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.

Frequently Asked Questions about Knee Pain

Frequently Asked Questions about Knee Pain

Article Featured on WebMD

Your knee hurts and you want to know why. Whether it’s an injury or arthritis, here are answers from an orthopedic surgeon who specializes in sports medicine and knee care.

Could my pain be from osteoarthritis?

Yes. Probably 95% of knee pain caused by arthritis is osteoarthritis, which is caused by “wear and tear” on the joints. Other types, like rheumatoid arthritis, are much less common causes of knee pain.

What kind of injuries can cause knee pain?

They’re usually twisting injuries to the knee: ACL, meniscus, or ligament injuries.

What’s the difference?

The main difference between arthritis and other kinds of knee pain is there’s no trauma associated with it. A person who tore their ACL or had a meniscus injury knows exactly when it happened. With arthritis, it’s more of a dull, aching pain. It gets worse as time goes on.

Will my pain go away on its own?

It depends. Arthritis pain tends to wax and wane over time. It may not completely go away, but sometimes it feels much better. Pain from an injury improves at first, but if you’re left with a sore joint, you may not be able to do certain activities.

When do I need to see a doctor?

Everyone has a different pain threshold. If you’ve an injury and your knee swells, you need to see your doctor. Even if the swelling goes away, you need to have your knee examined — you might have injured something inside the joint. If you have arthritis pain and the bad days outnumber the good, you should see your doctor.

How do I keep my knees healthy?

I think weight control is important. Flexibility helps as well. If you take part in a sport that requires a lot of physical exertion, like skiing or tennis or soccer, you need to get in shape.

Also, when you get tired, you need to stop. Look at the rate of knee injury: It goes up in the fourth quarter or final period of a game. Just a millisecond or two of delay of muscle function can cause injury. If the muscles that protect the ligament are tired, they don’t do a good job.


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.

Roots of Post-Surgical Knee Nerve Damage Uncovered

Roots of Post-Surgical Knee Nerve Damage Uncovered

Article Featured on PPP

Two recent studies1,2 have uncovered tiny cutaneous nerves on the anterior and medial thigh and around the knee using high-resolution ultrasound imaging, which may explain the occurrence of chronic pain following knee operations. Previously, it has been deemed impossible to demonstrate that these tiny cutaneous nerves (less than 1-mm thick) exist around the knees.

In the first study,1 a team of researchers at the Medical University of Vienna, Austria located the entire course of ramus infrapatellaris (a sensitive nerve branch in front of and below the kneecap) with high-resolution ultrasound imaging. They showed that neuropathy of the intermediate and medial femoral cutaneous nerve can be reliably visualized throughout the course of the nerves, both in anatomical specimens and in patients.

The second study,2 also led by researchers at the Medical University of Vienna, Austria, highlighted the branched anterior cutaneous branches of the femoral nerve, nervus femoralis, confirming the reliability to visualize these branches using high-resolution ultrasound in anatomic specimens and in healthy volunteers, which could enhance the diagnostic and therapeutic management of patients with anteromedial knee pain. It was also found that the nerve pathways are highly variable for each patient.

To accurately isolate the nerve branches causing the pain, it is essential to carry out a “diagnostic blockade,” according to lead researcher Georg Riegler, MD, lead researcher from MedUni Vienna’s Department of Biomedical Imaging and Image-guided Therapy. “Since the nerve supply is so variable, it is essential to first make sure which of these tiny nerves [are] causing the pain,” he said in a press release.3 “This can only be done by selectively temporarily anesthetizing, or blockading, the suspected nerve, with a maximum of 1 mL of anesthetic. If the pain is significantly reduced immediately after a blockade has been done and returns once the anesthetic has worn off, then we have located the problem.”

One of the first options for treating nerve pain in the knee is to use localized pain patches or physiotherapy, followed by ultrasound-guided treatment. Other possibilities include cortisone injections, radiofrequency ablation, and surgical procedures. Dr. Riegler urged the importance of determining the exact position of the damaged nerve fibers before giving any targeted treatment to combat nerve pain.

View Sources


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.

Knee Osteoarthritis: Overview

By Joseph J. Ruane, DO Article Featured on PPP

Osteoarthritis is the most common form of arthritis, and approximately 10 million people in America have osteoarthritis in the knees.

During your life, your knees go through a lot—these joints cushion your movements and help support your weight. Over time, this natural wear and tear process can lead to osteoarthritis (OA) in the knees. This is when the cartilage, which normally cushions your joints, wears away. The joints aren’t as protected as they should be then, and the bones in your knees can starts to rub on each other, leading to pain, stiffness, and swelling.

At the ends of bones, you have cartilage, which is a slippery tissue that helps bones glide over each other—it keeps the joints working smoothly. Additionally, cartilage works as a shock absorber for your movements.

If you develop osteoarthritis, the top layer of your cartilage around the joints starts to break down and erode. As it wears away, the bones can rub together, and bone-on-bone rubbing can cause pain, swelling, and less movement in your joint.

As more time passes, the joint affected by osteoarthritis may lose its normal shape. You also may develop bone spurs on the edges of the joint. You may have bits of bone and/or cartilage break off your joint; they then “float” in the joint space, and that can cause more damage and pain.

Knee Osteoarthritis Causes
Currently, researchers don’t understand the exact cause of knee osteoarthritis. Many factors can lead to the degeneration of the knee cartilage, including overuse and injury. But sometimes, knees can develop osteoarthritis without a clear cause.

Some factors that influence the development of osteoarthritis are:

  • Age:The older you are, the more likely it is that you will develop osteoarthritis. We put our joints through a lot of daily stress, and over the years, this can start to wear down the cartilage. Most people affected by osteoarthritis are older than 45.
  • Playing particular sports:Running, soccer, and tennis all put extra strain on the knee joint, and this can lead to the eventual development of osteoarthritis.
  • Repetitive stress:This is similar to playing certain sports—it’s all about the strain you put on your knees. Certain jobs that require a lot of lifting, squatting, or kneeling may make people more prone to osteoarthritis.
  • Weight:If you carry extra weight, this can put more strain on the knee joint, making it more likely to wear out.
  • Gender:In people older than 45, women are more likely than men to develop osteoarthritis.
  • Heredity:It is known that genetics plays a role in developing osteoarthritis. If someone in your family has or had osteoarthritis, you may be more at risk for developing it.


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.

6 Types of Knee Exercises and Which Ones to Avoid

6 Types of Knee Exercises and Which Ones to Avoid

Article Featured on Medical News Today

The knee is the largest joint in the body. People use it heavily every day as they walk, run, climb, or jump. As a result, it is also very prone to injury and pain. When these occur, a doctor may recommend exercises to help a person strengthen the muscles around the knee.

People of all ages may experience knee pain. According to one article, a type of knee pain called patellofemoral pain syndrome, or runner’s knee, is the most common orthopedic condition in sports medicine. In addition to being common in athletic people, knee pain can also be a problem for people who have arthritis.

While it may be tempting to avoid exercise when knee pain occurs, this is not always the appropriate solution. Certain types of exercise can help alleviate existing knee pain and prevent future pain or injury by providing the knee with extra support.

Benefits of knee strengthening exercises

The Arthritis Foundation state that exercise may be the most effective way to treat osteoarthritis without surgery, while the American Academy of Orthopaedic Surgeons note that strong and flexible muscles can keep knees healthy and prevent injury.

Knee strengthening exercises do not affect the knee joint directly, but they strengthen the muscles surrounding it. Strong muscles in the legs can help provide support for the knees. This support may alleviate pressure and strain on these joints, which can relieve pain and help a person be more active.

The following exercises can help strengthen the muscles surrounding the knee. If a person experiences pain during these exercises, they should stop doing them and speak to a doctor. Anyone with severe knee pain should consult a doctor before trying to exercise.

It is best to warm up with light exercise before starting any knee strengthening exercises. Examples of gentle exercise include walking, cycling, and using an elliptical machine, all of which put minimal stress on the knees. This activity will help increase blood flow to the muscles and allow them to be more flexible.

1. Leg lifts

Muscles involved: Quadriceps (front of the thigh) and abdominal (stomach) muscles.

  1. Lie down on the floor with the back flat. Use a yoga mat, folded blanket, or exercise mat for comfort on a hard floor.
  2. Keep the left leg straight and bend the right leg slightly at the knee, bringing the foot closer to the body.
  3. Pull the abdominal muscles inward by imagining the belly button pulling down toward the floor. Doing this should bring the lower back down against the floor and help provide extra support during the exercise. Place a hand beneath the lower back to make sure that there is no space between the small of the back and the floor. If there is space for the hand, gently push the lower back down on top of the hand.
  4. Slowly lift the left leg without bending the knee. Keep the toes pointed toward the ceiling and stop when the leg is about 12 inches off the floor. It should not be higher than the bent knee on the right leg.
  5. Hold the left leg up for 5 seconds.
  6. Slowly lower the leg back down to the floor. Do not put it down too quickly or let it drop.
  7. Repeat two more times with the same leg.
  8. Switch sides and repeat.

What not to do

  • Do not let the back arch during the exercise.
  • Do not jerk or bounce the leg or lift it above the knee on the bent leg.
  • People who have osteoporosis or a back compression fracture should not perform this exercise.

2. Standing hamstring curls

Muscles involved: Hamstrings (back of the thigh) and gluteal (buttock) muscles.

  1. Stand straight with the knees only 1–2 inches apart. Hold on to a stable chair, the countertop, or another object for balance.
  2. Slowly bend one knee behind the body, lifting the heel off the floor while keeping the thighs aligned. Continue to lift the heel in a smooth motion until the knee bend reaches a 90-degree angle. Keep the straight leg slightly bent to avoid locking it.
  3. Hold the bent leg up for 5 seconds and then slowly lower it to the floor.
  4. Repeat two more times with the same leg.
  5. Switch sides and repeat.

What not to do

  • Do not point the toes or flex the foot on the lifted leg. Allow the foot to remain in a neutral, flat position.

3. Hamstring curls on a weight bench

Muscles involved: Hamstrings and gluteal muscles.

This exercise is a variation of the standing hamstring curl. A person can try this version if they have access to a weight bench that is purpose-built for this exercise. It may be more challenging than the standing hamstring curl, depending on how much weight a person uses.

  1. Lie face down on the bench with the knees close together. Grip the handles for stability.
  2. Tuck the feet under the weight. The weight should sit just above the heels.
  3. Slowly bend both knees, using the force of the legs to raise the weight up. Continue to lift the weight in a smooth motion until the knees bend at a 90-degree angle.
  4. Hold the weight up for 5 seconds and then slowly lower it back down.
  5. Perform up to 15 repetitions (reps).

What not to do

  • When first attempting this exercise, do not use a heavy weight. Beginners should use the lowest weight and work their way up to heavier weights as they build strength.

4. Step exercises

Muscles involved: Quadriceps, hamstrings, hip flexors, and gluteal muscles.

  1. Use a large, sturdy stool or exercise platform no taller than 6 inches.
  2. Step up onto the stool with the right foot and allow the left foot to follow behind. The left foot should not be on the stool but should hang behind it.
  3. Keep the body weight on the right foot and hold for up to 5 seconds.
  4. Slowly lower the left foot down and then follow it with the right foot.
  5. Switch legs, stepping up with the left foot first.
  6. Repeat.

What not to do:

  • Do not lock the knees during this exercise. The knees should remain slightly bent.
  • Do not allow any part of the stepping foot to hang off the stool or platform.
  • People who have issues with balance should not perform this exercise.

5. Chair dips

Muscles involved: Quadriceps, hamstrings, hip flexors, and gluteal muscles.

  1. Use two high-backed, stable chairs, placing one on either side of the body with the chair backs next to the arms. Place a hand on the back of each chair for balance.
  2. Bend both legs at the knee, being careful not to let the knees extend past the toes.
  3. Extend the right leg out in front of the body in a slow kicking motion. Focus on keeping the weight balanced on the left foot.
  4. Bring the right leg down slightly, holding it just a few inches off the floor for 5 seconds while continuing to balance on the left leg.
  5. Slowly lower the right leg completely to the floor.
  6. Stand up straight on both feet.
  7. Switch sides and repeat.

What not to do:

  • Do not bring the leg up more than 45 degrees off the floor.
  • Do not lean backward when lifting the leg. Keep the back and upper body straight.

6. Wall squats

Muscles involved: Quadriceps and gluteal muscles.

  1. Stand with the head, shoulders, back, and hips flat against a wall.
  2. Step both feet out about 24 inches away from the wall, while keeping the back and shoulders against it. Keep the feet no more than hip width apart.
  3. Slide the back down the wall slowly until the body is just above a normal sitting position.
  4. Hold for 5 seconds and then slide back up.
  5. Repeat.

What not to do:

  • Do not squat too low. The knees should not go over the toes.
  • Do not use fast, jerky movements. Perform the exercise slowly and smoothly.

Post-exercise stretching

After exercising any muscle group, it is essential to stretch the muscles. Stretching helps improve flexibility and reduce pain and injury.

Quadricep stretch

  1. Hold on to the back of a chair or put one hand on a wall for balance.
  2. Lift one foot behind the body and grab the ankle with the hand.
  3. Keep the back straight and the knees close together.
  4. Pull the heel close to the buttocks without forcing it or causing pain.
  5. Hold for up to 30 seconds and then slowly lower the leg.
  6. Switch sides and repeat.

Toe touches

There are many different ways to stretch the hamstrings in the back of the legs. One is through traditional toe touching.

  • With the feet close together, slowly bend over at the hips and extend the arms downward. Keep the legs straight but do not lock the knees.
  • Reach the fingers to the top of the toes and hold for 30 seconds.
  • Initially, it may not be possible to reach the toes. In this case, try to get the fingers as close as possible to the toes without causing pain.

What not to do:

  • Do not use a bouncing motion. Hold the body still.

Standing hamstring stretch

A standing hamstring stretch is also an effective way to stretch the backs of the legs, and it is less strenuous for the lower back than toe touches.

  1. Stand up straight with the feet no more than shoulder width apart.
  2. Bend at the hips slightly and extend the right leg out a few inches in front of the body. Allow the left leg to bend slightly.
  3. While keeping the back straight, slowly bring the chest downward.
  4. Bend down as far as possible without causing pain. Hold for 30 seconds.
  5. Slowly bring the leg back toward the body and stand up straight.
  6. Repeat with the other leg.

Summary

Exercise is a noninvasive and healthful way to help with minor knee pain due to overuse, arthritis, or other causes. Knee strengthening exercises are an effective way to help prevent injury and keep the legs strong. Stretching can also help keep the muscles flexible, which can prevent or alleviate pain.

People who have health conditions should speak with a doctor before beginning any exercise program.

Patellar (Kneecap) Fractures

Patellar (Kneecap) Fractures

Article Featured on AAOS

A patellar fracture is a break in the patella, or kneecap, the small bone that sits at the front of your knee. Because the patella acts as a shield for your knee joint, it is vulnerable to fracture if you fall directly onto your knee or hit it against the dashboard in a vehicle collision. A patellar fracture is a serious injury that can make it difficult or even impossible to straighten your knee or walk.

Some simple patellar fractures can be treated by wearing a cast or splint until the bone heals. In most patellar fractures, however, the pieces of bone move out of place when the injury occurs. For these more complicated fractures, surgery is needed to restore and stabilize the kneecap and allow for the return of function.

Read more

What are the symptoms of knee ligament injuries

What are the symptoms of knee ligament injuries?

What are knee ligament injuries?

Knee ligaments are the short bands of tough, flexible connective tissue that hold the knee together. Knee ligament injuries can be caused by trauma, such as a car accident. Or they can be caused by sports injuries. An example is a twisting knee injury in basketball or skiing.

The knee has 4 major ligaments. Ligaments connect bones to each other. They give the joint stability and strength. The 4 knee ligaments connect the thighbone (femur) to the shin bone (tibia). They are:

  • Anterior cruciate ligament (ACL). This ligament is in the center of the knee. It controls rotation and forward movement of the shin bone.
  • Posterior cruciate ligament (PCL). This ligament is in the back of the knee. It controls backward movement of the shin bone.
  • Medial collateral ligament (MCL). This ligament gives stability to the inner knee.
  • Lateral collateral ligament (LCL). This ligament gives stability to the outer knee.

What causes knee ligament injuries?

Cruciate ligaments

The ACL is one of the most common ligaments to be injured. The ACL is often stretched or torn during a sudden twisting motion. This is when the feet stay planted one way, but the knees turn the other way. Slowing down while running or landing from a jump incorrectly can cause ACL injuries.  Skiing, basketball, and football are sports that have a higher risk for ACL injuries.

The PCL is also a common ligament to become injured in the knee. But a PCL injury usually occurs with sudden, direct hit, such as in a car accident or during a football tackle.

Collateral ligaments

The MCL is injured more often than the LCL. Stretch and tear injuries to the collateral ligaments are usually caused by a blow to the outer side of the knee. This can happen when playing hockey or football.

What are the symptoms of knee ligament injuries?

Cruciate injury

A cruciate ligament injury often causes pain. Often you may hear a popping sound when the injury happens. Then your buckles when you try to stand on it. The knee also swells. You also are not able to move your knee as you normally would. You may also pain along the joint and pain when walking.

The symptoms of a cruciate ligament injury may seem like other health conditions. Always see your healthcare provider for a diagnosis.

Collateral ligament injury

An injury to the collateral ligament also causes the knee to pop and buckle. It also causes pain and swelling. Often you will have pain at the sides of the knee and swelling over the injury site. If it is an MCL injury, the pain is on the inside of the knee. An LCL injury may cause pain on the outside of the knee. The knee will also feel unstable, like it is going to give way.

How are knee ligament injuries diagnosed?

Your healthcare provider will ask you have your health history and do a physical exam. You may also needs one or more of these tests:

  • X-ray. This imaging test can rule out an injury to bone instead of a ligament injury. It uses energy beams to make images of internal tissues, bones, and organs on film.
  • MRI. This test uses large magnets, radio waves, and a computer to make detailed images of organs and structures within the body. It can often find damage or disease in bones and a surrounding ligament, tendon, or muscle.
  • Arthroscopy. This procedure is used to diagnose and treat joint problems. The healthcare provider uses a small, lighted tube (arthroscope) put into the joint through a small cut (incision). Images of the inside of the joint can be seen a screen. The procedure can assess joint problems, find bone diseases and tumors, and find the cause of bone pain and inflammation.

How are knee ligament injuries treated?

Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is.

  • Treatment may include:
  • Pain medicine such as ibuprofen
  • Muscle-strengthening exercises
  • Protective knee brace
  • Ice pack to ease swelling
  • Surgery

Key points about knee ligament injuries

  • Knee ligaments are the short bands of elastic tissue that holds the knee together. There are 4 main ligaments in each knee.
  • Knee ligament injuries can be cause by trauma, such as a car accident. Or they can by caused by sports injuries.
  • The anterior cruciate ligament (ACL) is one of the most common ligaments to be injured.
  • Treatment may include medicine, muscle-strengthening exercises, a knee brace, or surgery.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
  • Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
  • Ask if your condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if you do not take the medicine or have the test or procedure.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.

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.