Knee Pain Relief : Running Knee Pain - Here Is An Effective Way To Survive This Issue

Do you love to run?

If so, you are probably one of those people who will run no matter what the conditions are outside. It probably does not even matter what else you have going on in your busy life. Runners are a unique breed of people who live to be pounding the pavement and wish to feel the cool breeze in their hair as they stride along. Even if you are a runner who uses a treadmill during the winter months, you are probably serious about logging your miles and will not let anything stop you. Of course, we all need to slow down from time to time and sometimes we do not have a choice.

Running is a unique sport in that although you are not faced with contact injuries like in other sports, there is an extreme amount of pressure and strain that is placed on the knee joint and the ligaments that help support your knee. Due to the repetitive motions and stress that is placed on the knee, running injuries like acl tears, mcl tears, or meniscus tears do happen. Even if you do not experience a knee injury, you are very likely to experience discomfort at some point in your life if you run for years.

Are you looking for a way to survive the knee pain you have when you run?

You do not need to avoid running to avoid a knee injury. Even if you were told that you should not run excessively, many runners are so determined to run that they will not let anything get in their way. In order to help protect your knees from injury there is a simple thing that you can do. Although you should always focus on your knee injury first, and then the sport of running second, there are low profile knee supports that lend themselves very well to running longer distances. They come in different styles and levels of protection. Knee supports for running are made to help stabilize the knee joint so that it will not be put under as much as stress as without wearing one. You can obtain a knee brace for running at a very affordable price, and this decision could be the best thing you have done for your knees.

Lastly, we would like to give you an inside secret on how to save money when you do buy a knee brace. Most of the time you do not need to have a custom knee support made for you, a well designed non custom knee brace can provide you with great knee support, unless your knee anatomy is abnormal. These non custom knee supports can seriously save you hundreds, if not a thousand dollars. Just something to consider as you search for a knee support.

By: Daniel Sims

Article Directory: http://www.articledashboard.com

If you are looking for pain relief, the use of a low profile knee brace can be the answer you are looking for. Visit us online now, and Dr. Brace Company can provide several low cost, yet effective knee braces to help provide the meaningful knee support that you need. Visit us online now, if you would like to learn more at www.drbraceco.com

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Technorati Tags: knee brace, knee brace for running, knee injury, knee pain, Knee Pain Relief, knee support, running, running injuries

ACL knee braces are great supports to wear if you have a painful or injured knee. Many people wear them for extra support and to prevent knee injuries from occurring when participating in sport. Knee Braces are made from modern materials and are designed to be lightweight and breathable.

ACL knee braces are often used by people who are suffering from an knee injury and requiring protection during knee rehabilitation. A knee brace limits the amount of damage to an injured knee by supporting the patient with stabilization to his or her knee joint. Knee braces are designed to substitute for damaged ligaments. These knee braces are designed to compensate for a knee ligament tear.

ACL knee braces are also used as rehabilitation aids after surgery. For example, in severe cases of patella femoral, which is surgically treated, several types of knee braces are used for rehabilitation. These range from prefabricated, lightweight athletic braces to custom-made braces incorporating structured support, such as splints and hinges.

A passive stretching program while wearing a knee brace follows after a period of time after surgery and prevents excess tightness from developing in the knee. This program promotes healing, improves flexibility and strengthens the surrounding muscles around the knee while wearing a knee brace.

In conclusion, ACL knee braces are great aids for knee support, knee injury rehabilitation and knee injury prevention. They can either be worn to play sport, to perform physical labor or for rehabilitation after surgery.

Jumper’s Knee Symptoms - 1

So my self prognosis was close, I don’t have runner’s knee, I have jumper’s knee.  It makes sense, even though I am a runner, I used to be a jumper when I was in the 82nd Airborne Division.

Jumper’s Knee Symptoms -  2 

Knee strengthening is important. Wear a Band: Wear a band across the patellar tendon, called an infrapatellar strap, which will support your patellar tendon and prevent it from becoming overused. You overdo everything. 

Don’t Neglect A Stiff Knee In The Morning! 

Swimming and walking are two good exercises that can help your knee. Wearing a knee brace and proper shoes will help. Knee supports can help provide you with meaningful support and can help to reduce your knee discomfort as well.  

Technorati Tags: acl, ACL Knee Braces, athletic knee braces, custom-made braces, knee, knee brace, knee injury, knee pain, knee support, rehabilitation

 The knee is the largest joint in the human body, and it’s used on a daily basis. Most of us take our knees for granted, and it’s not until something goes wrong with them that we take a moment, pause and realize just how much we actually need our knees.

  Those who suffer from any kind of knee pain on a regular basis know how frustrating it can be to find relief. They also know that it can hard for knee injuries to heal since we are always on our feet. We put a lot of pressure and stress on our knees every day through movements as simple as bending and twisting.

  There are many kinds of knee problems that people can suffer from, ranging from mild discomfort to more serious injuries or conditions. For problems that do not involve conditions such as significant tears in the ligaments or other injuries to the knee area, elastic knee supports can be what you need to alleviate the discomfort.

  Excess body weight : Try to stay within health weight parameters for your height and age. Being obese or even overweight can add increase stress to your knee joints, even during activities of daily living such as walking and climbing or descending stairs. Being overweight also increases your chances of suffering from osteoarthritis by breaking down the joint cartilage in your knees at a more rapid pace.

  While we can not prevent all kinds of knee injuries, we can do our best to protect ourselves by wearing a sport knee brace. Giving the knee support can help stabilize the joint and also protect the surrounding ligaments. Tearing of the ACL, MCL, or a meniscus tear are some of the most common knee injuries that take place. These kinds of injuries can also be hard to heal because for most of us simply staying off our feet is not an option.

  Knee pain and knee injuries are common among basketball players. Although it is not a contact sport, the constant motions of jumping and running, cutting and pivoting can place a lot of stress on the knee. Unfortunately, an injury to the ligaments in your knee can can put a stop to your playing days

  You can also consider elevating the knee and wrapping it in an elastic bandage. Anti-inflammatory drugs, such as Advil or Motrin will can also help to reduce the pain and swelling (Ask your physician before taking any drugs). Wearing a knee brace will also lend support to the knee and the patellar tendons and quadriceps muscles, which are the root cause of the pain. A brace will help provide gentle compression to the knee area, which will help keep the swelling at bay. Even if your child isn’t planning on doing anything strenuous, it’s a good idea for them to continue to wear the knee brace in order to lend the knee area as much support as possible.

By: Hutch Peter

Article Directory: http://www.articledashboard.com

Read about Natural Supplements. Also read about Natural Remedies for Blood Pressure and Natural Remedies for High Cholesterol

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Technorati Tags: brace, Excess body weight, injuries, joint cartilage, knee, knee joints, meniscus tear, overweight, patellar tendons

"My knees ain’t what they used to be when I was 25!" joked my husband after he exercised. He’s right; even though I told him he still has a great body. The dreadful truth may be broadcasted loud and clear from our knees for those of us who are reaching boomer status. Exercise can hurt, so you are tempted to pass it up.

Knees take a beating in life, particularly if you have played sports in your youth, run or jogged for exercise, or had knee injuries, such as ACL tears (anterior cruciate ligament tears). The cushioning of the meniscus in the knee joint gets worn down or damaged with age and use. Lubrication, called synovial fluid, dries up.

So - what are you to do about exercise if you have knee pain?

First, see a good orthopedic specialist, who has a sub-specialty in sports medicine, for an evaluation. You need to know from an expert exactly what you are dealing with. You can only devise a good exercise program when you know just how much to push and just how much to limit your activity. Ask your physician for specific recommendations about what you can and cannot do when you exercise.

Paradoxically, some knee pain will lessen with mild to moderate exercise. Ask your orthopedic doctor to prescribe several sessions of physical therapy to get you started with some knowledgeable supervision. Then you can continue on your own.

It was a surprise that Louise, who was severely overweight and had massive damage to her knees, benefited from physical therapy. Strengthening the supporting muscles and ligaments around her knee joints with certain specific, limited exercises helped take some of the pressure off of her damaged knees, while she waited for knee replacement surgery.

Hopefully you are not in that category. For most boomers it is a matter of engaging in and enjoying non-weight bearing exercise. For instance it may be time to give up the basketball court for the swimming pool. It may be time to replace your jogging time with a bicycling time to take the pressure off of your complaining knees. They are complaining for a good reason.

Keep in mind that the leg muscles above and below your knee, front and back, must be stretched regularly to help your knee joint remain in alignment and flexible.

Stretch your hamstrings by sitting on the floor, steps or a low chair and bend slowly from the waist.

Stretch your quadriceps muscles, the muscles on the front of the thigh, by pulling your foot up behind your buttocks - gently and slowly.

Stretch your calf muscles by standing on something, like a book or a step, so that you heel is lower than the ball of your foot.

See your doctor if you have knee pain and get it evaluated. Then you can trust that your exercise is helping, not hurting, your knee joints. It is most important to keep on exercising in the best way for your body’s well being.

By: Lynn Kennedy-Baxter, RN, MA

Article Directory: http://www.articledashboard.com

Download a free guide to more energy to exercise at wwwSmartWomenExercise.com. Lynn Kennedy, RN, MA delights in helping people find more energy and motivation to exercise.

 

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Exercise Trampoline
Before one starts a work out with a trampoline there are some basics to keep in my mind; one should always start workout with a routine of warm up exercises, these warm up exercises are generally the same as the cool down exercises and both of these sets of exercises are extremely important. ..  

More Talk On Warming Up 
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Technorati Tags: anterior, cruciate, exercise, knee, ligament, miniscus, muscles, orthopedic, physical therapy, stretching, tears

Preventing Soccer Injuries

There are various types of soccer injuries such as sprains, fractures, bruises, strains, etc. However, you can take some precautions to prevent such soccer injuries.

Soccer is one of the popular sports among the youth. It is a good form of exercise and fun activity. This game is full of energy and enthusiasm. Playing soccer is beneficial for physical fitness and overall health. Soccer ground is such a place that offers a lot of fun and excitement. But at the same time, it is a source of a number of playground injuries. Some of the injuries can really be very serious and the person has to face long-term consequences.

Common Soccer Injuries

Soccer injuries can be acute (traumatic) injuries or cumulative (overuse) injuries. Acute or traumatic injuries are due to sudden impact or force. Overuse soccer injuries result from stress on joints, muscles and soft tissues without proper time for healing. Such injuries start as a small, nagging pain and if left untreated, they result in a debilitating injury. Most soccer injuries involve knee, ankle and hip region. Soccer injuries are strains, sprains, bruises, fractures, abrasions and muscle-tendon injuries. Soccer players often get the injuries to upper leg, lower leg and head. Lower leg injury is due to the contact with other players. Knees and ankles are most commonly injured. Head injury results from heading the ball, head to head contact with another player or being struck by a ball kicked at high speed. Some other causes of soccer injuries are over-exertion, falls, being struck by the ball and overuse. Some of the common soccer injuries include knee ligament sprains, ankle sprains, Achilles tendonitis, concussion, muscular strains, Iliotibial Band syndrome and meniscus tears. Knee injuries are also very common in soccer players.

How to prevent soccer injuries?

Soccer injuries can be very severe and may leave serious, long-term consequences. Hence, it’s very important to take all the necessary precautions in order to prevent soccer injuries. Here are some useful tips for preventing soccer injuries:

• Always take enough time to warm up and stretch. Stretching exercises are necessary especially for your knees, hips, calves and thighs. Research studies have proved that cold muscles are more vulnerable to injury. Warm up your muscles with stationery cycling, walking or running in place for about 3-5 minutes. Then gently and slowly stretch your muscles, holding each stretch for about 30 seconds.
• Warm-up is very important for your body. It increases your body temperature and prepares it for physical activity. Kicking the ball without warm-up can cause certain injuries.
• If you experience pain in any of your body part, then have a rest for some time. Pain can be a warning sign of injury and hence, it should not be neglected.
• You need to be knowledgeable about basic first-aid. You should be able to manage some minor injuries such as minor sprains, strains, bruises, facial cuts or minor tendinitis/tendonitis.
• There should be appropriate preparations for emergency situations at the soccer ground. Medical personnel should be there at the ground to treat the common soccer injuries.
• Always wear shin guards in order to protect your lower legs. Select the shoes with molded cleats or ribbed soles. Shoes with screw-in cleats can lead to a greater risk of injury.
• Don’t crawl or sit on the goal. Avoid hanging from the net. Many soccer injuries are associated with falling the goals onto the players.
• Always use nonabsorbent, synthetic balls on wet playing fields. Leather balls may get waterlogged and heavy and increase the risk of injury.
• Keep the playing surface in good condition. Holes on the ground should be filled. Playing ground should be kept free from debris and obstructions.

So, next time before you go to the soccer ground, don’t forget to take these precautions for preventing soccer injuries. After all, prevention is better than cure, isn’t it?

By Reshma Jirage Published: 11/22/2008   Sport Specific Moves Prevent Injury Girls who spent 20 minutes before soccer practice focusing on exercises aimed at improving strength were less likely to sustain an injury.   Can ACL Knee Injuries Be Prevented In Female Athletes?  My daughter is a high school soccer player and I am concerned about the large number of ACL injuries that female athletes  suffer.   Warm Up Program To Prevent Injuries  [Abstract/Free Full Text]; Caraffa A, Cerulli G, Projetti M, Aisa G, Rizzo A. Prevention of anterior cruciate ligament injuries.   How To Prevent Soccer Injuries By learning how to prevent soccer injuries, you can minimize the chances of this happening to you. There are several injuries that are commonplace in soccer and most involve the legs.

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Technorati Tags: knee injuries, knee ligament sprains, preventing injuries, soccer injuries

Knee Pain

Knee pain can be debilitating and caused by various reasons. Here is a discussion about the various causes and their treatment.

One of the parts of the body that is prone to injury is the knee. A complex joint, we use our knees for most activities like sitting down, standing up, walking, running, and so on. Being one of the main weight-bearing joints, it bends, straightens, rotates and twists, all of which make it susceptible to overuse or acute knee injuries, resulting in knee pain.

Generally speaking, knee pain can be categorized as either acute, or immediate, or chronic knee pain that is long-term. Chronic knee pain can occur due to inflammation, e.g., arthritis, or from injuries, and sometimes because of infection.

Knee Pain Caused by Acute Injuries

Acute injuries can affect the ligaments, tendons, and bursae that surround the knee joint. Or knee pain can also be caused by injury to the meniscus, bones and cartilage that make up the knee joint. Acute knee injuries are usually caused by falling or twisting the joint. Sports that require fast turning, abrupt stopping, jumping and running like baseball, tennis, basketball, hockey, or soccer increase the chances of acute injury to the knee, resulting in knee pain.

Fracture of the knee can also be categorized as an acute knee injury, which can affect any of the bones that make up the knee joint. Fractures in the knee joint is usually serious and may require surgical intervention in order to repair it along with the joint being immobilized by a cast or other forms of support.

As for injuries of the ligaments, they are usually treated at first by immobilizing the affected knee and using ice packs, along with elevation and rest. If the injuries are severe, however, open surgery or arthroscopic surgery may be required to alleviate the knee pain. Tears of the meniscus usually need to be repaired by arthroscopic surgery.

Knee Pain Caused by Overload or Overuse Injuries

Knee pain is also caused by overload or over use injuries of the knees such as bursitis, tendonitis, and muscle strain, which can develop slowly over weeks or days. Initially, the knee pain is usually sporadic and mild, which becomes worse with time. When stress is caused on tendons and muscles, it results in tiny tears in them. The pain is caused by the resultant inflammation, which is part of the process of healing. These tears in the muscles and tendons must be given time to heal before performing similar activity that caused them. Overuse knee injuries should be treated promptly in order to prevent the knee pain becoming chronic.

The treatment for tendonitis involves immobilizing the knee with the help of a knee brace, ice packs, anti-inflammatory medications, and rest. Later therapeutic exercises can help in rehabilitating the tissues around and in the affected tendon. If a tendon in the knee is ruptured, however, it often requires surgery to repair it.

The treatment of bursitis in the knee is also ice packs, along with anti-inflammatory drugs and immobilization of the knee joint. Corticosteroid injections may also be given at the location, along with physical therapy to strengthen the muscles of the front area of the thigh.

Knee Pain Caused by Runners Knee

Also referred to as anterior knee pain or patellofemoral pain, runners knee is one of the most common causes of knee pain that affects young people. It is felt behind the patella, or the kneecap, and is a diffuse kind of pain. The pain usually worsens after running, jumping, climbing stairs, or after sitting for a period of time. Knee pain caused by runners knee is mainly treated by appropriate physical therapy exercises advised by a physical therapist or doctor. High-impact activity should be avoided in case you are suffering from runners knee.

Knee Pain Caused by Arthritis

Knee pain is also caused by various types of arthritis affecting the knee joint, such as osteoarthritis, which is non-inflammatory, wherein the cartilage of the knee degenerates, or the inflammatory kinds of arthritis like gout, rheumatoid arthritis, psoriatic arthritis, and so on. The treatment of these conditions has to be done according to the individual requirement of each.

By Rita Putatunda Published: 3/19/2008   Causes of Knee Pain | Home Remedies Help Causes of knee contracting can troth entirely varied and numerous. Injuries, arthritis…   Read more… Knee Pain Relief - Can You Play Basketball With a Knee Brace? The … Knee supports were created in order for you to get added stability and to help reduce your Read more… Causes and Treatment for Knee and Elbow Joint Pain One of the most frequent joint pains, knee joint pain is often involved in rheumatic d…   Read more…

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Technorati Tags: arthritis knee pain, knee pain from injury, runners knee pain

Common Knee Injuries

The knee is a complex joint which has ligaments, tendons and bones. Here are some of the common knee injuries that can affect it.

The knee is a complex joint made up of various types of structures, which include ligaments, tendons, and bones. Stiffness, swelling, and pain are some of the symptoms of knee injuries. Given below are some of the common knee injuries:

Internal Fracture or Torn Ligaments: Has your knee changed in shape or become misshapen? It could be due to torn ligaments or a fracture in the internal part of the knee.

Pre-Patellar Bursitis or Fracture: Do you experience pain when performing any activity? Is the kneecap warm, tender, and swollen? These could be due to a fracture or bruise of the kneecap if you have fallen hard on that affected knee. Or else, it could be a symptom of pre-patellar disease, which is caused due to the irritation of the bursa, which is a small fluid-filled sac located in front of the kneecap.

Chondromalacia Patellae or Torn Ligament or Torn Cartilage: Is there pain in your knee? Is it swollen and tender? It could be due to a torn ligament or torn cartilage. Or because of a condition known as Chondromalacia Patellae, which results in the softening of the cartilage or ligament beneath the kneecap.

Torn Hamstring Muscle: Is there a sharp pain on the posterior part of your knee? And, is stretching your leg painful? It could be due to a torn hamstring muscle.

Articular Cartilage Injury: Is there a swelling in the knee accompanied by a vague pain? It could be because of Articular Cartilage Injury, which can be caused due to wear and tear or because of physical injury.

Hyperextension of the Knee: This pertains to an injury wherein the knee is extended beyond its normal straightened position. In this position the lower leg is forced excessively in front in relation to the upper part of the leg. The knee is often hyperextended due to a contact injury caused to the lower leg, or landing awkwardly after a jump. It is one of the common knee injuries that occurs in leaping or jumping sports like basketball and gymnastics. The symptoms are pain, impaired mobility, instability, and swelling of the knee joint.

Patellar Tendinitis: Is there a pain between your patella, or kneecap, and the area where the tendon is attached to the tibia, or shinbone? Does the pain become especially sharp during physical activity, particularly when jumping or running? And is there a persistent dull pain after a practice session or a workout? This could be due to Patellar Tendinitis, which is an overuse injury affecting the tendon that connects your patella to your tibia.

Injuries to the Knee Ligaments: The knee has two cruciate ligaments, one located in the front side of the knee, known as the anterior cruciate ligament, or ACL, and the other located at the posterior side of the knee, known as the posterior cruciate ligament, or PCL. When these ligaments are injured, there may not be immediate pain, however there may be a popping sound and the knee may give out from beneath you. There will be swelling in the knee within 2-12 hours and there will be pain when you try standing.

Torn Meniscus: Is there persistent pain in your knee? Are you unable to move it as usual? Is there instability of the knee? These symptoms could be due to a torn meniscus, which is a cartilage disc that helps to cushion the ends of the bones that meet at the knee joint.

Torn Cartilage: If you feel grinding sensation in your knee joint or it locks, it could be because of a tear in the cartilage.

Osgood-Schlatter Disease: If you are between 12-18 years of age and suffer from pain, swelling, or tenderness that is located just under your kneecap which becomes worse during activity, it could be due to Osgood-Schlatter disease. This is a condition that affects most boys during their preteen years when they have a growth spurt.

Baker’s Cyst: If there is a swelling in the posterior side of your knee, it could be because of Baker’s Cyst.

Osteoarthritis of the Knee: If your has been experiencing stiffness, pain, tenderness, swelling, and redness over several months or even years, with the pain worsening when the weather changes, it could be due to osteoarthritis.

By Rita Putatunda Published: 12/25/2007

 
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Technorati Tags: acl pain, patella injury, torn ligament

Recovery Protocols for an ACL Injury

An Anterior Cruciate Ligament (ACL) tear has become a common injury among athletes. Learn more about the ACL and what to expect during rehabilitation.

Whether you are a fan of football, baseball, basketball, or any other recreational activity you have at one time or another heard of an ACL injury. Maybe your favorite athlete was sidelined for months with a tear to their ACL, or possibly it was you that had to watch from the sidelines for a few months. The Anterior Cruciate Ligament (ACL) is in fact a common major injury to the knee. Luckily for us with a good surgeon and physical therapist, an ACL injury is not career threatening. Read more about ACL injuries and what to expect during the rehab process.

Anatomy of the Anterior Cruciate Ligament (ACL)

Each one of our knees contains a number of ligaments that help stabilize its movements. Of the four major ligaments contained within the knee capsule, the ACL is considered by many to be the most important because it provides the majority of the knee’s stability. The ACL’s main objective is to stabilize the knee during planting and twisting motions, as well as prevent forward movement of the lower leg from the upper leg. It is able to do this by attaching to our upper leg at the front of the femur and crosses the knee to attach to the lower leg at the back of the tibia. When an injury to the ACL occurs it is either a partial or full tear of the ligament. The joint responds as it would to any other soft tissue injury by swelling. Some people hear a pop while others just notice an extreme lack of stability and a sense of the knee giving out when weight is shifted on to that leg. Depending on the extent of the injury a patient may or may not have surgery to repair a partial tear of the ACL. As previously mentioned it is not just athletes that experience tears of their ACL. Women tend to be more prone to an ACL injury, an unfortunate problem attributed to a number of factors. Anatomical factors that can contribute to one’s likelihood of injury include: strength imbalances between the hamstrings and quadriceps, joint laxity, and a large Q-angle.

Typical Rehabilitation Actions

Surgical and non-surgical rehabilitation protocols are very similar, if not the same in many cases. Once the surgical wounds have healed a patient will then schedule their first appointment with a physical therapist. The physical therapist will develop a plan of action for the patient’s treatment. The most important objective early on is to reduce swelling and work to prevent scar tissue buildup. The next objective is to regain full range of motion, while simultaneously strengthening the muscles that support the knee joint. With full of range of motion and increasing strengths, eventually a physical therapist will finish their rehab treatment with a phase of neuromuscular control activities and functional movements that correspond with the patient’s everyday needs.

It is wise to follow the acronym PRICE during the early stages of recovery from an ACL tear. PRICE stands for protection, rest, ice, compression, and elevation. By following these five steps each day a patient will effectively decrease their pain and swelling and better prepare their joint for the recovery process. About one or two weeks following surgery the patient will begin physical therapy. The physical therapist will perform an initial evaluation consisting of background questions, and visual and physical inspection of the knee itself. With this information a physical therapist will develop a detailed plan specific to each patient’s rehabilitation needs.

Rehabilitation Timetable & Expectations

As with any injury the expected time of recovery is based on numerous factors, such as: age, extent of injury, success and type of surgery, work ethic during rehab, physical therapist technique and care to detail, and overall health and fitness of the patient. An average patient, who had a traditional ACL surgery, will begin light jogging about four months post-surgery with full strength and mobility not being full restored until about six to nine months after surgery. Most doctors will advise a patient to not return to more aggressive physical activities until their recovering leg has gained at least 90% of the strength of the healthy leg. There are more advanced surgeries that can put an athlete on the playing field in about six months. This option is intended for serious athletes only and a physician should be consulted before investigating this alternative.

Any type of major injury can be a setback in an athletic career, or quite a struggle to deal with in day-to-day life, and an ACL tear is no different. Surgery and rehabilitation techniques are improving each day and are therefore making the recovery from such an injury less painful. A patient who is dedicated to their complete recovery will have a much better experience throughout the process and give themselves a great opportunity to continue their life, be it as an athlete or not.

Robert Tendick is a student preparing himself to earn a Doctor of Physical Therapy. Through his degree in Kinesiology and experiences as an athlete, Robert has become familiar with injuries to the ACL and common expectations for ACL post surgery recovery. He has also had the opportunity as a physical therapy aide to help heal a number of Los Angeles physical therapy patients through the use of cutting edge injury rehabilitation techniques.

By rob tendick Published: 4/29/2007

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Technorati Tags: ligament tear, torn acl, torn knee ligament

Knee injuries are very common in accidents and sporting incidents and can cause chronic pain, loss of joint stability and difficulty with daily activities. Physiotherapy starts with a subjective examination, enquiring about how the injury occurred, what forces were involved in the event, how quickly the knee swelling appeared, whether there was knee instability or difficulty putting full weight on the knee.
The amount of pain a patient suffers indicates the severity of the injury involved and the particular location of the pain can point to which anatomical structures have been injured. As the knee will be very difficult to walk on in the presence of a fracture these injuries are rarely missed in diagnosis. During the examination the physiotherapist will test the knee structures to look for the cause of the injury.
The Knee Examination
The physiotherapist will look at the knee and check for effusion by observation or doing the patellar tap test. The knee can swell greatly and be very tight, needing aspiration by a needle. How well the knee can move when not weight bearing is assessed by the physio. Knee extension is the movement of straightening the knee out and flexion is bending the knee. The knee does have a certain degree of rotation but that is rarely checked in the initial period.
The reaction to examination testing indicates how the treatment plan should proceed. The pain level, ease of joint movement and reaction to tests are included in this assessment. The patient moves the joint actively with the physiotherapist adding passive movement to test the joint further. The power of the main antigravity muscles, the hamstrings and quadriceps, are tested by manually resisting the knee movements or asking the patient to perform weight bearing movements.
Manual testing of the knee ligaments by the physiotherapist tells him or her about these important stability structures. The physio levers the knee inwards and outwards to test the medial ligament and the lateral ligament (the collateral ligaments) and pulls the shin bone back and forward to test the anterior cruciate ligament and the posterior cruciate ligament. Manual palpation around the joint and adjacent structures can help indicate which structure has been injured.
Physiotherapy treatment plan
Cryotherapy, or cold treatment, is an initial treatment for an acute painful knee and is used to reduce the swelling and pain. If pain is reduced then movement can occur more readily, allowing rehabilitation to progress to the next stage. A compression sleeve useful to compress the effusion as swelling inhibits the function of knee muscles. Of the knee is unstable on weight bearing a brace can be used to stabilise and protect it, with crutches or a stick necessary if the patient cannot weight bear well or achieve a reasonable gait.
Once the swelling and pain are under control the physio will work on the range of motion and move onto the strength of the major muscles. The quadriceps is the most important knee muscle, allowing normal gait and stability in the knee, and so this is the first and main target of muscle strengthening physiotherapy. Weight bearing exercises are started once the knee has settled and progressed to gradually more dynamic exercises.
A normal knee joint involved in activity sends a stream of impulses up to the brain, informing us of the joint position at all times, the degree of muscle activity and movement. This is known as joint position sense (JPS) or , which is lost to some degree after injury and restoring it to a normal level is vital if the knee is to successfully return to activity. The physio starts with balancing on one leg and progresses to standing on a wobble board and finally works on active, dynamic exercises in preparation for sport.

By: Jonathan Blood-Smyth..

Article Directory: http://www.articledashboard.com

Jonathan Blood Smyth is a Superintendent Physiotherapist at an NHS hospital in the South-West of the UK. He specialises in orthopaedic conditions and looking after joint replacements as well as managing chronic pain. Visit the website hepublishes if you are looking for Physiotherapists in Kensington.

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What is Total Knee Replacement?

This article will provide you with a detailed overview of total knee replacement.

Total Knee Replacement is a surgical procedure where the bones of the knee are resurfaced with metal and plastic implants and are "realigned" so that the weight that passes through the knee is normally distributed.

THE KNEE JOINT - BASIC ANATOMY

The knee joint is the mating and movement of three bones; the femur or thigh bone, the tibia or shin bone and the patella or knee-cap. The bones are joined together by ligaments and tendons. The tendons attach the muscles to the bones and the ligaments attach the bones to one another .

THE KNEE JOINT - WHAT GOES WRONG

If the surfaces of the knee bones become worn (arthritis), pain and limited mobility may result. Often, the surfaces of the bone will wear unevenly causing a bow-legged (varus) or knock-kneed (valgus) deformity. If the pain and deformity become severe enough, Total Knee Replacement may be indicated.

KNEE REPLACEMENT SURGERY OVERVIEW

In general, Total Knee Replacement is a very safe and effective procedure. However, it is a major operation that is quite invasive.

The outline below is indicative of the "standard" approach. A minimally invasive technique is similar, but the incision and disruption to surrounding soft-tissue is reduced.

An incision is made a few inches above the knee cap and extends just below the knee into the shin. The outer capsule of the joint is opened and the bones of the knee are inspected. In one type of procedure, both the ACL and PCL are removed (if present). The ACL (anterior cruciate ligament) and the PCL (posterior cruciate ligament) are the primary front-to-back stabilizers of the knee joint. In patients with advanced disease, these ligaments are compromised or absent.

Femoral Preparation in Total Knee Replacement

A small hole is drilled in the end of the femur (at about the center of the knee joint.)

A long rod is placed in the intramedullary canal of the femur (the hollow portion of the bone where the marrow is).

A cutting guide is placed on the rod and rotated so that it sets up a slot to make the femoral distal cut. This is a cut that created a plane that is roughly parallel to the floor if you were in a standing position. This cut is made such that it is perpendicular to a line connecting the center of the hip and the center of the ankle. This line is the mechanical axis of the lower extremity and it is important that the implant is aligned properly with respect to this. In doing so, the load distribution across the implant is optimized and the longevity of the implant maximized.

Next, a cutting guide is placed on the plane of the distal cut, it is aligned in rotation and 4 more cuts are made. The rotational alignment here (which is called internal/external rotation) is important in balancing the soft tissue and aligning the patella track of the implant. The patella track is literally a track or groove in the implant in which the patella moves during knee motion. Incorrect alignment of this track can lead to pain and/or accelerated wear of the patella component.

Once these cuts are made, the preparation is basically finished. Some implants have small fixation pegs on the distal surface so two holes are sometimes drilled for these. In the case of a PS implant (see PS implant post), a "box" is cut out from roughly the center of the prepared femur to make space for the cam/post mechanism of the PS implant. The outline below is indicative of the "standard" approach. A minimally invasive technique is similar, but the incision and disruption to surrounding soft-tissue is reduced.

Tibial Preparation in Total Knee Replacement

Typically, the top surface of the tibia is resected creating a planar surface that is perpendicular to the shaft of the tibia. In a "PCL retaining" procedure, a "bony island" is preserved around the insertion site of the Posterior Cruciate Ligament in the tibia. In a "PCL sacrificing" procedure, the PCL and the insertion area are removed.

About 8mm of bone is removed as measured off of the "good" side of the joint surface of the tibia known as the tibial plateau. In the arthritic knee, there is usually uneven wear of the joint surface. The joint basically collapses on the diseased side. The resection level is typically a couple of millimeters below the surface of the worn side of the joint, or 8mm off of the "good" side. Creating a flat tibial surface therefore requires a wedge shaped piece of bone to be removed.

Once the resection is made, trial components are placed in the joint. With the femoral and tibial prep complete (and often the patella prep as well), and a trial femur and tibia implant in place, the surgeon basically moves and tenses the joint through a range of motion. The surgeon can use tibial insert trials (also called tibial bearings or tibial spacers) of various thicknesses until the correct stability is achieved. The tibial insert trial corresponds to the tibial insert implant that will eventually sit in between the metal femoral and tibial
implant components.

Often, the surgeon must make surgical corrections of certain soft-tissue structures to help align and stabilize the knee.

Once trialing is complete, the appropriate "keel" preparation is made. The keel is a fin or cross shaped protrusion on the implant that helps it stay fixed and in the bone. This can be punched, chiseled, broached or cut into the tibia and a set of instruments is used so that the resulting shape matches the implant. Here, the surgeon must take care in aligning the keel preparation so that the correct rotation of the implant about the axis of the tibia is achieved. Correct rotational alignment of the implant promotes better distribution of load across
the implant and better motion of the knee joint.

Next, the "tibial baseplate" portion of the implant is simply pressed or cemented in place.

A plastic tibial insert is then snapped into the tibial baseplate (see the Implant section for more details). The insert comes in the various thicknesses that correspond to the trial used previously.

Total Knee Replacement
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