9 Surprising Facts About Runner’s Knee

Article featured on Healthgrades

Runner’s knee, the common term for patellofemoral pain syndrome, is a knee problem that affects many people. It happens when your kneecap (patella) is either misaligned because of a defect, or your knee is stressed, causing it to be out of alignment. Although it is painful, runner’s knee is usually not a serious knee injury, although it can have a significant impact on your life by limiting your activity. How much do you know about runner’s knee? Here are some facts about the condition that might surprise you.

1. You don’t need to be a runner to get runner’s knee.

Patellofemoral pain syndrome is called runner’s knee because it affects a lot of runners. However, many people who never run anywhere also develop runner’s knee. It’s like people who don’t golf can get golfer’s elbow, or those who don’t play tennis can get tennis elbow. Anyone who participates in an activity that bends the knee and puts a lot of strain on it is at risk of developing runner’s knee. This includes cycling, walking, jumping or climbing up and down stairs.

2. Repetitive movements can irritate your knee.

Do you have a job that requires you to bend and squat a lot? When you squat repeatedly, your knee makes the same movement and carries your body’s weight in the same places over and over again. You could be squatting to lift boxes, pick items off the floor, or reach lower shelves. Even parents of young children who have to pick them or their playthings off the floor are at risk of irritating their knees to the point of developing runner’s knee.

3. Your hamstring could be causing runner’s knee.

Your hamstrings are really three muscles in the back of your thigh. They help you extend and retract your leg. You may feel your hamstrings pull if you bend at your waist without bending your knees or you straighten your legs in front of you while sitting on the floor. When your hamstrings are too tight, they cause extra stress on your knees and could cause runner’s knee. Exercises and stretches to loosen the hamstrings can help reduce knee pain and keep it from coming back.

4. Your glutes can also cause runner’s knee.

Like your hamstrings, your gluteus medius, a muscle in your buttocks, may also be the culprit behind your runner’s knee. Instead of being too tight, like the hamstrings, if your gluteus medius, or glutes, are not tight enough, the rest of your leg tries to compensate. This puts stress on your knee. The gluteus medius is responsible for helping to pull your leg away from your body and rotate it externally. This is called hip abduction. If the muscle isn’t strong enough, the other muscles respond by trying to pull the leg inward instead.

5. Flat feet can equal knee pain.

Your feet play a vital role in your knees’ health. If you have flat feet, a low arch, or no arch at all, this puts your feet in an unnatural position when you step forward, particularly when you run. The impact of walking or running without arch support can cause extra tension on the muscles in your legs and pull on the knee, causing misalignment and stress. Wearing appropriate shoes and orthotics in your shoes can help fix how your foot lands when you take a step, taking stress off your legs and knees.

6. Where you exercise could cause runner’s knee.

Concrete and asphalt are unforgiving surfaces. If you’re running or playing sports on these hard surfaces, the stress on your legs and knees could cause runner’s knee. The solution is to run or play on more forgiving surfaces, like synthetic tracks, grass or dirt. This is also where good shoes appropriate for the activity are beneficial. They can help absorb some of the shock of running and jumping, taking away some of the stress on your knees.

7. Women are more prone to developing runner’s knee.

Doctors aren’t entirely sure why more women than men develop runner’s knee, but overall women do develop more knee problems. A woman’s pelvis is wider than a man’s. This wider pelvis affects how a woman stands and places a different type of pressure and strain on the knee. As well, women tend to have looser ligaments, the tough fibrous tissue that connects bones. Women also land on their feet differently when they run or jump, adding to the difference in knee stress.

8. Runner’s knee can be easy to treat.

Once you know what is causing your runner’s knee, it can be fairly easy to treat. If it is caused by improper foot support, good shoes or orthotics will help. If it’s caused by too tight ligaments or muscles, physical therapy and exercise can ease the pain and reduce the risk of it returning. Muscles too weak? Strengthening them at home or in a gym will help. Running on a hard surface? Switch locations for a gentler landing when you run or jump. The key is working at it and staying consistent.

9. Surgery is rarely necessary for runner’s knee.

Doctors only consider surgery for runner’s knee if you have tried non-surgical treatment for 24 months and you still have pain. It’s rarely necessary. If you have runner’s knee and you have faithfully tried all the exercises and changes recommended by your doctor or physical therapist, an orthopedic surgeon will assess you to see if surgery will help.


New Mexico Orthopaedics is a multi-disciplinary orthopedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

6 Ways to Ruin Your Knees

Article featured on WebMD

Whether you’re a seasoned athlete, a weekend warrior, or totally laid-back when it comes to exercise, knowing how to protect your knees from damage can mean the difference between a fulfilling lifestyle and longterm, strained mobility.Cruising on the track in the heat of a roller derby match, 27-year-old Rachel Piplica was not at all prepared for the realization that her knee could sideline her from competitive skating for months, possibly years.

“Suddenly, I heard a pop and it felt like my knee bent sideways. The pain was so bad I just fell and crawled away,” Piplica tells WebMD.

The Los Angeles fashion designer who skates under the name Iron Maiven tried to keep going. “I took one more stride and my knee just let go again. The doctor immediately said, ‘I think you tore your ACL.'”

Piplica had experienced some warning signs during her previous season of skating as captain of her team, but she ignored them for the most part. “I had tremendous pain in my leg anytime I’d squat down so I just kept my right leg straight. But I never saw a doctor for it. I just assumed, ‘I’m in a contact sport and this is what happens,’” she tells WebMD.

Knee deep: A complex and vulnerable joint

Her torn ACL diagnosis confirmed, Piplica quickly learned how susceptible the knees can be to injury. According to the American Academy of Orthopaedic Surgeons, these joints are responsible for sending nearly 15 million Americans to the doctor every year.

And it’s not just athletes who suffer. Knee problems can happen to anyone.

“Because they’re the main hinge between the ground and the rest of your body, the knees serve as your ‘wheels’ that get you around and allow you to be active,” says University of Pennsylvania orthopedic surgeon and sports medicine specialist Nicholas DiNubile, MD. “Life can really go downhill when you damage your knees,” says DiNubile, who is a spokesman for the American Academy of Orthopaedic Surgeons and author of FrameWork – Your 7-Step Program for Healthy Muscles, Bones and Joints.

Bound by an intricate system of ligaments, tendons, cartilage, and muscle, the knee is highly prone to injury. It’s a complex hinge where the femur (thigh bone), tibia (shin bone), fibula (next to tibia) and kneecap all come together.

“It’s hard to find the right balance between mobility and stability; the knee needs to move back and forth, twist a little, and pivot too,” DiNubile says. The knee’s ligaments can tear, its tendons can swell up, osteoarthritis can take hold, and even everyday wear and tear can ruin a perfectly good set of knees.Here are six pitfalls you can avoid to save your knees.

1. Ignoring knee pain.

An occasional ache here and there is common. “But knowing when you can and can’t ignore pain is key,” says sports medicine specialist Jordan Metzl, MD, from the Hospital for Special Surgery in New York City.

Metzl’s rule of thumb: When the pain limits your ability to do what you normally do, you need to have it checked out.

“If your body is sending you signals, you need to listen to them. If they persist, you need to have it checked out,” he tells WebMD.

For Piplica, exploratory surgery revealed a torn meniscus she had endured in the past — unbeknownst to her — followed by the more recent ACL tear.

“In hindsight, maybe that first injury could have been repaired earlier, although I don’t know if I could have avoided this one altogether,” she says. “At least I would have been more careful.”

2. Being overweight.

Every pound of body weight yields five pounds of force on the knee, so even 10 extra pounds can put a considerable load on those joints.

Being overweight also increases your chances of osteoarthritis in the knee, a common and often disabling form of arthritis that wears away the knee’s cushiony cartilage. Excess pounds also cause existing arthritis to worsen more rapidly. According to the CDC, two out of three obese adults suffer from knee osteoarthritis at some time in their life.

Although diet and exercise are critical for weight loss, it’s a double-edged sword.

“If your knees hurt, it’s harder to lose weight through exercise,” says Metzl. So he recommends activities that go easy on the knee.

For example, opt for a stationary bike over running on the treadmill, and walk on a flat surface instead of hilly turf. If you’re a die-hard treadmill fan, then go for longer sessions of walking punched with brief intervals of brisk walking or running every three to five minutes, DiNubile says.

3. Not following through with rehab and rest.

The rest and rehabilitation period after a knee injury is critical to avoiding future pain or reinjury. Depending on the type of damage and treatment, recovery could last anywhere from a couple of weeks to several months.

“During the rehab period, you need someone to help you tell the difference between something that just hurts, and something that’s going to do you harm,” says DiNubile.He tells WebMD that many of his young athlete patients are too eager to return to regular play as soon as they stop limping. He advises patients to work with an orthopedic surgeon, a sports medicine physician, a physical therapist, an athletic trainer, or some combination of these pros, in order to ensure proper focus is placed on gradually strengthening the knees.

4. Neglecting your ACL.

One of the most commonly injured ligaments in the knee, the anterior cruciate ligament (ACL) is responsible for about 150,000 injuries in the U.S. every year.

As Piplica learned firsthand, sports like roller derby that involve quick cuts, twists, and jumping, put the ACL at higher risk for rupturing. More traditional high-risk sports include soccer, basketball, football, and volleyball.Women in particular have a two- to eight-times higher risk for ACL tears compared to men, mainly because the way women naturally jump, land, and turn puts greater strain on the ACL.

However, male and female athletes alike can be trained to “rewire” themselves and thus lower risks of knee injury. That’s done through neuromuscular training, which involves supervised practice in improving agility, leg strength, and jump-landing techniques for better knee joint stability.

These specialized techniques are effective in reducing risks of knee injury by almost one-half, according to a 2010 review of seven neuromuscular training studies.

“Given what we know in how useful it can be in reducing ACL tears, it’s irresponsible of coaches and parents to not require athletes to undergo neuromuscular training,” says DiNubile.

He recommends that athletes of any age who play ACL risk-prone sports should seek help from an athletic trainer or other trained professional to help avoid this debilitating injury.

5. Overdoing it.

“You make gains in fitness when you work hard and then allow your body to recover. You can’t do a hard workout every day,” Metzl says.

A sudden increase in intensity or duration of exercise can cause overuse injuries from repetitive strain. Tendonitis and kneecap pain are common symptoms in the knee.Pushing too hard is also related to overtraining syndrome, a physiological and psychological condition among athletes in which they exceed their ability to perform and recover from physical exertion, often leading to injury or lowered performance.

Be sure to include stretching exercises before and after working out. And follow hard training days with easy ones so your body can recover.

6. Overlooking other muscles around the knees.

Weak muscles and lack of flexibility are primary causes of knee injuries. When the muscles around the kneecap, hip, and pelvis are strong, it keeps the knee stable and balanced, providing support by absorbing some of the stress exerted on the joint.DiNubile stresses the importance of building the quadriceps and hamstring muscles, as well as proper strengthening of the body’s core muscles, including the obliques, lower back muscles, and upper thigh.

His favorite tool to help accomplish this strengthening is a Swiss medicine ball. Other exercises to try are knee extensions, hamstring curls, leg presses, and flexibility exercises.Piplica recalls realizing just how weak some of her leg muscles were.

“Roller girls are striding out so much with their outer leg muscles, but we aren’t necessarily working our inner knees,” she says. “I remember when I would run for exercise, my calves and shins would hurt so bad. That surprised me, because I thought if anything was strong, it was my legs.”

Piplica says she wishes she had been better educated about crosstraining activities for roller skaters, and what muscle groups they need to focus on to keep their knees healthy.

As she awaits surgery to repair her torn ACL, Piplica tells WebMD that her perspective on long-term care for her knees has definitely changed.

“Half of me is frustrated about not being able to skate sooner, but the other half knows how important it is to get better so I don’t do this again. I’m 27 years old with a serious knee injury preventing me from moving around. So I need to look beyond just skating, skating, skating. I don’t want to have knee problems when I’m 40 or 50 because I’m not giving my body the kind of attention it needs right now.”


New Mexico Orthopaedics is a multi-disciplinary orthopedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Total Recovery Time for Total Knee Replacement Surgery

Article featured on Arkansas Surgical Hospital

If your doctor has suggested total knee replacement surgery, it’s crucial to know what to expect after the procedure. Recovery from a total knee replacement surgery takes about three months and depends on how well you follow your surgeon’s instructions. Understanding the timeline will help you prepare for the downtime you’ll need while your knee takes time to heal and rebuild strength.

Understanding Total Knee Replacement Surgery

Knee replacement surgery is usually suggested when you experience severe, unrelenting pain that hasn’t been alleviated by other means. If there is loss of motion, a lot of grinding in the joint, or misalignment of the knee, a knee replacement can help.

What to Expect After Total Knee Replacement Surgery

Recovering from a knee replacement is a lengthy but worthwhile process. Here’s what to expect when you recover from your knee surgery at Arkansas Surgical Hospital.

The Day of Surgery

After your knee replacement is complete, you’ll be taken to the post-anesthesia care unit, where a nurse will carefully monitor your vital signs and incision. When your pulse, blood pressure, and breathing rate are normal, you’ll be transferred to your private suite in our patient care unit. In most cases, you’ll stay overnight. You’ll be given pain medication to keep you comfortable after your surgery.

Postoperative Care

You will meet with a physical therapist on the day of or the day after your total knee replacement. Your therapist will develop an exercise regimen to help you with mobility, which will start as soon as possible after surgery to prevent stiffening of the knee joint.

While you’re in the hospital, your physical therapist will take you through various exercises designed to strengthen and stabilize the knee. By the time you leave the hospital, you should be walking independently with an assisted device. Most patients discharge home from the hospital after 1-2 nights. Your surgeon will decide which is appropriate for you.

The First Six Weeks

Before you return home, make sure you have safety features installed. These may include a shower seat in the tub or shower, grab bars where needed, and other mobility aids recommended by your surgeon or physical therapist.

During the first six weeks at home following a total knee replacement surgery, the focus is on healing. You may take over-the-counter medications for pain, which your doctor can recommend.

Eat lots of iron-rich foods to promote healing and keep your strength up. At the six-week point after your surgery, you should be able to stand, sit, walk, and use the stairs unaided.

Returning to Work & Activities

Most patients can return to work after six to eight weeks. If your job involves manual labor or long stretches of time spent walking and standing, it may take you longer to return to full-time work. Your doctor can advise you on when you’re ready. It’s essential to pace yourself and not put too much stress on your knee joint before it’s strong enough to handle the load.

Exercise is vital for proper recovery from total knee replacement surgery. During the first several weeks after your procedure, walking and gentle exercises may be appropriate in addition to your physical therapy. Sports, jogging, and other high-impact activities need to be postponed until about two to three months after your surgery to give your joint time to heal and strengthen. Avoid lifting anything over 40 pounds during the first three months after your total knee replacement surgery.

Getting Back to Normal

Your body and your knee joint will continue to gain strength for several months after your surgery. There shouldn’t be any pain after the first four months. If you continue to feel pain, be sure to talk to your surgeon.

If you’ve participated in activities that are hard on your knees in the past, talk to your doctor about how to return to jogging, skiing, and other activities while protecting your new knee implant. There may be some activities that aren’t advisable.

Most patients fully recover within six months to a year of total knee replacement surgery. While this may seem like a long time, the knee replacement itself can last as long as 15-20 years, giving you many years of comfort and mobility.


New Mexico Orthopaedics is a multi-disciplinary orthopedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Getting Back Into Sports After a Knee Surgery

Article featured on Cone Health

While the time it can take to return to sports after knee surgery varies, it is important to follow doctor’s orders, according to Stephen Lucey, MD, an orthopedic surgeon in Greensboro and member of the Cone Health Medical and Dental Staff.

Before surgery, you may do specific exercises to aid in recovery. “Recommended exercises can be done at home or with a physical therapist to improve strength and range of motion,” says Dr. Lucey.

Then, you can expect to follow a 3-step process to get back to the sports you enjoy.

After surgery, you should use the RICE method: Rest the knee, ice it, compress or wrap the injured area and elevate it to prevent swelling. “At first, you should take it easy,” adds. Dr. Lucey. “You may benefit from pain relievers as directed by your surgeon.” Second, you can expect to begin mobilization or therapy techniques that improve range of motion and begin to strengthen your knee. Once you have sufficiently recovered, the focus shifts to the final phase of recovery – strengthening exercises. “For runners, strengthening might include biking or running on a treadmill,” shares Dr. Lucey. “For soccer players, juggling, kicking or passing the ball are options.”

The timeline for returning to sports depends on your knee issue and extent of surgery. “After arthroscopic knee surgery requiring a small incision, you may be able to return to sports in a month while it could take 6 months or more after tearing an ACL, a ligament that helps stabilize your knee joint,” concludes Dr. Lucey. “The key is following your doctor’s instructions on your road to recovery.”


New Mexico Orthopaedics is a multi-disciplinary orthopedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

10 Tips for Getting Around on Crutches

Article featured on Healthgrades

1. Verify Your Fit

Properly fitting crutches can make the difference between comfort and calluses. When you’re standing up straight with your arms at your side, the top of the crutches should be 1 to 2 inches below your armpit, and the handgrips should be at wrist-level. Your elbow should be slightly bent in this position. If your crutches don’t feel right after using them for a day or two, don’t hesitate to ask your care team for a different size.

2. Walk This Way

To walk, start standing up straight on your good leg with your crutches gripped in your hands. Lean onto your good leg, lift your crutches, and set them down 6 to 12 inches in front of your good foot. Lean your weight into your hands and step your good leg 6 to 12 inches in front of your crutches. Rest as necessary and repeat. Always look ahead—and not down—as you walk. Your body will follow your gaze.

3. Get a (Cushioned) Grip

Your hands—not your armpits—should bear your weight when you use crutches. If you push your crutches into your armpits, nerve damage could occur and send pain down your arms. If your hard-working hands become sore, cushion the handgrips with an adhesive pad. Or consider wearing fingerless gloves with padding if you need to walk a far distance.

4. Scan for Obstacles

You certainly don’t want to take a tumble while you’re on crutches and risk injuring another body part, like a wrist or your good leg’s ankle. While you’re walking, be on the lookout for ice patches, puddles, curled-up rug edges, gravel, and small steps. Think about how to safely and slowly get past your obstacle—or find another way to get where you’re going.

5. Use Care When Sitting

Sit down slowly every time. Transfer both crutches to the hand on the same side as your injured leg. Lean into your crutches, then reach back with your free hand to feel the chair, sofa, stool or bed. Sit down into the seat. Be sure to set your crutches down upside-down within reach. When standing up, slide to the edge of the your seat, and reverse these steps. Keep the back of your good leg touching the seat.

6. Sit Down on the Steps

If there’s an elevator to take you up and down floors, use it. But if you need to negotiate stairs on crutches, The American College of Foot and Ankle Surgeons recommends that you do so seated. That may feel odd, but it reduces your risk of a tumble and further injury. Be sure to push your crutches up or down in the direction you’re going before you start, so they’re available when you stand up again.

7. Contain Beverages and Foods

When you’re on crutches, carrying a cup of coffee or a sandwich to the couch can be a challenge without help. One way to do this on your own is to transport foods in closed travel containers, such as plastic containers or travel mugs. You can carry even more if you use a backpack or side-slung pack.

8. Equip Your Pad

You may spend more time at home than usual while your leg heals. So outfit your pad with props that save you time and effort. Use a wheeled office chair to roam the rooms of one level of your house. In the kitchen, set up a high, stable bar stool that you can lean on while you prepare food and drinks. And use (clean) trash grabbers or long barbeque tongs to pull small items down from tall shelves.

9. Care for Your Crutches

Once a week when you’re sitting down, check your crutches for anything that may weaken their support. Look for things like loose hardware, worn tips, and items like small rocks or stickers that have become lodged to the rubber ends. The more sturdy your crutches are, the more steady your pace will be.

10. Embrace Your Pace

You simply aren’t going to get around as quickly or as easily on crutches as you could before them. Give yourself plenty of time to get everywhere. And give yourself a pass on most of the items on your to-do list for a bit. The more slowly you go, and the more rest you give yourself and your injured leg, the more quickly you’ll regain strength and speed. And ultimately, you’ll recover quickly and safely.


New Mexico Orthopaedics is a multi-disciplinary orthopedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

What a torn meniscus means

Article featured on Mayoclinic.

Overview

A torn meniscus is one of the most common knee injuries. Any activity that causes you to forcefully twist or rotate your knee, especially when putting your full weight on it, can lead to a torn meniscus.
Each of your knees has two C-shaped pieces of cartilage that act like a cushion between your shinbone and your thighbone (menisci). A torn meniscus causes pain, swelling and stiffness. You also might feel a block to knee motion and have trouble extending your knee fully.
Conservative treatment — such as rest, ice and medication — is sometimes enough to relieve the pain of a torn meniscus and give the injury time to heal on its own. In other cases, however, a torn meniscus requires surgical repair.

Symptoms

If you’ve torn your meniscus, you might have the following signs and symptoms in your knee:

  • A popping sensation
  • Swelling or stiffness
  • Pain, especially when twisting or rotating your knee
  • Difficulty straightening your knee fully
  • Feeling as though your knee is locked in place when you try to move it
  • Feeling of your knee giving way

When to see a doctor

Contact your doctor if your knee is painful or swollen, or if you can’t move your knee in the usual ways.

Causes

A torn meniscus can result from any activity that causes you to forcefully twist or rotate your knee, such as aggressive pivoting or sudden stops and turns. Even kneeling, deep squatting or lifting something heavy can sometimes lead to a torn meniscus.
In older adults, degenerative changes of the knee can contribute to a torn meniscus with little or no trauma.

Risk factors

Performing activities that involve aggressive twisting and pivoting of the knee puts you at risk of a torn meniscus. The risk is particularly high for athletes — especially those who participate in contact sports, such as football, or activities that involve pivoting, such as tennis or basketball.
Wear and tear on your knees as you age increases the risk of a torn meniscus. So does obesity.

Complications

A torn meniscus can lead to a feeling of your knee giving way, inability to move your knee normally or persistent knee pain. You might be more likely to develop osteoarthritis in the injured knee.

Diagnosis

A torn meniscus often can be identified during a physical exam. Your doctor might move your knee and leg into different positions, watch you walk and ask you to squat to help pinpoint the cause of your signs and symptoms.

Imaging tests

  • X-rays. Because a torn meniscus is made of cartilage, it won’t show up on X-rays. But X-rays can help rule out other problems with the knee that cause similar symptoms.
  • MRI. This uses radio waves and a strong magnetic field to produce detailed images of both hard and soft tissues within your knee. It’s the best imaging study to detect a torn meniscus.

Arthroscopy

In some cases, your doctor might use an instrument known as an arthroscope to examine the inside of your knee. The arthroscope is inserted through a tiny incision near your knee.
The device contains a light and a small camera, which transmits an enlarged image of the inside of your knee onto a monitor. If necessary, surgical instruments can be inserted through the arthroscope or through additional small incisions in your knee to trim or repair the tear.

Treatment

Initial treatment

Treatment for a torn meniscus often begins conservatively, depending on the type, size and location of your tear.
Tears associated with arthritis often improve over time with treatment of the arthritis, so surgery usually isn’t indicated. Many other tears that aren’t associated with locking or a block to knee motion will become less painful over time, so they also don’t require surgery.
Your doctor might recommend:

  • Rest. Avoid activities that aggravate your knee pain, especially any activity that causes you to twist, rotate or pivot your knee. If your pain is severe, using crutches can take pressure off your knee and promote healing.
  • Ice. Ice can reduce knee pain and swelling. Use a cold pack, a bag of frozen vegetables or a towel filled with ice cubes for about 15 minutes at a time, keeping your knee elevated. Do this every four to six hours the first day or two, and then as often as needed.
  • Medication. Over-the-counter pain relievers also can help ease knee pain.

Therapy

Physical therapy can help you strengthen the muscles around your knee and in your legs to help stabilize and support the knee joint.

Surgery

If your knee remains painful despite rehabilitative therapy or if your knee locks, your doctor might recommend surgery. It’s sometimes possible to repair a torn meniscus, especially in children and young adults.
If the tear can’t be repaired, the meniscus might be surgically trimmed, possibly through tiny incisions using an arthroscope. After surgery, you will need to do exercises to increase and maintain knee strength and stability.
If you have advanced, degenerative arthritis, your doctor might recommend a knee replacement. For younger people who have signs and symptoms after surgery but no advanced arthritis, a meniscus transplant might be appropriate. The surgery involves transplanting a meniscus from a cadaver.

Lifestyle and home remedies

Avoid activities that aggravate your knee pain — especially sports that involve pivoting or twisting your knee — until the pain disappears. Ice and over-the-counter pain relievers can be helpful.

Preparing for your appointment

The pain and disability associated with a torn meniscus prompt many people to seek emergency care. Others make an appointment with their family doctors. Depending upon the severity of your injury, you might be referred to a doctor specializing in sports medicine or a specialist in bone and joint surgery (orthopedic surgeon).

What you can do

Before an appointment, be prepared to answer the following questions:

  • When did the injury occur?
  • What were you doing at the time?
  • Did you hear a loud “pop” or feel a “popping” sensation?
  • Was there much swelling afterward?
  • Have you injured your knee before?
  • Have your symptoms been continuous or occasional?
  • Do specific movements seem to improve or worsen your symptoms?
  • Does your knee ever “lock” or feel blocked when you’re trying to move it?
  • Do you ever feel that your knee is unstable or unable to support your weight?

New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.
New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.
Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.
If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

What is Knee Hyperextension?

Article featured on News Medical Life Sciences
Knee hyperextension is a condition caused when the knee straightens too far, beyond the normal maximum limit of 00 and often with the joint in varus malalignment. In the properly aligned knee, the load is borne on a line running down the center of the hip, knee and ankle, but in a varus deformity (bowleg form), the line is shifted outwards and back.
The most common injuries are posterolateral joint injury and avulsion of the bone attached to the anterior cruciate ligament, and they are especially common in young children due to their softer bones. Posterior cruciate ligament, however, is rare.

Causes

Knee hyperextension may occur because of:

  • Trauma caused by impact to the front of the knee, which makes the joint move backward, putting high strain on the anterior cruciate ligament – such as when a football player faces a leg tackle.
  • Pushing the femur or patella over the tibia, the lower leg bone, for example when one slides to a sudden stop using one leg, which stresses the major ligaments within the knee.
  • Genu recurvatum: this is a deformity characterized by knee hyperextension over 5 degrees.
  • Nerve damage, such as Brain injury (congenital, stroke-induced or traumatic), or poliomyelitis, may cause hyperextended gait because of muscle (quadriceps or calf muscle) atrophy, spastic plantar flexion of the ankle, or contractures of the heel tendons.

Symptoms

The cause of hyperextension predicts the symptoms, which may be minor pain and swelling when it occurs to a trivial degree, but may consist of sharp pain, strained or torn cruciate ligaments, avulsion of bone chips accompanying such tears, and bone bruising may occur on the anterior part of the knee joint. When the injury is at the posterolateral aspect, the ACL and the PCL typically tears. The rate of strain doesn’t seem to be the major factor as anterior cruciate ligaments tears vary at all rates of strain. Genu recurvatum may present with knee pain, abnormal gait, and a lack of proprioceptive perception, which makes it difficult to tell when the terminal extension of the knee is attained.
The hyperextended knee gait is marked by various degrees of abnormality. In some, the patient can walk only with the aid of a cane or a crutch. In others with minimal weakness, the knee becomes hyperextended only when the patient walks too much or indulges in other heavy work or exercise, leading to muscle fatigue and loss of joint support. The associated ligamentary and muscle weakness and joint integrity also contribute to the final abnormality of gait, as does the presence of arthritis in the knee joint.
Another symptom is knee instability, or a feeling of giving way at the knee, in part or full, during normal activities.
Pain may be felt over the knee or to the medial side, and is caused by compression of the soft tissues by the malaligned knee, as well as on the posterolateral aspect, due to stretching of the soft tissue. In acute hyperextension injury the knee may pop and acute swelling often occurs within a few hours of the injury. The pain can become too severe for normal support of weight during walking or running.

Anatomy

The knee joint is supported on the lateral and posterior aspects by the fibular collateral ligament, and the popliteus muscle with its tendon and ligament. This complex of structures keeps the knee compartment from widening laterally, prevents dislocation of the lateral surface of the tibial component of the knee to the back, keeps the tibia from rotating, and thus prevents both knee hyperextension and genu recurvatum. The bones may show varus alignment, in some cases. A triple varus knee is caused by three factors:

  • Tibiofemoral alignment is disturbed.
  • The lateral tibiofemoral compartment separation is increased because of weak supporting structures on the posterolateral aspect of the knee.
  • The knee appears bowlegged in skeletal outline when fully extended.

In most cases both the posterolateral structures and the anterior cruciate ligament is damaged or at least weak, as following a knee injury or any other cause of muscle atrophy. Patellofemoral arthritis is another cause, but in this case the hyperextended knee gait is due to pain as well as muscle weakness.

Diagnosis

The history will offer clues to the diagnosis, such as prior knee injury. A physical examination will help confirm and grade the injury, including joint mobility, visible injury, bruising or swelling, and locking of the joint. Imaging is needed in severe injury and especially if surgery is contemplated. MRI and X-ray imaging are typically performed.

Treatment

Minor hyperextension of the knee may require only the R.I.C.E approach:

  • Rest and avoidance of physical activities that strain the knee in any way for a few weeks.
  • Ice application several times a day.
  • Compression using a knee brace and crutches for support are helpful in protecting the ligaments of the knee against any further damage.
  • Elevation to reduce edema.

Severe cases will require physical therapy, with graded exercises of the quadriceps and other hip and knee muscles. This should be done under supervision so that further injury does not occur, and full joint mobility is attained. Surgery is required to reattach torn ligaments and will again be followed by physical therapy.
Correction of the hyperextended knee gait is crucial if the deformity is to be corrected permanently, otherwise the excessive tensile force on the ligaments inside the joint and increased muscle force could increase the load on the joint capsules, especially the medial and lateral compartments. This can be harmful to joint integrity in varus malalignment.


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.
New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.
Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.
If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Preventing Future Patellofemoral Pain

Article from UCSF Health
To decrease the risk of patellofemoral pain returning after surgical kneecap realignment, doctors generally recommend that you make the stretching and strengthening exercises you learned in rehabilitation part of your everyday routine.
Proper rehab will help your new kneecap attachments heal in a normal position and keep it moving smoothly in its track. To prevent rupturing your new kneecap attachments while they heal, avoid bending your knee more than 90 degrees. Try to be patient in rehab and do not rush to return to activities.
Many of the popular fitness exercises and activities put stress on your knees. To prevent patellofemoral pain it is important to learn knee-sparing exercise techniques. This can be done by dividing your activities into three components:

Daily Living

The average person takes between 12,000 and 15,000 steps a day, exerting a force between two and five times his or her body weight on the knees. After a knee injury, take it easy on your knees during the day whenever possible to save them for activities and exercise. Avoid stairs when there is an elevator, take the shortest path when walking, and consider wearing athletic shoes designed to absorb shock rather than hard-soled shoes.

Muscle Strengthening and Conditioning

Activities themselves are not a substitute for conditioning, and your need for special conditioning to prepare for activities increases with age. The best strengthening programs are low-impact and non-weight-bearing, like stationary bikes and certain weightlifting programs, which do not require the knees to absorb shock.

Recreation

Sports that require twisting and quick-direction changes put great strain on your knee. Any climbing or jumping activity where the knee is bent beyond 90 degrees puts undue pressure on the cartilage surfaces under the kneecap. To prevent injury, stick to light, non-impact activities for your recreation. If you decide to return to sports like football and basketball, a doctor should carefully examine your kneecap and test it for proper alignment.
If you plan on participating in sports, remember to take it easy during daily activities and to keep your kneecap tracking properly with stretching and strengthening exercises. Your doctor may prescribe a brace to wear during recreational activities, which will help keep your kneecap in track.
A small amount of pain is normal during physical activity, but if you feel so much pain in your knee to warrant taking a painkiller before an activity, you should consider cutting back or discontinuing that activity.


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.
New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.
Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.
If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Do I Need Surgery for a Meniscus Tear?

Article on WebMD, medically reviewed by Tyler Wheeler, MD on May 16, 2019
You have two C-shaped discs of cartilage (soft tissue) that connect your thigh bone to your shinbone. These are called menisci. They’re like shock absorbers for your bones. They also help to keep your knee stable.Athletes who play contact sports like football and hockey are prone to meniscus tears. But you can also get this injury when you kneel, squat, or lift something heavy. The risk of injury increases as you get older, when bones and tissues around the knee begin to wear down.
If you tear your meniscus, your leg might swell and feel stiff. You might feel pain when twisting your knee, or be unable to straighten your leg fully.

What Are My Treatment Options?

Treatment for a meniscus tear will depend on its size, what kind it is, and where it’s located within the cartilage. Most likely, your doctor will recommend that you rest, use pain relievers, and apply ice to you knee to keep the swelling down. They may also suggest physical therapy. This will help to strengthen the muscles around your knee and keep it stable.
If these treatments don’t work — or if your injury is severe — they might recommend surgery. To be sure, your doctor will probably have an MRI done. And they might look at the tear with an arthroscope. That’s a thin tool that has a camera and light at the end. It allows doctors to see inside your joints.
If your doctor’s exam shows your meniscus tear is mild (Grade 1 or 2), you may not need surgery. If it’s Grade 3, you probably will. Your doctor might choose to do any of the following:

  • Arthroscopic repair. Your doctor will make small cuts in your knee. They’ll insert an arthroscope to get a good look at the tear. Then they’ll place small devices that look like darts along the tear to stitch it up. Your body will absorb these over time.
  • Arthroscopic partial meniscectomy. Your doctor will remove a piece of the torn meniscus so your knee can function normally.
  • Arthroscopic total meniscectomy. During this procedure, your doctor will remove the whole meniscus.

Meniscus repair is low-risk. Complications are rare. They may include injury to skin nerves, infections, and knee stiffness. Your doctor may prescribe antibiotics to help stave off infection. They may also recommend compression stockings to help prevent blood clots.

How Long Is Recovery?

You may have to wear a brace or cast to keep your knee stable. You’ll likely also have to use crutches for at least a month to keep weight off your knee.
Your doctor may recommend physical therapy as part of your recovery. It’ll help increase your range of motion and help your knee get stronger. They may also share some exercises you can do at home.
If you have a partial or total meniscectomy, you can expect your recovery to take about a month. If your meniscus was repaired, it may take as long as 3 months.


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.
New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.
Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.
If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Partial and Total Knee Replacement: How are they different?

From Noyes Knee Institute
Strong, healthy knees are important for your mobility. Unfortunately, the knee joint is easily injured and is susceptible to damage from arthritis. Any damage or injury to the knee is painful and may limit your daily activities. Depending on which part of your knee is damaged, you may have the option of either a total or partial knee replacement.
Learn more about the difference between partial and total knee replacement to decide which is right for you.

Parts of the Knee

The knee joint consists of four bones: the femur, tibia, fibula, and patella. Four ligaments — two collateral and two cruciate — stabilize the connection of the bones while allowing movement. Menisci, or cartilage, minimizes the trauma of the femur and tibia sliding across each other, and small sacs of fluid between bones allow for smooth movement.
The knee is also divided into three distinct compartments: The medial compartment is the section of knee on the inside of the leg, the lateral compartment is on the outside of the leg, and the patellofemoral compartment is the area directly under the kneecap. A partial knee replacement is done when only one of these compartments is damaged.

Total Knee Replacement

A total knee replacement involves resurfacing the ends of the tibia and femur to remove all the damaged tissue. The damage could be deteriorated bone, cracked bone, or calcified bone as well as the damaged cartilage. Once the bad tissue is removed, metal caps are placed over the bones to recreate their original shape and size. These caps may snap on snugly or be glued in place.
With the bones recreated, the doctor determines whether the kneecap has been damaged or not. If there is damage, the underside will be cleaned, and then a plastic disc will be fit into place. Finally, plastic pacers are placed between all parts that may rub or slide against each other during movement.
Either or both of the cruciate ligaments of the knee may be removed during a total knee replacement if they are damaged. The collateral ligaments are not removed. When a cruciate ligament is taken out, the metal caps over the bones have a ridge or locking mechanism to ensure your bones do not move too far or slip out of place.

Partial Knee Replacement

A partial knee replacement requires the same resurfacing and metal caps but involves either the medial or lateral compartment. If both compartments have damaged tissue, or if the problem is within the patellofemoral compartment, a different treatment is needed.
If your knee is unstable and the bones slip to the side, forward, or backward, partial knee replacement is not an option. In addition, the anterior cruciate ligament must not be damaged for this procedure to work. No ligament is removed during a partial knee replacement.
When only one compartment needs repaired, you may consider a partial knee replacement. If your doctor deems you a good candidate for this procedure you will experience a few benefits over a total knee replacement. One of the most important benefit is that your knee will still function the way it always has because less of the joint is removed and replaced.
With a partial replacement, you may require more surgery and a total replacement in the future. One reason for this is that a partial replacement does not last as long as a total replacement. The other reason is that the remaining natural parts of the joint may become damaged as you age and require replacement too.


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.
New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.
Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.
If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.