hours in the Accident & Emergency Unit - but look at it this way - if you have damaged it, you want it fixed up asap so that you can skate again very soon, no?

[froggy]

ouch hate when those happen. Ice your bruise, take some advil, I doubt you broke anything, had you -you would be in excruciating pain. You may have given yourself a slight strain on your collateral ligaments (side of your knee) I would recommend you go to a doctor, if you won't until next week, try to slowly slowly bend your knee a bit, (sitting and bending the knee, or if its hard to sit, lay down in sidelying and bend the knee in that position) movement will help get the swelling down in addition to the ice and advil. You may also want to pick up from a local drugstore a knee brace --the one just made out of strechy cloth (neoprene material) it's inexpensive ($10), it'll help give some compression. Don't do anything too strenious (sp?).

feel better, update us and how your knee is doing and what the doc says
:o)

[flippet]

Hmm...considering it's Friday afternoon, it might not be the worst idea to be seen now. If it weren't, my advice would just be to ice the heck out of it (being careful to use a towel to avoid ice-burning your skin), and elevate it, and reassess it in a few hours. (Although, if it looked like it was really bad and getting worse, or appeared unusual in any way, I'd have it looked at now anyway. But only you can determine that, since we can't see it.)


My guess is you've strained some of the tendons/ligaments that wrap around your knee. Did you bend it really tightly when you fell, or did your body weight fall onto a strongly bent knee? I've had pain that sounds similar, and that's the kind of thing I did to it. It's an odd sort of pain if you've never had it before, but rest/ice for swelling and then gentle movement has usually done the trick. The only time it didn't was when I fell while skiing, and twisted my knee really good---I had bruising along the sides of my knee, couldn't really bend it, and whoa, was that painful. I'm amazed I didn't permanently damage something. Because of the tendon/ligament thing, it's probably a good idea to have it looked at as well--you really don't want to ignore possible damage in there.

But...again, it's been a couple of hours since you posted, and if the ice/rest has made it feel lots better by now, just a little stiff and sore, then you're probably just fine. If you've still got *pain*, or still can't bend it, then you'd probably better go in.

[sue123]

Well, I've been icing it since I came home, taking Advil or Aleve, can't remember which bottle I grabbed, and resting with elevation. And I did wrap it with an Ace bandage. I think the swelling has gone down some, but I showed it to my mom, who gave me one of those "oh boy" looks. At this point, it's too late anyway, since for some reason, all my doc's are Jewish, and close really early on Friday's anyway. But I've been trying to gently move it, kinda hurts a lot. It's just weird because I can put pressure on it. I can even stand on that leg so long as it's not bent past a certain point.

I'm not reallly sure how I fell, my knee was definitly bent when I fell, and ended up underneath me. It's a really strange pain, because the kneecap doesn't hurt at all, as in there are no bruises on the kneecap, but there is some bruising around the sides. If it gets any worse, then maybe I'll go in. Maybe. I was hoping someone would say "Sure, that happened ot me once, I was fine the next day." :) I did once hurt my ankle somehow so that the day it happened, I couldn't walk, at all. The next day, it was as if nothing happened. So that's what I'm hoping for.

[kar5162]

I'm not reallly sure how I fell, my knee was definitly bent when I fell, and ended up underneath me. It's a really strange pain, because the kneecap doesn't hurt at all, as in there are no bruises on the kneecap, but there is some bruising around the sides. If it gets any worse, then maybe I'll go in. Maybe. I was hoping someone would say "Sure, that happened ot me once, I was fine the next day." :) I did once hurt my ankle somehow so that the day it happened, I couldn't walk, at all. The next day, it was as if nothing happened. So that's what I'm hoping for.

It sounds from the swelling and the lack of bruising that it was a "twisting" injury. Did you hear or feel a pop when you fell? That's the typical warning sign of an ACL tear, but doesn't sound likely since you can stand on it. Another possibility is a cartlige tear, which could account for the swelling and the inability to bend. Although both of those are less likely than just a sprain, they should be treated earlier rather than later. The typical initial response is Ace bandage or immobilizer depending on severity and then lots of rest, ice, and elevation. Ibprofen along with ice and elevation will help reduce the swelling.

If you can't get in to see them this weekend, you should probably see your doctor or a sports medicine/orthopedist early next week. So many longer term issues are easily preventable with a little extra upfront care.

And even if it feels tomorrow like nothing happened, you should still take the weekend easy.

Kim...currently recovering from ACL reconstruction and meniscus (cartlige) repair.

[skateflo]

Ah hate to tell you this, but you could have fractured your kneecap even though it doesn't hurt when you press on it (like mine last September) - The swelling is what concerns me, which may get worse. If you did fracture it and you try to bend it you could dislocate the fragments and put you in surgery. If you don't bend it and it is not 'displaced' (fragments or crack is still all together) you will need a rigid knee immobilizer for a month.....

Do you have any walk-in doc-in-the-box type places somewhere in your community? Some ER's even have an intermediate care section for non-life-threatening injuries. Smaller hospital ER's can be less busy. I would opt for an X-ray.

Yes, it is a Holiday weekend and you may have to wait hours to be seen, but the other side of not getting it checked out, might keep you from skating a lot longer than you would like.

I'm really sorry for your pain and injury but I think your Mom is right - this is one of those "ut oh" moments not to take lightly. I hope it turns out to be just a bad bruise and soft tissue swelling (which can be very painful from the stretching of the inside structures!) If you want to wait until tomorrow, keep it elevated, don't try to bend it to test it, keep an ace around it but watch for swelling and the ace getting too tight, ice it on a regular basis.

Keep us posted.

[dbny]

I agree with everyone else who said "see a doctor now". Especially in light of Skateflo's experience; please don't put it off.

[jenlyon60]

knees are definitely nothing to mess around with, injury-wise. Definitely recommend get thee to a doc sooner rather than later.

[batikat]

Definitely worth seeing a doctor but in my experience even doctors and X-rays can't always tell you what is wrong.

I damaged my knee in a skiing accident. Stupidly I was on my own skiing in Scotland 8O when I fell and twisted my knee. The two hour drive home was agony and it swelled alarmingly. Saw a doctor the next day and was sent for an X-ray but it was inconclusive. They recommended an arthroscopic (keyhole surgery) examination but we were leaving for Brunei (to be expats) within weeks and I didnt want surgery just before we went. To cut a long story short I just lived with the swelling and inability to bend my knee for a while and then never had the arthroscopy as when I discovered the doctor out there had only ever done one before, I didnt' fancy being the guinea pig for his second.

I had physio on it for a while and it improved (or at least the supporting muscles especially the quads got stronger so I could live with it). In the end it never stopped me doing anything - I took up sailing 470 dinghies while out there and happily went out on the trapeze and everything and later I also taught aerobics classes. My mum said my knee looked odd in photos but I stopped noticing it, despite the fact it often ached. However I think I was unconsciously compensating with other muscles and that contributed to back problems I had.

I even went skiing again, though I used to wear a support bandage on my knee.

Back in the UK (10 years later) I started horseriding and the instructor immediately noticed an imbalance. Then I took up skating and that seems to have really helped, probably by strengthening the muscles around the knee. In fact the injured knee seems in better shape than the uninjured one - I certainly get more kneebend out of it. :D It's not my landing leg so doesnt' get the same stresses the landing leg does but in all other respects it seems fine now. I often wonder what would have happened if I'd had the arthroscopy.

The really weird thing is that before the skiing accident my left knee would often lock up for no apparent reason, especially when I was driving, 'clutch knee' I called it, (those with automatic cars will not understand this!). It meant that in order to change gears, I had to move my whole leg from the hip as the leg locked straight. Since the accident it never happened again; so while there was obviously some damage it also did some good :lol:

So get to a doctor but be cautious if they recommend surgery.....

[sue123]

So, I didn't go to a doctor, but I did call my uncle who is a doctor. He said based on what I've told him, it sounds like a PCL tear. Apparently, it happens when you fall with your knee bent. He also said, generally, people who have them don't know they injured the PCL, unless they've injured something else along with it. So if it's not better by tomorrow, I'll try to find a doctor who is open on Saturdays, or grudgingly let my dad take me to the ER, hopefully the fast track. I went there when I got my concussion, and total time from when I went to triage to going home was about an hour, hour and a half. So, if I do go, I will probably end up there.

I've put some joint and muscle pain ointment on it, and it seems to have worked a little. Or it at least numbed it, can't quite tell. But I hope it won't be anything to serious, I leave for Israel in a few weeks and I'm going on a peer trip where we do a lot of hiking, climbing, stuff like that. I always have good timing with these things. I wound up fracturing my foot when I was studying in Paris, a few days before I was suppoesd to go to London for a weekend. Kinda puts a damper on things when you can't get around easily.

[aussieskater]

It sounds from the swelling and the lack of bruising that it was a "twisting" injury. Did you hear or feel a pop when you fell? That's the typical warning sign of an ACL tear, but doesn't sound likely since you can stand on it. Another possibility is a cartlige tear, which could account for the swelling and the inability to bend. Although both of those are less likely than just a sprain, they should be treated earlier rather than later. The typical initial response is Ace bandage or immobilizer depending on severity and then lots of rest, ice, and elevation. Ibprofen along with ice and elevation will help reduce the swelling.

If you can't get in to see them this weekend, you should probably see your doctor or a sports medicine/orthopedist early next week. So many longer term issues are easily preventable with a little extra upfront care.

And even if it feels tomorrow like nothing happened, you should still take the weekend easy.

Kim...currently recovering from ACL reconstruction and meniscus (cartlige) repair.
Sue123, I know it's now the weekend and all, but please, please please get it looked at. I'm speaking as one who's done just what you did (fell off a fwd XO over the toepick hard onto the knee) about two years ago, and foolishly continued skating the rest of that 2-hour session.

I found as the evening wore on that I could not move it at all without great pain. Eventually an MRI diagnosed a partial MCL tear and a torn meniscus. I was off the ice completely for a few months, and I'm still carrying the meniscus tear, two years later (stops me doing lunges - or what I think you call drags - as I can't bend the knee at all that way without pain and the threat of completely tearing the meniscus). My sports medico said that I was lucky to avoid a reconstruction of the MCL but that I wlll eventually have to do something about the other.

Kim - I'm sorry to hearing about your circumstances - you will get back there! How long ago did you have the operation?

[kar5162]

So, I didn't go to a doctor, but I did call my uncle who is a doctor. He said based on what I've told him, it sounds like a PCL tear. Apparently, it happens when you fall with your knee bent. He also said, generally, people who have them don't know they injured the PCL, unless they've injured something else along with it. So if it's not better by tomorrow, I'll try to find a doctor who is open on Saturdays, or grudgingly let my dad take me to the ER, hopefully the fast track. I went there when I got my concussion, and total time from when I went to triage to going home was about an hour, hour and a half. So, if I do go, I will probably end up there.


Just so you know, if it is the ligament, the hospital visit will be inconclusive. They can rule out fractures with x-rays, but can't view the meniscus or ligaments so you will likely need to also go for an MRI.

Treatment for meniscus tears is through a simple arthroscopy. They cut a few small holes into your knee and using a camera and little tools clean out the torn tissue. The recovery time is now super quick and they generally have you walking the next day. ACL tears are generally the most common. I'm not sure about PCL or MCL tears, but for ACL tears, depending on the severity of the tear and the activity level you want to achieve, they will just clean out the torn tissue with the arthroscopy or they will replace the ligament using part of your tendon, quad or hamstring muscle, or a cadaver ligament. This is actually done arthroscopically too, but with one longer incision (mine is slightly less than 2 inches). Recovery time for this is longer, but...

3 weeks after surgery I am walking unassisted (albeit much slower than usual) and have good, but not full movement. I'm riding the recumant bikes in therapy and can return to full skating 4-8 months after surgery. Having had a partial tear since 1993, I'm used to frequent soreness and stiffness and am excited about fully recovering. I plan to be back on the ice by Nov 1! 8-)

I have a picture of my knee 2.5 weeks after surgery if anyone is interested.

Moral - go to a doctor, get it checked out. If the swelling continues, get a referral to an orthopedist and get an MRI as that's the only way to really rule out ligament/meniscus damage. And if you do have damage, get it fixed. The surgical techniques are so much better than they used to be and if the injury is fairly severe, you're really risking future damage by waiting.

Hope you're feeling better soon.

[jenlyon60]

I had a partial ACL tear from skiing in 1992, and finished the job plus MCL tear in 1999. My ortho chose to wait until the MCL healed (MCL can heal on its own) before doing an ACL reconstruction. He gave me the choice of the hamstring graft or the patellar tendon graft (he didn't do cadaver grafts), and based on his recommendation, I chose the patellar tendon graft.

I was walking w/ brace and mostly crutches through the 1st week after surgery, and with brace but no crutches part of that time. By the end of the 2nd week, the crutches were gone except for very occasionally--I think I stopped using the brace at 3 weeks. 5 weeks after my surgery I moved across country from Colorado to the East Coast.

I resumed skating about 9 months after the surgery. I probably could have gone back sooner, though (at about the 6 month point).

[sue123]

I had a partial ACL tear from skiing in 1992, and finished the job plus MCL tear in 1999. My ortho chose to wait until the MCL healed (MCL can heal on its own) before doing an ACL reconstruction. He gave me the choice of the hamstring graft or the patellar tendon graft (he didn't do cadaver grafts), and based on his recommendation, I chose the patellar tendon graft.

I was walking w/ brace and mostly crutches through the 1st week after surgery, and with brace but no crutches part of that time. By the end of the 2nd week, the crutches were gone except for very occasionally--I think I stopped using the brace at 3 weeks. 5 weeks after my surgery I moved across country from Colorado to the East Coast.

I resumed skating about 9 months after the surgery. I probably could have gone back sooner, though (at about the 6 month point).

9 months???? How did you survive??? I don't think I'd last even 6 months. Wow. I'm impressed that you went through that. I tend to be one to ignore doctors orders though, usually making injuries worse than when they started. It's a stupid thing to do, I know.

My knee is doing a bit better today though. I took some Tylenol with codeine that I had left over from wisdom teeth extraction, and I slept through the night until I woke up in screaming pain because I tried to bend my knee or straigten my knee as I rolled over to my other side. My mom somehow thought Vioxx would be a good idea, and it actually seemed to work. The swelling has gone down a bit and I can move it some more. Although it's not like I'm moving it all the time, just to see how it's doing.

But here's hte creepy part. It feels like there's something in my knee. It's creaky. I can put my hand over it and move it, and that doesn't hurt unless it's the wrong spot, but it sounds like there's something creaking under there. Geez, this is getting annoying. I think my doctor might actually be open tomorrow, so I might drag myself in. Because I'm getting a bit grossed out by the noises coming out of a seemingly stationary knee, and the feeling when I touch it.

[dbny]

My knee is doing a bit better today though. I took some Tylenol with codeine that I had left over from wisdom teeth extraction, and I slept through the night until I woke up in screaming pain because I tried to bend my knee or straigten my knee as I rolled over to my other side. My mom somehow thought Vioxx would be a good idea, and it actually seemed to work. The swelling has gone down a bit and I can move it some more. Although it's not like I'm moving it all the time, just to see how it's doing.

But here's hte creepy part. It feels like there's something in my knee. It's creaky. I can put my hand over it and move it, and that doesn't hurt unless it's the wrong spot, but it sounds like there's something creaking under there. Geez, this is getting annoying. I think my doctor might actually be open tomorrow, so I might drag myself in. Because I'm getting a bit grossed out by the noises coming out of a seemingly stationary knee, and the feeling when I touch it.

Better? 8O Maybe as in "you BETTER go to the doctor!" I hate going to the doctor myself, but what you describe would have me there in a minute.

[sue123]

Better? 8O Maybe as in "you BETTER go to the doctor!" I hate going to the doctor myself, but what you describe would have me there in a minute.

It would have most normal people there too. Except I think I inherited this trait from my dad in that I ignore medical problems until I can't anymore, because I think it's not that bad, or at least not as bad as anybody else's pain. I walked, actually hobbled, on a grade 3 ankle sprain for a week before I went to my school's health center. My roomate had to drag me, literally. She made the appointment for me, otherwise I wouldn't have gone. But maybe I'll be smarter this time and not wait a week. I'm just afraid of what they would tell me.

I thought it would be better because I have more range of motion. So that counts for something, no?

[Stormy]

Honestly, I's stop making excuses and GO! You wanted advice by posting here, so listen to it!

[Figureskates]

Go. From one who has had a rebuilt left knee, letting these things go without proper treatment is just asking for trouble.

[Isk8NYC]

Go to the doctor immediately and make sure you tell them everything. (You could even print out this thread to make it easier.

[jeujeulovesme]

OMG girl, I just saw this thread now (late Saturday night) and YOU BETTER have gone to the doctor today :evil: If I was within reach of you I'd personally come pick you up by the scruff of your neck and dump you in the doctor's office... we care about each other here and you're worrying us sick. Your health is more important than anything else!!! This is NOT the time to give in to inherited stubborness.

I really hope your next message will say you went to the doctor..... PLEASE.....

Jeujeulovesme

[aussieskater]

Sue, have you gone to the doctor yet? Please??

[sue123]

I have an appointment later today at 1. I really wanted someone to tell me it was fine, but I guess I wasn't getting that. Oh well. See, I listen occasionally! I'll let you know what happens. I hope it's not too bad. So what are the odds I'll be able to skate on Friday? Or at least go to work on Wednesday when I'm supposed to start again? Lets take bets.

[sue123]

Alright, so I went, came back. My doc thinks it is a PCL tear, with maybe the meniscus involved. Right now it's splinted and uncomfortable. I may be getting an MRI sometime this week. Grrr.... I'm mad now. I can't skate on Friday. UNless..... I could always sneak out of the house in the morning, be back before anybody else.... but that would probably cause more harm than good.

[dbny]

Alright, so I went, came back. My doc thinks it is a PCL tear, with maybe the meniscus involved. Right now it's splinted and uncomfortable. I may be getting an MRI sometime this week. Grrr.... I'm mad now. I can't skate on Friday.

I'm relieved to hear that you went to the doctor! I'm sorry to hear that you've got real damage and have to wear a splint, but at least that can help prevent further damage, and you should feel more comfortable with it too. I don't know much about PCL tears, but I do know that the meniscus can sometimes heal without surgery, so please do give it a chance.


UNless..... I could always sneak out of the house in the morning, be back before anybody else.... but that would probably cause more harm than good.


That would definitely do more harm than good! Don't even think about it!

[jeujeulovesme]

Hi Sue,

:) Thank you, I am so relieved that you went to the doctor! You had me freaking at the computer late last night, I was so worried you weren't going to listen.

If you really want to be able to keep skating happily next month, next year, and in your future... or any other physical activity for that matter, including plain simple walking, sitting down and getting up trouble-free from chairs ... then for the next few weeks until your knee is honestly healed, you make yourself stay OUT of the rink and focus on doing everything to help it recover. This means you listen to your KNEE, not your temptations.

We athletes, no matter how obsessive we are about our sports, HAVE to know that our body is our most important tool -- when it tells us it's hurt, LISTEN! Ignoring it is abuse and sooner or later it will say to h*ll with you, it's going on strike. It will choose the worse timing to do so and more often than not it will be permanent and its consequence felt in all areas of your life. Your life really is much bigger than the skating rink!

Sorry about getting on my soapbox like this. It's just that I don't want you to end up with permanent damage by ignoring it now when it's treatable and then one day realize you should've looked after it when you had the chance... and then you regret it for the rest of your life.

Jeujeulovesme

[sue123]

Hi Sue,

:) Thank you, I am so relieved that you went to the doctor! You had me freaking at the computer late last night, I was so worried you weren't going to listen.

If you really want to be able to keep skating happily next month, next year, and in your future... or any other physical activity for that matter, including plain simple walking, sitting down and getting up trouble-free from chairs ... then for the next few weeks until your knee is honestly healed, you make yourself stay OUT of the rink and focus on doing everything to help it recover. This means you listen to your KNEE, not your temptations.

We athletes, no matter how obsessive we are about our sports, HAVE to know that our body is our most important tool -- when it tells us it's hurt, LISTEN! Ignoring it is abuse and sooner or later it will say to h*ll with you, it's going on strike. It will choose the worse timing to do so and more often than not it will be permanent and its consequence felt in all areas of your life. Your life really is much bigger than the skating rink!

Sorry about getting on my soapbox like this. It's just that I don't want you to end up with permanent damage by ignoring it now when it's treatable and then one day realize you should've looked after it when you had the chance... and then you regret it for the rest of your life.

Jeujeulovesme


Sorry, didn't mean to make you worry! I know I don't want permanent damage. I just hate being left on the sidelines. Really annoying, especially when I thought I could take lessons regularly for a bit now that I have summer break. I know I have to take it easy, and I am going to call my coach tomorrow and cancel. It's too late to call now. But I'll be doing physical therapy (again!) so hopefully it'll heal quickly and all will be good again. I'm just hoping that by the time I leave for my Israel trip, it'll be pain free enough to walk and be able to do everything we do on the trip, even if I use a brace to do it.

Stupid injuries: what happens when you just zone out too much and don't concentrate. Or think too much. This kid I tutor looks at me all funny when I told him. This is what he says: I thought you already knew how to skate. We used to go skating together (we did when we were younger, our dad's are best friends and former hockey teamates). How do you fall by not doing anything, just skating? What's the matter with you?

I told him, it happens. Now show me which pages are going to be on your test.

[Mrs Redboots]

Bad luck, Sue. You rest quietly and do as the doctor tells you, and I'm sure you'll be back on the ice very soon. It won't feel soon, though, alas....

I caught my toe last night and landed hard on both knees and one hand.... Luckily I haven't damaged it, but one knee is very bruised and a bit sore. Arnica and ibuprofen gel..... Another skater did the same thing, and was very worried that she'd twisted her knee, but she found that was just the initial pain, and she too, had done nothing worse than banged herself. I'm sorry you weren't as lucky.

[kar5162]

Alright, so I went, came back. My doc thinks it is a PCL tear, with maybe the meniscus involved. Right now it's splinted and uncomfortable. I may be getting an MRI sometime this week. Grrr.... I'm mad now. I can't skate on Friday. UNless..... I could always sneak out of the house in the morning, be back before anybody else.... but that would probably cause more harm than good.

Sorry to hear the news, but glad you went. Getting your knee healed correctly now will help you immeasurably in the future, even if it means discomfort and not skating now. Follow their instructions and get better.

[Debbie S]

Arnica and ibuprofen gel.....

Be careful, Annabel. I've heard Arnica can result in serious allergic reactions, as can Vitamin E oil, which I found out all too well. And I'd used Vitamin E oil before, but I suppose anyone can develop an allergy to something at any time. Actually, I thought I heard that Arnica was banned in the UK, but maybe that was the pill form/dietary supplement.

I hope your knee feels better soon - both Annabel and Sue!

[Mrs Redboots]

Actually, I thought I heard that Arnica was banned in the UK, but maybe that was the pill form/dietary supplement.

I hope your knee feels better soon - both Annabel and Sue!Arnica isn't a dietary supplement - it's a homeopathic remedy, as far as I know! I did take some tablets, but mostly have been applying it in cream form - with the ibuprofen gel on top as a pain-killer! Hopefully won't need the latter after tomorrow..... the bruise is coming out nicely now.