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.

Preventing Future Patellofemoral Pain

Article from UCSF Health

To decrease the risk of patellofemoral pain returning after surgical kneecap realignment, doctors generally recommend that you make the stretching and strengthening exercises you learned in rehabilitation part of your everyday routine.

Proper rehab will help your new kneecap attachments heal in a normal position and keep it moving smoothly in its track. To prevent rupturing your new kneecap attachments while they heal, avoid bending your knee more than 90 degrees. Try to be patient in rehab and do not rush to return to activities.

Many of the popular fitness exercises and activities put stress on your knees. To prevent patellofemoral pain it is important to learn knee-sparing exercise techniques. This can be done by dividing your activities into three components:

Daily Living

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

Muscle Strengthening and Conditioning

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

Recreation

Sports that require twisting and quick-direction changes put great strain on your knee. Any climbing or jumping activity where the knee is bent beyond 90 degrees puts undue pressure on the cartilage surfaces under the kneecap. To prevent injury, stick to light, non-impact activities for your recreation. If you decide to return to sports like football and basketball, a doctor should carefully examine your kneecap and test it for proper alignment.

If you plan on participating in sports, remember to take it easy during daily activities and to keep your kneecap tracking properly with stretching and strengthening exercises. Your doctor may prescribe a brace to wear during recreational activities, which will help keep your kneecap in track.

A small amount of pain is normal during physical activity, but if you feel so much pain in your knee to warrant taking a painkiller before an activity, you should consider cutting back or discontinuing that activity.


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

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

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

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

Do I Need Surgery for a Meniscus Tear?

Article on WebMD, medically reviewed by Tyler Wheeler, MD on May 16, 2019

You have two C-shaped discs of cartilage (soft tissue) that connect your thigh bone to your shinbone. These are called menisci. They’re like shock absorbers for your bones. They also help to keep your knee stable.Athletes who play contact sports like football and hockey are prone to meniscus tears. But you can also get this injury when you kneel, squat, or lift something heavy. The risk of injury increases as you get older, when bones and tissues around the knee begin to wear down.

If you tear your meniscus, your leg might swell and feel stiff. You might feel pain when twisting your knee, or be unable to straighten your leg fully.

What Are My Treatment Options?

Treatment for a meniscus tear will depend on its size, what kind it is, and where it’s located within the cartilage. Most likely, your doctor will recommend that you rest, use pain relievers, and apply ice to you knee to keep the swelling down. They may also suggest physical therapy. This will help to strengthen the muscles around your knee and keep it stable.

If these treatments don’t work — or if your injury is severe — they might recommend surgery. To be sure, your doctor will probably have an MRI done. And they might look at the tear with an arthroscope. That’s a thin tool that has a camera and light at the end. It allows doctors to see inside your joints.

If your doctor’s exam shows your meniscus tear is mild (Grade 1 or 2), you may not need surgery. If it’s Grade 3, you probably will. Your doctor might choose to do any of the following:

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

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

How Long Is Recovery?

You may have to wear a brace or cast to keep your knee stable. You’ll likely also have to use crutches for at least a month to keep weight off your knee.

Your doctor may recommend physical therapy as part of your recovery. It’ll help increase your range of motion and help your knee get stronger. They may also share some exercises you can do at home.

If you have a partial or total meniscectomy, you can expect your recovery to take about a month. If your meniscus was repaired, it may take as long as 3 months.


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

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

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

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

Partial and Total Knee Replacement: How are they different?

From Noyes Knee Institute

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

Learn more about the difference between partial and total knee replacement to decide which is right for you.

Parts of the Knee

The knee joint consists of four bones: the femur, tibia, fibula, and patella. Four ligaments — two collateral and two cruciate — stabilize the connection of the bones while allowing movement. Menisci, or cartilage, minimizes the trauma of the femur and tibia sliding across each other, and small sacs of fluid between bones allow for smooth movement.

The knee is also divided into three distinct compartments: The medial compartment is the section of knee on the inside of the leg, the lateral compartment is on the outside of the leg, and the patellofemoral compartment is the area directly under the kneecap. A partial knee replacement is done when only one of these compartments is damaged.

Total Knee Replacement

A total knee replacement involves resurfacing the ends of the tibia and femur to remove all the damaged tissue. The damage could be deteriorated bone, cracked bone, or calcified bone as well as the damaged cartilage. Once the bad tissue is removed, metal caps are placed over the bones to recreate their original shape and size. These caps may snap on snugly or be glued in place.

With the bones recreated, the doctor determines whether the kneecap has been damaged or not. If there is damage, the underside will be cleaned, and then a plastic disc will be fit into place. Finally, plastic pacers are placed between all parts that may rub or slide against each other during movement.

Either or both of the cruciate ligaments of the knee may be removed during a total knee replacement if they are damaged. The collateral ligaments are not removed. When a cruciate ligament is taken out, the metal caps over the bones have a ridge or locking mechanism to ensure your bones do not move too far or slip out of place.

Partial Knee Replacement

A partial knee replacement requires the same resurfacing and metal caps but involves either the medial or lateral compartment. If both compartments have damaged tissue, or if the problem is within the patellofemoral compartment, a different treatment is needed.

If your knee is unstable and the bones slip to the side, forward, or backward, partial knee replacement is not an option. In addition, the anterior cruciate ligament must not be damaged for this procedure to work. No ligament is removed during a partial knee replacement.

When only one compartment needs repaired, you may consider a partial knee replacement. If your doctor deems you a good candidate for this procedure you will experience a few benefits over a total knee replacement. One of the most important benefit is that your knee will still function the way it always has because less of the joint is removed and replaced.

With a partial replacement, you may require more surgery and a total replacement in the future. One reason for this is that a partial replacement does not last as long as a total replacement. The other reason is that the remaining natural parts of the joint may become damaged as you age and require replacement too.


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

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

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

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

Did You Know That Inactivity is Actually HARD On Your Knees?

Between working from home and being glued to the television watching the latest election updates, many of us are guilty of increased “couch potato” behavior lately.  And we’ve all heard of the dangers of sedentary lifestyles contributing to obesity, etc.,  but did you know that *not* moving can actually weaken your knees and increase your chances of osteoporosis?

Continue reading for more from Noyes Knee Institute and the Journal of Public Health.

From Noyes Knee Institute

Do you spend a lot of time sitting? Maybe you work at an office where most of your time is at your desk, or maybe when you’re at home, you prefer to rest on the couch instead of being on your feet. Many people live a mostly inactive lifestyle, but they might not realize that inactivity can be the reason why they experience increased joint pain.

Learn the reasons why inactivity can hurt your knees and what you can do to change it.

Weakens Your Knees

If you live a life or limited activity, your body adapts to that lack of motion. Essentially, when you aren’t using your legs muscles, ligaments, and joints for moderate levels of activity, you are losing them. Your knees become weaker as you require less of them.

One runner found that as she took time off running to rehabilitate an injury, she could not run after completing her recovery because of knee pain. She had to complete additional physical therapy because the rest had caused her to develop a condition called chondromalacia of the patella.

Essentially, her kneecap would not follow the proper range of motion because she had developed some weakness in the joint. It’s a common condition for people who are not active. Even something as simple as going up or down the stairs can make your knees ache.

If you spend your day sitting, you also experience pain in other areas that can also aggravate the knee. Your quadriceps become tight, which exert a pulling sensation on your knees.

You can help your knees feel better by focusing on flexibility. Stretch daily, and participate in joint-stabilizing exercises like yoga. Try to be more active during the day. Stand at your desk, or take time to walk around the office a few times. Use the stairs instead of the elevator.

Increases Your Risk of Arthritis Pain

If you start to experience joint pain as a result of arthritis, your first instinct is to rest more, because walking, running, biking, or other activities cause pain. However, resting when you have knee pain is often the worst solution.

Resting will cause the muscles that give the knee support to weaken. As a result, they become less able to bear your weight, which results in greater joint pain. Reduced strength in the knee joint also translates to reduced stability, which can increase your risk for accidents and make exercising even more difficult to do safely.

If you have arthritis or if you have a history of arthritis in your family, staying active is one way you can help to prevent it from getting worse. Ask a knee specialist for exercises that are safe and helpful for strengthening your knees without causing you too much pain during workouts.

Promotes Weight Gain

A sedentary lifestyle is often why people struggle to manage their weight. Gaining weight with age is common, and spending your days seated can make that problem worse. With every extra pound, the pressure on your knees increases by about four pounds. So, just 10 pounds of extra weight means 40 pounds of pressure on your knees.

All that stress naturally means that your knees start to hurt, and they can hurt even more when you try to be active again. Make sure you intentionally choose low impact exercise as first. Try a stationary bike or a brisk walk in supportive shoes to begin. Focus on losing weight through diet control.

After you lose some weight, you can increase your physical workouts if your doctor believes they will be safe. You might try incorporating some resistance training to really give your lower body some increased strength and stability, as long as you also spend time stretching and increasing your flexibility.

Increases Risk for Osteoporosis 

From the Daily Mail

Being a couch potato weakens your bones: Adults in their 60s face greater risk of fractures if they spend hours sitting down each day – but walking 10,000 steps each day helps

  • The study of 214 adults was published today in the Journal of Public Health
  • It is the first to show a link between a sedentary lifestyle and osteoporosis
  • Participants’ hips and spines were scanned to measure their bone density

A couch potato lifestyle leads to weaker bones in later life, particularly for men, researchers have found.

Experts discovered that men spent more time on average sitting still than women and therefore had weaker bones, particularly in their lower back.

But the new findings, conducted by academics from Durham and Newcastle universities, show that even just completing 10,000 steps a day can help to keep bones strong.

The study showed that people in their sixties who spent a lot of time sitting down had weaker bones which increased their risk of developing ‘fragility’ fractures.

It is well known that weight-bearing and muscle strengthening exercises are important for building bone strength and preventing osteoporosis.

The study, published in the Journal of Public Health, is the first to show that a sedentary lifestyle in men is associated with weaker bones and osteoporosis.

More than half a million fragility fractures – where a fracture occurs from a fall at standing height or less – happen each year in the UK. It is estimated that by 2025, that number will have gone up by 27 per cent.

Dr Karen Hind, of the Department of Sport and Exercise Sciences at Durham University, said: ‘We know that excessive sedentary time can lower someone’s metabolism which can lead to being overweight and Type 2 diabetes.

‘What we now know is that being inactive is also associated with lower bone strength and an increased risk of osteoporosis.

‘Osteoporosis is a disease that affects older people but by encouraging this age group to keep active, it will help improve their bone health.’

The research team followed 214 men and women, aged 62, from Newcastle University’s Thousand Families Study.

Each participant wore a monitor for seven consecutive days which measured their physical activity and sedentary time. The number of daily steps was also recorded, and then compared with public health recommendations.

The participants’ hips and spines were scanned to measure their bone density.

Participants involved in 150 minutes of light physical activity a week had better bone strength than the more sedentary participants, according to the findings.

The men who spent more than 84 minutes per day sitting still, compared to the average of 52 minutes, had 22 per cent lower bone density in their spine.

The researchers say the impact on their bone density is similar to that of smoking, which is also a risk factor for osteoporosis.

The economic and personal costs of osteoporosis are substantial – in the UK the direct costs of fragility fractures are estimated to be £4.4billion which includes £1.1billion for social care.

The participants all lived in Newcastle-upon-Tyne, and Public Health England statistics indicate that the North East has the greatest proportion of physically inactive adults and the highest incidence of hip fractures compared to the rest of the UK.

The researchers said that the message from their findings is: stay active and reduce sedentary time.

They emphasised that the study shows that hitting the daily target of 10,000 steps and avoiding long periods of sedentary time will increase bone strength.

They say that even making daily lifestyle ‘hacks’ can make a difference – such as parking the car further away from the shopping centre or taking the stairs instead of the lift.

Dr Hind added: ‘Currently there are no specific guidelines for this age group to encourage light physical activity or to reduce sedentary time.

‘Yet, as people retire they are more likely to increase the time they spend watching television and reduce their daily step count.

‘It would be great to see initiatives that specifically target this group to increase their awareness of the importance of staying active and reducing the amount of time spent sitting still.’

Learn more about bone health


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.

3 Trends That Are Disrupting the Total Knee Replacement Market in 2020

By Amanda Pedersen | Jan 16, 2020 MDDI (Source)

Big changes lie ahead for knee replacements in 2020 and beyond. MD+DI recently spoke with an expert at DePuy Synthes for insight into how three key trends are impacting the market.

In recent years MD+DI has reported on a number of ways emerging technologies such as artificial intelligence (AI) and machine learning (ML), surgical robotics, and 3D-printing are impacting a number of different sectors in medtech. In 2020, we expect these technologies to become even more relevant in the industry, particularly in orthopaedics.

MD+DI recently spoke with an expert at DePuy Synthes for insight into how key trends are impacting the total knee replacement (TKR) market, and how emerging technologies can be part of the solution. Rajit Kamal is vice president and global franchise leader of the knee business at Warsaw, IN-based DePuy Synthes.

Outpatient Is No Longer Just a Niche

“We are seeing a very persistent shift toward outpatient or ambulatory surgical care centers and we think that shift makes sense, Kamal said, pointing out several benefits of this trend, including faster recovery and a lower cost of care.

“We think anything that makes sense for the patients clinically and economically is the right thing to do,” he said.

While outpatient will never be right for every patient, Kamal said up to 70% of TKRs could eventually be handled in outpatient settings such as ambulatory surgical centers (ASCs).

“Outpatient is not a niche,” Kamal emphasized. “Outpatient is the site of care of the patient. So when we develop our portfolio, when we drive innovation, it is with outpatient in mind.”

What that means from an R&D perspective is that companies in the TKR space like Depuy Synthes need to keep in mind the fact that ASCs are smaller than in-patient hospital settings.

“We are making sure we are developing the portfolio that is enabling our customers to be able to operate in this site of care and that means developing products that are portable, smaller, and cost effective,” Kamal said.

Kamal sees opportunities to address these and other unmet TKR needs with emerging technology such as AI, ML, robotics, and 3D printing.

“We think technology has the potential to transform total knee replacement, and we are at the leading edge of that transformation,” Kamal said. “Technology has unlocked a lot of constraints that we had.”

Here are three examples of how technology can play a role in TKR trends:

1. Enhancing Patient Selection and Optimizing Pre-Operative Care

Today, one in five patients who undergo total knee replacement surgery are not fully satisfied but surgeons are perplexed by this problem. Sometimes a patient will come in for a follow-up appointment and everything looks perfect from the surgeon’s perspective, yet the patient is not happy with the outcome of their procedure. Other times, a surgeon may expect a particular patient to be unhappy with their TKR results but the patient will surprise them.

The solution, according to Kamal, is to drive personalization, automation, efficiency, and connectivity. All of these together can really transform total knee replacement, he noted.

“Today, if you go to five different surgeons and ask them which patient is the right patient for surgery you will get five different answers,” Kamal said.

For example, some surgeons will not operate on a patient whose body mass index (BMI) is 35 or higher, while other surgeons are willing to operate on patients whose BMI is 50 and those surgeons say their BMI 50 patients are their most satisfied TKR patients, Kamal explained.

Kamal says this is where AI and machine learning tools could go a long way toward enabling surgeons to not only make the right decision on patient selection, but also help them optimize their pre-operative care pathway.

“So if a patient is not the right patient today, the surgeon can work with them and get them in the best shape before they go through surgery,” he said.

2. Enhancing Efficiency with AI and Robotics

Today, if two different TKR patients go to the same surgeon they are likely to get a similar procedure based on that particular surgeon’s training and clinical experience. Surgeons tend to perform the same procedure on all of their patients because it makes them more efficient, Kamal said.

Once again, AI can help surgeons develop a very personalized surgical plan that analyzes each case based on dynamic motion of the knee and other variables, without costing the surgeon any efficiency.

Surgical robotics also comes into play here.

“We think the right robotic solution should be easy to use, it should be portable, and it should be cost effective,” Kamal said.

Technology also enables surgeons to better monitor their patients remotely.

“Five years ago a patient would be sent home after surgery and come back six weeks later and that’s the first time they saw the surgeon post-op. Or you would end up in the ER if you had a problem,” he said. “Sometimes six weeks might be too late. Technology has unlocked that constraint.”

3. Taking Implant Design to the Next Level with 3D Printing

The emergence of 3D printing in medical device manufacturing has benefited companies like Depuy Synthes not only in terms of cost but in terms of design.

“3D printing enables us to develop designs that we couldn’t do with traditional manufacturing,” he said. “So we are actively investing in all of these technologies because we truly believe that it has the potential to take a very successful procedure to the next level.”

Bringing It All Together

DePuy Synthes recently unveiled its Velys Digital Surgery platform, which will consist of connected technologies that leverage data insights for patients, surgeons, and healthcare systems across the continuum of care. Today, the new platform will focus on joint reconstruction including existing technologies like the Kincise System and the Joint point System, the company noted. Over time, DePuy Synthes plans to add new technologies like its orthopedic robotic solution, patient selection tools, advanced visualization, sensors, and mobile apps. Read more about the Velys Digital Surgery platform here.


At New Mexico Orthopaedics, we like to post articles we think our patients will find interesting. While these posts occasionally contain brand names or product manufactures, etc., we would like to note that we are not necessarily endorsing or recommending these products, brands or techniques.


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico.

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.

12 Tips for Walking When You Have Sensitive Knees

Sensitive knees can be a challenge for walking, but it is a recommended way to maintain your function and reduce your symptoms. If you have knee pain due to osteoarthritis or other causes, you don’t have to let that keep you from starting a walking program.

A regular program of walking can reduce stiffness and inflammation and it won’t make most chronic knee conditions worse. Walking is the preferred exercise by people with arthritis, and can help you improve your arthritis symptoms, walking speed, and quality of life, according to the CDC.

Walking is part of a healthy lifestyle to keep your heart and bones strong and your joints functioning. Here are tips for walking when you have sensitive knees.

Why Walking Is Good for Your Knees

Your knee joint is composed of bone and cartilage. Cartilage doesn’t have a blood supply that is always nourishing it by the pumping action of the heart and so it relies on joint fluid for nutrition. Moving your joints is the way that you ensure the cartilage receives the nourishment it needs to stay healthy.

You may notice that your joints are stiff and sore in the morning or when you’ve been sitting and inactive during the day. By moving your joints, you help them maintain their function and you may help keep them functioning longer.

Regular exercise maintains and builds muscles, which you need to support your knee and maintain functioning. Weight-bearing exercise such as walking also helps maintain bone health.

Discuss your exercise options with your doctor and physical therapist when you have any condition that is causing knee pain. While walking is recommended for many people, it may not be appropriate for you.

Should You Walk When You Have Knee Pain?

If you have mild to moderate pain in your knees due to osteoarthritis, walking and other exercise helps mobilize your joint fluid and lubricate the joints. You should walk and do other exercises that move your knee joints. You are likely to find that the stiffness, pain, and fatigue improve with exercise.

If you have moderate to severe pain in your knees before you start walking, take it easy. Do a shorter walk at an easy pace or try an activity that doesn’t place much stress on the joint, such as water exercises in a pool. If joint pain remains severe, stop immediately as it is a sign of inflammation or joint damage that needs treatment.

If you have joint pain occasionally the day after a walk or run, you should take a day off and do a shorter workout or one that doesn’t put stress on the joint. If you always have joint pain after exercise, you may have to switch to a form of exercise that doesn’t put stress on the knees, such as cycling or swimming.

Tips for Walking With Sensitive Knees

Taking certain precautions can make it easier to continue your walking routine despite sensitive knees. Here are 12 ways to protect your knees when walking.

  • Add cycling: Incorporate cycling on a stationary bike, bicycle, or even an under-desk cycle to help keep your opposing muscles in shape for better support of the knee.
  • Aim for 6000 steps per day: A study found that people with osteoarthritis knee pain benefit most when they walk 6000 steps or more per day.2 If you wear a pedometer or use a phone app to track your steps, all of your steps during the day count. Make that your first goal. If you can eventually exceed that regularly without increasing pain, that is good.
  • Build your walking time: If you are new to walking, steadily build up your walking time following a plan for beginners. Walking can be broken up into 10-minute segments, with an ultimate goal of 30 minutes per day. Start at an easy or moderate pace as you build endurance. Eventually, aim to walk briskly at 2.5 to 3.5 mph or a pace that has you find challenging.
  • Choose softer walking surfaces: Walking on natural surface trails (dirt, bark dust, pea gravel) is easier on the joints. Although sometimes uneven, natural surfaces provide more balanced exercise. For even surfaces, choose a cinder track or asphalt rather than concrete. Note that flooring in malls and stores is primarily concrete.
  • Choose the right shoes: Shoes should be flat and flexible, bendable in the forefoot with a low heel-to-toe drop. Avoid high heels, pointy toes, and heavy shoes. Look for shoes with a wide toe box. Even a 1.5-inch higher heel can increase pressure on two common sites for knee osteoarthritis damage. Choose heels that are 3/4 inch or less.
  • Keep moving throughout the day: Get up and move around or stretch every 15 minutes. This will keep your joint fluid moving and nourish your knees. Even just a minute can help reduce the health risks of sitting and will be good for your joints.​
  • Lose excess weight: If you are overweight, losing even a few pounds can reduce stress on your knees. Diet is the most effective way to lose weight. You will be able to walk and exercise with less pain and discomfort after some of the excess weight has been lost.
  • Use cold packs after walking: You’ve done well by getting your joint fluid moving. You can apply cold packs afterward to help reduce inflammation.
  • Use inserts: When you have sensitive knees, avoid arch supports and shoes that have a high amount of arch support. You want your foot to move as naturally as possible. You can use over-the-counter orthotics that provide cushioning and support if you think that is helpful for you or they have been recommended by your doctor or podiatrist.
  • Use walking poles: Some people find that using trekking poles or Nordic walking poles helps them with stability and reducing joint fatigue when walking. Canes and other walking aids may be useful, depending on your condition.
  • Walk during low-pain times of the day: If you have a lot of pain or stiffness in the morning, simply try to get up and move around for a minute or two every half hour. You will better enjoy long walks at a time when you have fewer aches, and that will help you be consistent.
  • Warm up: You may benefit from applying heat to your joints before you walk, or walking after taking a warm shower or bath. Starting at an easy pace is recommended for everyone, but especially when you have stiff or sore joints. Start slow to get your joint fluid moving. Then you can pick up your pace after a few minutes.

A Word From New Mexico Orthopaedics

Walking is the most accessible form of physical activity and can help you maintain joint health. However, it’s not the only option. If your sensitive knees keep you from walking, you can get the physical activity you need by enjoying cycling, pool exercises, swimming, or water aerobics.

You should also include resistance exercise to build and maintain muscles, including any specific exercises recommended for your knees by your doctor or physical therapist. Balance exercises can also be beneficial. Once you are confident walking, you can even include them in your walking workouts. Just keep moving!

 


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 you need to know about sudden knee pain

What you need to know about sudden knee pain

Article Featured on Medical News Today

The complexity of the knee joint allows it to support a wide range of movements — but it also makes the area vulnerable to a variety of injuries and chronic conditions.

Each year in the United States, about 12 million people see doctors for knee pain. Researchers found that among all people seeking medical treatment in the country between 2007 and 2011, 1.5–7.3% sought care for pain in the front of the knee alone.

Below, we describe common causes of sudden knee pain and the symptoms that tend to accompany it. We also look into the options for diagnosis, treatment, and prevention.

Causes of sudden knee pain

Some of the more common causes of sudden knee pain are:

  • Anterior cruciate ligament, or ACL, injuries. These often occur during sports that involve jumping or other sudden changes in direction. They can cause instability or prevent the knee from bearing weight.
  • Posterior cruciate ligament, or PCL, injuries. These can develop after a blow to the front of the knee.
  • Collateral ligament injuries. These contact injuries often happen during sports.
  • Meniscus tears. Tackles, twisting, aging, and arthritis can each damage the knee’s meniscus, its shock-absorbing cartilage. A person may feel the knee “locking” or experience discomfort going down the stairs.
  • Fractures. The three bones of the knee joint can fracture or break. The patella, or kneecap, does so most frequently.
  • Patellofemoral pain syndrome. Sometimes called runner’s or jumper’s knee, this mainly causes pain at the front of the knee that gets worse with climbing the stairs, squatting, or bending. It sometimes causes popping sounds or swelling.
  • Dislocation. This can occur when the thighbone, shinbone, and patella are out of alignment, due to structural problems or injuries.
  • Tendinitis. This issue, inflammation of the tendons around the joint, stems from overuse and is more common among middle-aged athletes.
  • Bursitis. Repetitive motions, like running, can cause sacs of fluid around the knee to become irritated, painful, and swollen.
  • Osgood-Schlatter disease. This overuse injury is most common in teenage boys, particularly in athletes. The symptoms include soreness around the knee and pain when extending the leg.
  • Arthritis. This develops when the cartilage protecting the joints breaks down and leaves the bones rubbing against each other. It can cause swelling, stiffness, and a reduced range of movement.

Sometimes, physicians cannot identify what is causing knee pain. For about 30% of teenagers who seek treatment for pain at the front of the knee, a doctor cannot diagnose the cause.

Accompanying symptoms of sudden knee pain

In the list above, we describe specific symptoms of issues that commonly cause sudden knee pain. But in general, one or more of the following tend to accompany this pain:

  • swelling
  • stiffness
  • a clicking sound with the pain
  • pain when rising after sitting
  • pain climbing the stairs
  • pain descending the stairs
  • the knee “locking” or not bending
  • the knee giving way

The exact location of the pain can help identify the cause and the best way to treat it. For example, pain between the kneecap and the shin can be a sign of a repetitive use injury, such as from running.

Risk factors for sudden knee pain

Above, we list some risk factors for specific causes of sudden knee pain. Overall, the following tend to increase the chances of developing this pain:

  • increasing activity levels suddenly, which can put too much stress on the body too quickly
  • having poor alignment and a weak core, which can place stress on the knees
  • having weakness in one or both hips, which can lead to an uneven gait and eventual knee problems
  • having tight hamstrings and iliotibial bands, which can limit the body’s ability to recover from a workout
  • having an imbalance of strength and flexibility
  • wearing poorly fitting or worn out shoes
  • having overweight or obesity

Diagnosis and testing of sudden knee pain

Unless sudden knee pain clearly results from an injury or accident or the pain is severe, most people can safely wait for a few days before seeing a doctor. During this time, people should avoid or limit any activities that cause discomfort.

Resting, applying ice packs, and using nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil), can provide relief. Symptoms may then start improving. However, this does not always happen.

A visit to a physician typically begins with a complete medical history and an overview of the person’s activity level. The doctor then manipulates the person’s leg, checking for pain, tenderness, and swelling. They also do this to assess the range of motion. To make a diagnosis, the doctor may need imaging, such as MRI scans or X-rays.

Treatment Options for Sudden Knee Pain

The treatment for sudden knee pain depends on its cause and severity. Some examples are below:

  • Arthritis. NSAIDs, physical therapy, yoga, and Pilates can help reduce pain, but if the condition is severe, a person may need knee replacement surgery.
  • Meniscus tears. When a tear is smaller, rest and over-the-counter pain relievers can help. More severe cases may require arthroscopic surgery to repair the tear or remove pieces of torn tissue.
  • Tendinitis. Thoroughly stretching the affected leg can increase blood flow, reduce inflammation, and help correct alignment shifts.

When a person is in too much pain to do physical therapy, the doctor may recommend cortisone shots. These provide a degree of relief that usually allows a person to start their rehabilitation exercises.

How to Prevent Sudden Knee Pain

Wear and tear on the body is inevitable, and injuries can be hard to avoid entirely. Still, the following can help people can maintain or improve their balance, strength, and flexibility, offering some protection from sudden knee pain:

  • strengthening the core and hips
  • maintaining flexibility in the joints
  • improving alignment
  • increasing levels of activity slowly
  • wearing shoes that fit well
  • stretching regularly

Summary

Sudden knee pain is a common issue — the complex structure of the knee means that it can be injured in various ways. Often, recovery from a knee problem just involves rest and self-care.

However, people with severe or persistent pain may require physical therapy or surgery.


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.