After listening to my medical history, Dr. Lim examined me. Once he touched my back it took him about 5 seconds to diagnose the problem: prolapsed disc L4-L5. He says it is not uncommon for such to create knee pain. When I asked 'why only one knee?' he replied with a smile, "Give it time!" While there is a knee problem as well, based on recent symptoms - the spine primarily and the knee secondarily have to be attended to with...
1. physiotherapy (had a 90 minute session of 5 parts today for USD30)
2. losing weight (20 kilos extra around the waist is doing my back no favours)
3. exercises to strengthen back (was instructed how)
4. proper bike fitting (my seat my be too LOW)
5. swimming style alteration (stop breast stroke and do freestyle where legs don't get kicked)
6. Reducing cycling duration or replace cycling with a different non-impact sport (see
#5 )
7. Choosing a more moderate gear (not necessarily first)
A demonstration on a mat with multiple corrections until I got them perfect, like a yoga tutor, would indeed be an improvement in value for money. But at least the physio checked that I more or less understood by asking me to show her what she just taught me and correcting errors. My objection was that I don't have a massage table at home and therefore shouldn't we be doing this on a mat together? Never the less, neither the doctor nor physio rushed me. They explained everything. Their English was perfectly fluent. The consultation with the doctor was USD37. While cheaper doctors and physios can certainly be found in Penang (and the capital KL which is cheaper still - Penang is a tourist destination) I wanted to start at the top.
While not exactly dismissive sounds like the MD doesn't consider TCM/ ayurveda to be replacements, but useful 'complimentary' medicine "if it makes you feel good" .
I go back for two more physio sessions then a follow-up. If no significant improvement it's time for an MRI. But as I do no impact sports he thinks the likelihood that I have 'boney oedema' very unlikely. He offered me the option of getting an MRI right away but said if it improves that expense could be spared. I will enquire as to the price - in KL they cost more than my bicycle.