Understanding Common Knee Injuries - Blue Ridge HealthCare

Understanding Common Knee Injuries
“The knees are always the first thing to go.”

Click here to view this story as it appeared in the Morganton News Herald (Includes additional graphics and information) in pdf format.

BY ANNA WILSON
BLUE RIDGE HEALTHCARE

MORGANTON - The knees are the first to go. You’ve probably heard that old saying many times: from an aging athlete ready to retire, a recreational runner sidelined by an injury or an older adult hobbled by arthritis.

Of course, the knees are easily injured. They carry a heavy load in virtually every movement you make from the time you first start to crawl as a baby. For that same reason, it’s important to keep your knees healthy; they’re your lifeline - not only carrying you from point A to point B but allowing you to exercise the large muscles of your lower body and keep your cardiovascular system strong and healthy.

From the bursitis you get from kneeling in the garden to the mangled ligaments and tendons suffered in a skiing mishap, knee injuries can be painful and temporarily disabling but are nearly always fixable.

BURSITIS

BURSITIS is an inflammation in one of the 13 protective fluid-filled sacs or bursae that surround the knee. It can be caused by a blow to the knee, constant rubbing or kneeling, repetitive movements or excess weight.

“After a blow to the knee, you might feel a tender, swollen area right away - usually due to inflammation of a bursa,” said Dr. Albert Cecchini, one of Blue Ridge HealthCare’s orthopaedists at Mountain Orthopaedics. “The best treatment is ice, compression with an elastic bandage and NSAIDs such as aspirin or ibuprofen to reduce the swelling and inflammation.”

Chronic bursitis results from constant minor irritation. What’s known as housemaid’s knee affects the bursa directly in front of the kneecap; clergymen’s knee involves the bursa just below that. Carpet layers, roofers and gardeners are vulnerable because of pressure on the knee from constant kneeling. Repetitive motions from running, stair stepping or other activities can also inflame one or more bursae.

“In addition to ice and NSAIDs, treatment may involve rest from the activity that caused the problem and knee pads for future protection,” Dr. Cecchini said. “Runners might want to consider worn out or poorly chosen shoes as the source of the problem.”

Bursae on the side of the knee often become swollen and sore (anserine bursitis) in middle-aged persons simply because of excess weight and perhaps some early symptoms of osteoarthritis.

Bursitis is usually not very serious, but in rare instances the swelling and redness may signal an infection, which, if left untreated, could have disastrous consequences. A patient with an infected knee does not always have a fever. A doctor can check by draining the knee and examining the fluid for white blood cells.

TENDINITIS

TENDINITIS: Tendons are the tough cords of tissue that connect muscle to bone, and they can become inflamed when you work the muscles more than they are used to.

Almost anyone who’s physically active can get knee tendinitis, but athletes who do a lot of jumping are particularly vulnerable. Jumper’s knee typically involves tenderness at the spot where the thigh muscle attaches to the patella or kneecap.

Iliotibial band syndrome, frequently suffered by runners, is caused by friction of a tendon over the outer bone of the knee. Pain usually can be felt at the side of the knee, or sometimes on the side of the thigh.

Knee tendinitis may cause pain during faster movements such as running, as well as jumping, but not as much in leisurely walking. Prompt treatment with rest, ice and NSAIDs is necessary plus strengthening and stretching of appropriate muscles. Don’t try to work through the inflammation, or you may end up rupturing or tearing the tendon-a much more serious injury.

LIGAMENT INJURIES

LIGAMENT INJURIES: Ligaments are strong bands that attach bone to bone. They can be stretched or torn by a sudden twisting motion (as on the soccer field) or direct impact (from an auto accident or a football tackle).

Sometimes an injury to a ligament in the knee produces little or no pain but rather a popping sound and a buckling of the knee.

Strains and partial tears of a ligament can usually be treated with rest, physical therapy and protective knee braces. More severe tears usually require surgery, particularly if the person wants to resume a sports activity.

CARTILAGE INJURIES

CARTILAGE INJURIES: The menisci are crescent-shaped pieces of cartilage, one on each side, sandwiched between the thigh and shin bones. They stabilize the knee, spread out weight as it’s transferred during movement and keep the bones from rubbing together.

“Meniscal tears can occur in just about any sport or even every day activities that cause a twisting or rotating of the knee,” said Dr. Mario Sacchetti, also an orthopaedics physician at Mountain Orthopaedics. “In youth, the cartilage is fairly tough; with advancing age, it’s more vulnerable.”

Major symptoms include pain and swelling and sometimes a locking of the knee. The pain may not be great enough to cause an enthusiastic athlete to rest, but ignoring the pain is asking for trouble down the road.

“Most minor tears can be treated with rest and physical therapy,” Dr. Sacchetti said. “In surgery, the goal is to preserve as much cartilage as possible. When torn edges are stitched together to preserve the form and function of the meniscus, 90 percent of tears heal, and research suggests that the risk of later deterioration is reduced. Not all tears can be repaired, however.”

OSTEOARTHRITIS

OSTEOARTHRITIS: With advancing age plus wear and tear, cartilage tends to soften, deteriorate and develop cracks and holes. That’s what osteoarthritis is all about. Cartilage that has been damaged by previous injuries may be vulnerable to osteoarthritis so it’s important to get proper treatment for even minor injuries. Excess weight and genetics may also be factors.

Since the knee is such an important weight-bearing joint, severe arthritis-with its pain, swelling and stiffness-can lead to significant disability and the need for a knee replacement.

Human knees are built to last no matter how much you work them. But use them with good sense.

Tips for Healthy Knees

Stretch and warm up before and after exercise.
Try to vary your activities and avoid a sudden change in intensity or duration.
Wear shoes that fit well and are in good condition plus shoe inserts if you need them.
Keep your weight down.
Treat little injuries early before they develop into a big problem.

The second largest employer in Burke County, Blue Ridge HealthCare serves a four-county area and includes Grace and Valdese hospitals, Blue Ridge Home HealthCare, Grace Heights and College Pines Health & Rehabilitation Centers, Grace Ridge Retirement Community, Phifer Wellness Center and a number of physician practices.