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.

Walking Towards Healthier Knees

Article featured on ScienceDaily

A new study published today in Arthritis & Rheumatology led by researchers at Baylor College of Medicine reveals that walking for exercise can reduce new frequent knee pain among people age 50 and older diagnosed with knee osteoarthritis, the most common form of arthritis. Additionally, findings from the study indicate that walking for exercise may be an effective treatment to slow the damage that occurs within the joint.

“Until this finding, there has been a lack of credible treatments that provide benefit for both limiting damage and pain in osteoarthritis,” said Dr. Grace Hsiao-Wei Lo, assistant professor of immunology, allergy and rheumatology at Baylor, chief of rheumatology at the Michael E. DeBakey VA Medical Center and first author of the paper.

The researchers examined the results of the Osteoarthritis Initiative, a multiyear observational study where participants self-reported the amount of time and frequency they walked for exercise. Participants who reported 10 or more instances of exercise from the age of 50 years or later were classified as “walkers” and those who reported less were classified as “non-walkers.”

Those who reported walking for exercise had 40% decreased odds of new frequent knee pain compared to non-walkers.

“These findings are particularly useful for people who have radiographic evidence of osteoarthritis but don’t have pain every day in their knees,” said Lo, who also is an investigator at the Center for Innovations in Quality, Effectiveness, and Safety at Baylor and the VA. “This study supports the possibility that walking for exercise can help to prevent the onset of daily knee pain. It might also slow down the worsening of damage inside the joint from osteoarthritis.”

Lo said that walking for exercise has added health benefits such as improved cardiovascular health and decreased risk of obesity, diabetes and some cancers, the driving reasons for the Center for Disease Control recommendations on physical activity, first published in 2008 and updated in 2018. Walking for exercise is a free activity with minimal side effects, unlike medications, which often come with a substantial price tag and possibility of side effects.

“People diagnosed with knee osteoarthritis should walk for exercise, particularly if they do not have daily knee pain,” advises Lo. “If you already have daily knee pain, there still might be a benefit, especially if you have the kind of arthritis where your knees are bow-legged.”


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.

6 Tips for Parents With Kids Who Have Osgood-Schlatter’s Disease

Article featured on Orthogate
Anterior knee pain is a common complaint of young athletes participating in sports. As a teenager, most of the aches and pains disappear as fast as they show up. However, when the pain doesn’t go away it can be frustrating and scary to deal with as a parent. Osgood-Schlatters Disease (OSD) is one of the common ailments that cause pain in the front of knee particularly in teenage athletes ranging from 12-15 years old. Injuries at this age can be a challenge, as kids of that age have difficulty communicating their pain, understand their diagnoses, and can get frustrated with the missed time on the playing field.
Osgood-Schlatters also tends to linger and stay longer than any teenager would like. That’s when you decide to see a doctor. However, OSD is just common enough and not serious enough that some doctors might brush it off as unimportant. What’s a parent to do? Here’s a guide to help you and your growing teenager get through it and maintain the sanity of your household through the process.

What is Osgood-Schlatters Disease?

First, the word disease can be a little misleading. Osgood-Schlatters Disease is less of a disease and more of an overuse injury involving the patella tendon. OSD is most common during the adolescent growth spurt as the bones are maturing. The pull from repetitive movement such as jumping causes tension through the patella tendon on Tibial Tuberosity. This traction injury can cause inflammation, tenderness to the touch, and formation of a painful bony bump to form on the front of the shin.

Risk Factors for Osgood-Schlatters Disease?

The primary risk factors for Osgood-Schlatter disease are repetitive movements during a certain age range. Other risk factors include:

  • Age – OSD is most common during puberty and large growth spurts. The typical range for boys is 12-15 and girls from age 10-13
  • Gender – OSD occurs more frequently boys but the incidence is increasing in young girls as more young ladies are participating in sports
  • Sports – Most commonly found in sports with high force production in the legs such as running, jumping, and cutting. Basketball, hockey, and soccer are the most common sports associated with OSD.

Top Tips for Patients To Help Recover from Osgood-Schlatter Disease

Create a Schedule

This might be the most important tip to consider. Recovering from OSD requires consistency and a schedule can help. Create a daily schedule to ice the tendon, to stretch the quadriceps, and to even perform self-massage can speed up recovery. Also, schedule some downtime to allow the knee adequate rest. Kids tend to have a really hard time understanding the importance of treating their injuries seriously. For good time management skills try writing out daily, weekly, and monthly recovery goals.

Take Active Time Off

OSD is an overuse injury from repetitive patellar tendon tension. If the young athlete continues to play and practice without adequate tendon rest it could re-injure the tendon. This can prolong the recovery timeline and cause more frustration. The tendon needs proper time to heal and this can be difficult during the middle of the season, especially for a teenager. Try to help them understand that active movement and activities such as walking and biking are good but they need to take a break from jumping, running, and sports. Figure out other ways they can be involved with the team while they heal as OSD can take up to 6-8 weeks to heal in severe cases.

Brace it

For mild cases and athletes returning to their sport, a brace may help with pain and prevent a recurrence. A brace for Osgood-Schlatters changes the location of tension from the Tibial Tubercle to the brace. The tendon is allowed to heal with less tension but yet your athlete is still able to participate. This may also stop the progression of new cases of OSD before they become severe and help them get back to sports sooner.

Emphasize Proximal Hip Strengthening

The knee is a slave to the hip and ankle. The knee joint bends forwards and backward but the rotation of the knee is controlled from the joints above and below it. One of the best ways to stabilize the knee focuses on the lateral hip muscles through exercises such as the side-lying clamshell and the single-leg deadlift. The stronger the hip gets, the more stable the knee will become and it will be able to handle more stress. These exercises also won’t aggravate OSD, so they are safe to start at any time.

Talk about Expectations

Taking 4-6 weeks off during the middle of the season may seem like an eternity for a 13-year-old but it’s important to talk about expectations and timelines. The younger teens may not understand the importance of healing now to prevent future complications. They shouldn’t be running or jumping while at school. Take time to talk to them about how they feel about missing playing time. The young athlete may be seen apprehensive about losing their starting spot in the lineup or worry that they will be forgotten by their teammates. Feeling depressed about their injury is fairly common.

Prevent it with Cross-Training

One of the best ways to prevent OSD from returning or starting in the first place is through cross-training. Specializing in one sport has been shown to increase the injury rate in young athletes. The demands of participating in different sports change the repetitive trauma to the muscle, tendons, and ligaments. By playing multiple sports over the year it promotes well-rounded muscle development, better movement quality, and needed rest between seasons. Kids need to be well-rounded athletes before they can specialize.

Conclusion:

Osgood-Schlatters can be a frustrating and scary injury to deal with as a parent. However, with a solid game plan, proper communication, and maintaining active rest,  your young athlete will be back on the field in no time.


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.

Jog on: Exercise Won’t Raise Your Odds for Arthritic Knees

Article featured on MedicineNet
Dr. Kim Huffman, an avid runner, gets a fair amount of guff from friends about the impact that her favorite exercise has on her body.
“People all the time tell me, ‘Oh, you wait until you’re 60. Your knees are going to hate you for it’,” Huffman said. “And I’m like, ‘That’s ridiculous’.”
Next time the topic comes up, Huffman is well-armed: An extensive British analysis of prior study data has found no link between a person’s amount of exercise and their risk for knee arthritis.
The research team combined the results of six clinical trials conducted at different places around the globe, creating a pool of more than 5,000 people who were followed for 5 to 12 years for signs of knee arthritis.
In each clinical trial, researchers tracked participants’ daily activities and estimated the amount of energy they expended in physical exertion.
Neither the amount of energy burned during exercise nor the amount of time spent in physical activity had anything to do with knee pain or arthritis symptoms, the researchers concluded.
“This helps dispel a myth that I’ve been trying to dispel for quite a while,” said Huffman, an associate professor at the Duke University Medical Center’s division of rheumatology.
“If you add up the amounts of activity that people do and also the duration of activity, neither of those is associated with knee arthritis,” added Huffman, who wasn’t involved in the analysis.
Dr. Bert Mandelbaum is chief medical officer of the Los Angeles Galaxy soccer club and team physician for the U.S. Soccer Men’s National Team.
He agreed the study “further corroborates the fact that levels of exercise in one’s personal life do not increase the risk, the onset or progression of osteoarthritis.”

So where did this misconception come from?

Huffman thinks it’s because people mistake exercise-related injuries for the effect that exercise itself has on your joints.
“Right now, the clear risks for knee arthritis are genetics, injuries and female sex,” Huffman said. “People who exercise more may be more likely to injure their knee. That’s where I think the myth comes from.”
In fact, exercise can help ward off knee arthritis in several ways, Huffman said:

  • Flexing and extending the knee during exercise promotes the diffusion of fluid into the joint, promoting better nutrition.
  • An elevated metabolism created by exercise helps control inflammation in the knee joint.
  • Weight loss reduces the amount of load placed on the knee.
  • Exercise strengthens the muscles surrounding the knee, stabilizing it and reducing the risk of injury.

“I don’t think we’re finding that simple overuse or using your joint is a problem. It’s more an association with injuries and perhaps in the setting of obesity or high genetic risk,” Huffman said.
Your best bet is to choose an exercise that poses the least risk of a knee injury, Huffman said.
“If you want to go snow skiing, I don’t think that’s a huge problem but you’re probably going to be more likely to injure yourself downhill skiing than, say, walking in your neighborhood or training for a marathon,” Huffman said. “It’s not soccer or football or skiing itself. It’s just the risk for injury during those activities.”
On the other hand, exercise provides benefits that go far beyond healthy joints, said Mandelbaum, co-chair of medical affairs at Cedars-Sinai Kerlan-Jobe Institute at Santa Monica, Calif. He played no role in the research review.
“Physical activity is essential to optimize both physical and mental health and plays a central role in facilitating life’s quality and quantity,” Mandelbaum said. “The list of benefits includes decreased anxiety, better mood, decreased levels of coronary disease, hypertension, diabetes and obesity, and therefore a longer life.”


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.

Swollen Knee Causes and Treatments

Article featured on the Mayo Clinic

Overview

A swollen knee occurs when excess fluid accumulates in or around your knee joint. Your doctor might refer to this condition as an effusion (ih-FYU-zhen) in your knee joint. Some people call this condition “water on the knee.”
A swollen knee may be the result of trauma, overuse injuries, or an underlying disease or condition. To determine the cause of the swelling, your doctor might need to obtain a sample of the fluid to test for infection, disease or injury.
Removing some of the fluid also helps reduce the pain and stiffness associated with the swelling. Once your doctor determines the underlying cause of your swollen knee, appropriate treatment can begin.
Symptoms
Signs and symptoms typically include:

  • Swelling. The skin around your kneecap can puff up noticeably, especially when you compare the affected knee to the normal one.
  • Stiffness. When your knee joint contains excess fluid, you might not be able to bend or straighten your leg completely.
  • Pain. Depending on the cause of the fluid buildup, the knee might be very painful — to the point that it’s difficult or impossible to bear weight on it.

When to see a doctor

See your doctor if:

  • Self-care measures or prescribed medications don’t relieve the pain and swelling
  • One knee becomes red and feels warm to the touch compared to your other knee

Causes

Many types of problems, ranging from traumatic injuries to diseases and other conditions, can cause a swollen knee.

Injuries

Damage to any part of your knee can cause excess joint fluid to accumulate. Injuries that can cause fluid buildup in and around the knee joint include:

  • Torn ligament, particularly the anterior cruciate ligament (ACL)
  • Cartilage (meniscus) tear
  • Irritation from overuse
  • Broken bones

Diseases and conditions

Underlying diseases and conditions that can produce fluid buildup in and around the knee joint include:

  • Osteoarthritis
  • Rheumatoid arthritis
  • Infection
  • Gout
  • Pseudogout
  • Bursitis
  • Cysts
  • Tumors

Risk factors

  • Age. Your likelihood of developing a swollen knee related to arthritis increases as you age.
  • Sports. People who participate in sports that involve twisting the knee, such as basketball, are more likely to experience the types of knee injuries that cause swelling.
  • Obesity. Excess weight puts added stress on the knee joint, contributing to the tissue and joint overload and knee degeneration that can lead to a swollen knee. Obesity increases your risk of osteoarthritis, one of the more frequent causes of knee swelling.

Complications

Complications of a swollen knee can include:

  • Muscle loss. Fluid in the knee can harm the working of your muscles and cause thigh muscles to weaken and atrophy.
  • Fluid-filled sac (Baker’s cyst). The buildup of fluid in your knee can lead to the formation of a Baker’s cyst in the back of your knee. A swollen Baker’s cyst can be painful, but usually improves with icing and compression. If the swelling is severe, you might need to have fluid removed (cyst aspiration).

Prevention

A swollen knee is typically the result of an injury or chronic health condition. To manage your overall health and prevent injuries:

  • Strengthen the muscles around your knee. Strong muscles around a joint can help ease pressure on the joint itself.
  • Choose low-impact exercise. Certain activities, such as water aerobics and swimming, don’t place continuous weight-bearing stress on your knee joints.
  • Maintain a healthy weight. Excess weight contributes to the wear-and-tear damage that can lead to a swollen knee.

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.

Overview of Patellar Tendinitis

Article featured on Mayo Clinic

Overview

Patellar tendinitis is an injury to the tendon connecting your kneecap (patella) to your shinbone. The patellar tendon works with the muscles at the front of your thigh to extend your knee so that you can kick, run and jump.
Patellar tendinitis, also known as jumper’s knee, is most common in athletes whose sports involve frequent jumping — such as basketball and volleyball. However, even people who don’t participate in jumping sports can get patellar tendinitis.
For most people, treatment of patellar tendinitis begins with physical therapy to stretch and strengthen the muscles around the knee.

Symptoms

Pain is the first symptom of patellar tendinitis, usually between your kneecap and where the tendon attaches to your shinbone (tibia).
Initially, you may only feel pain in your knee as you begin physical activity or just after an intense workout. Over time, the pain worsens and starts to interfere with playing your sport. Eventually, the pain interferes with daily movements such as climbing stairs or rising from a chair.

When to see a doctor

For knee pain, try self-care measures first, such as icing the area and temporarily reducing or avoiding activities that trigger your symptoms.
Call your doctor if your pain:

  • Continues or worsens
  • Interferes with your ability to perform routine daily activities
  • Is associated with swelling or redness about the joint

Causes

Patellar tendinitis is a common overuse injury, caused by repeated stress on your patellar tendon. The stress results in tiny tears in the tendon, which your body attempts to repair.
But as the tears in the tendon multiply, they cause pain from inflammation and weakening of the tendon. When this tendon damage persists for more than a few weeks, it’s called tendinopathy.

Risk factors

A combination of factors may contribute to the development of patellar tendinitis, including:

  • Physical activity. Running and jumping are most commonly associated with patellar tendinitis. Sudden increases in how hard or how often you engage in the activity also add stress to the tendon, as can changing your running shoes.
  • Tight leg muscles. Tight thigh muscles (quadriceps) and hamstrings, which run up the back of your thighs, can increase strain on your patellar tendon.
  • Muscular imbalance. If some muscles in your legs are much stronger than others, the stronger muscles could pull harder on your patellar tendon. This uneven pull could cause tendinitis.
  • Chronic illness. Some illnesses disrupt blood flow to the knee, which weakens the tendon. Examples include kidney failure, autoimmune diseases such as lupus or rheumatoid arthritis and metabolic diseases such as diabetes.

Complications

If you try to work through your pain, ignoring your body’s warning signs, you could cause increasingly larger tears in the patellar tendon. Knee pain and reduced function can persist if you don’t tend to the problem, and you may progress to the more serious patellar tendinopathy.

Prevention

To reduce your risk of developing patellar tendinitis, take these steps:

  • Don’t play through pain. As soon as you notice exercise-related knee pain, ice the area and rest. Until your knee is pain-free, avoid activities that put stress on your patellar tendon.
  • Strengthen your muscles. Strong thigh muscles are better able to handle the stresses that can cause patellar tendinitis. Eccentric exercises, which involve lowering your leg very slowly after extending your knee, are particularly helpful.
  • Improve your technique. To be sure you’re using your body correctly, consider taking lessons or getting professional instructions when starting a new sport or using exercise equipment.

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 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.