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Preventing ACL Injuries

ACL (anterior cruciate ligament) knee injuries can cause many problems for kids who play sports. Besides the chance of having to sit out an entire season, they might face loss of scholarship funding, lowered academic performance,1 and long-term disability from osteoarthritis (a painful joint condition). More than 50,000 debilitating ACL injuries occur in female athletes at the high school and intercollegiate varsity levels in an average year.

Knee Bursitis

Knee Bursitis

Why do ACL Injuries occur in kids?

Most ACL tears do not occur from player-to-player contact. The most common causes of noncontact ACL injury include: change of direction or cutting maneuvers combined with sudden stopping, landing awkwardly from a jump, or pivoting with the knee nearly fully extended when the foot is planted on the ground.

Who is at Risk for An ACL Injury?

There is no definitive link between age and gender, and the rising rates of ACL injuries. However, landing, cutting, and pivoting maneuvers have been shown to differ between male and female athletes. For example, some female soccer players may perform playing actions with more of a knock-kneed position, or a reduced hip and knee joint range of motion, or decreased hamstring strength, any of which may underlie their increased risk for an ACL injury.

How can an ACL Injury be prevented?

It is difficult to assess how athletes can best modify their movements to prevent noncontact ACL injuries. Speaking with an athletic trainer, physical therapist, or sports medicine specialist is a good place to start. Recent research has allowed therapists and clinicians to easily identify and target weak muscle areas (e.g., weak hips, which leads to knock-kneed landing positions) and identify ways to improve strength and thus help prevent injury. In addition, other risk factors such as reduced hamstring strength and increased joint range of motion can be further assessed by a physical therapist or athletic trainer to improve performance—or rehabilitation efforts after an injury has occurred.

Current studies also demonstrate that specific types of training, such as jump routines and learning to pivot properly, help athletes prevent ACL injuries. These types of exercises and training programs are more beneficial if athletes start when they are young. It may be optimal to integrate prevention programs during early adolescence, prior to when young athletes develop certain habits that increase the risk of an ACL injury.

Summary

There are several factors that determine whether or not a young athlete will get an ACL injury. Preseason screening programs that monitor important risk factors and identify young “high-risk” athletes who would benefit from targeted neuromuscular training interventions may be the most beneficial way to reduce the risk of ACL injuries in young athletes.

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Back to Sports: Advance Knee Rehabilitation

Knee injury is one of the most common injuries sustained in sports. It can be in the form of meniscal or ligamentous  injury, the most notorious being the Anterior Cruciate Ligament (ACL) tear. As a result of such injuries, athletes of ten get frustrated as they are unable to perform as their best or even engage in the sport itself. More often than not, athletes do not manage their injuries well and many will attempt to return to sports much earlier than optimal and usually end up worse than before.

Bringing a competitive athlete from injury back to sports requires much more planning than just restoring range of motion and strength. It requires a good understanding of the healing processes, in depth knowledge of strength and conditioning as well as biomechanics of the body in relation to each sport, and the most important of all, the abiloty to implement the rehabilitation process systematically and appropriatelly. It is a science all to itself.

There are three phases in the rehabilitation process; healing and restoration phase, sports conditioning phase. Healing and restoration phase usually takes about four to six weeks and aims to get the athlete back to full range of motion and normal gait. Strength and conditioning phase takes another six to eight weeks with the aim of helping the athlete regain about 80% strength, and at the same time progressively improve their cardiovascular endurance. Finally, the sports conditioning phase aims to improve agility, balance, power and coordination. The phases are not distinct but overlap. With a thorough rehabilitation process, the athlete would be able to return to his sports with a firm foundation in all the key components of physical fitness, allowing him to ease into his sports training with confidence.

Healing and restoration phase (Week 0-4); Aims:

  • Reduce swelling and effusion to minimum
  • Restore normal gait pattern
  • The management of a knee immediately post-operatively focuses on the reduction of swelling and effusion and restoration of range of movement. Exercise such as isometric knee extension is introduced as well to reduce the rate of muscle control.

Strength and Conditioning phase (Week 4-12); Aims:

  • Full range of motion and minimal swelling
  • Unilateral knee exercises
  • Achieving 80% muscle strength of the non injured knee

Once the swelling has reduced significantly, full extension restored with flexion achieved to about 100-120 degrees, and normal gait almost regained, the athlete is then put through other strengthening exercises which can including cycling, leg press, step downs, mini squats (0-45 degrees flexion). All these exercises should be done with both legs, with emphasis on smoothness of execution of movement. The athletes are loaded with low weights at first and then progressed gradually to higher weights with low repetitions. Cardiovascular endurance exercises are also started at this place.

Unilateral knee exercises can be started once the athlete has sufficient muscle control to do a single knee squat of 0-45 degrees flexion. Once the quadriceps and hamstring muscles of the operated knee can achieve about 80% strength of the uninvolved knee, it is time to move on the next phase. The strength of the uninvolved knee, it is time to move on to the next phase. The strength of the knee can be easily gauged by testing the knee on a leg press machine, comparing the weights that be achieved by each knee on a single set of 15 repetitions. A much more accurate test of the strength of the muscles can be done using the isokinetic machine.

The isokinetic strength test is widely used in sports clinics to evaluate the strength of muscles pre and post operatively. However the main drawbacks of the test are that the data does not accurately determine the different performance between athletes of varying skill levels and do not correlate strongly with functional tasks.

Sports Conditioning Phase (Week 12 onwards); Aims:

  • Achieve 90-100% muscle strength in quadriceps and hamstrings
  • Achieve 90-100% in functional testing
  • Athlete is able to perform sports specific movements with ease

Once the athlete can achieve 80% of quadriceps muscle strength and good control over single leg exercise, the next step will be to do functional tests to gauge the performance of the knee. Functional tests have been devised for athletes who has ACL reconstruction done. The tests include jumps, hops, agility and quickness in navigating turns. Various components of physical fitness listed above are tested i.e agility, balance, power and co-ordination. As such, the tests are also suitable to be applied to chart the progress of athletes recovering from post-operative meniscal repair, menisectomy and other ligamentous injury. Being functional, the tests would also be more meaningful as they mimic the movements that would be performed during the sport itself. At this phase, the athletes will be continuing to increase the basic muscle strength through the similar exercises listed in phase 2. These strengthening exercises will form the foundation from which the athletes will be trained in the other components.

Balance is a state of equilibrium, the ability to control the body’s position at rest or in motion. The athlete starts his balance training through balancing on 1 leg on a flat surface before progressing to balancing on unstable surface such as a wobble board. Subsequently, single leg hopping exercises will be introduced and progressed to multi-directional movements, where the level of difficulty is increased.

STOP YOUR KNEE PAIN TODAY. CALL +65 6471 2744 or Email to info@boneclinic.com.sg for appointment

Knee Pain in Sports Injury

One of the top sports injuries today is a knee injury. Athletes commonly suffer from knee injuries because their knees are unfortunately not protected and therefore more susceptible to injury. Sadly, for some athletes, knee injuries are not only painful they are also career ending. Therefore, protecting the knees becomes a priority. Those that suffer from knee problems understand the frustration of this and they sympathize with anyone that has knee pain. And athletes are actually not the only ones that suffer from knee related injuries. This type of knee pain affects many individuals. Therefore, read the following information for a guide on the basic knee problems that could affect those around you.

Where It Starts And What It Feels Like

Any pain in or around the knee can be very difficult to deal with. Stabbing pains are hard to ignore when trying to walk or move around, and dull, achy pains can wear a person down quickly. Whether a person is young or old, heavy or thin, an athlete, knee pain can strike. And when it does, it is a pain that no one wants to suffer from. It is aggravating, irritating, and often hard to treat.

Sometimes people get just pains from a ‘catch’ in a muscle or a nerve momentarily misfiring. Most of the time, though, the pain comes from something that is already a problem or could develop into one. That being said, it may not be a serious problem and a little bit of extra care could easily take care of it.

List Of Common Causes And Conditions of Knee Pain

The most common causes of knee pain are listed here, so anyone who’s suffering with this kind of problem can get some insight into what might be causing their discomfort. Hopefully this will aid individuals as they seek to understand why they are suffering from knee trouble. They are definitely not alone in their pain. There are a wide variety of knee problems that affect many.

Cartilage injuries – when a person damages the cartilage in his knee, it can sometimes cause the bones to actually grind together rather than rest on the cartilage cushion that was originally there. Obviously, that can cause a lot of pain and discomfort, and it’s not something that can be easily adjusted or corrected. However, because of sports, exercise, and an active lifestyle, it’s becoming more common today.
Arthritis – because arthritis can strike in any joint, one of the main areas that people often notice it in is the knee. It can cause both pain and stiffness, and it can also keep a person from doing all the activities that he wants to do, simply because it’s just so very uncomfortable. It can also get worse and cause serious debilitation.
A sprain or strain – it’s possible to injure the knee in such a way that it will heal and doesn’t do damage to the cartilage. In other words, there isn’t any permanent damage done but the pain and discomfort from it is very real. It can also take a long time to heal up, especially because the knee is such an integral part of the body
Patellar Tendonitis – this is tendonitis around the knee joint. It happens to the patellar tendon, which is the large tendon over the front of the knee
Chondromalacia patella – this condition causes knee pain under the kneecap. It usually occurs because the cartilage begins to soften. Most of the people who suffer from this condition are between the ages of 15 and 35.
Dislocating Kneecap – when the kneecap has been dislocated the individual can experience acute symptoms of pain during the dislocation. However, this condition can lead to chronic knee pain.
Baker’s Cyst – this usually occurs because of the result of a meniscus tear. It causes swelling in the back of the knee joint, resulting in knee pain.
Bursitis – this condition affects people that kneel for work (i.e. gardeners or carpetlayers), and it affects the joint above the kneecap.
Plica Syndrome – this is an uncommon cause of knee pain and it is difficult to diagnose, however it can happen and cause knee pain.
Osgood Schlatter Disease – this knee problem occurs in many adolescents and happens because of the irritation of the growth plate in the front of the knee joint.
Osteochondritis Dissecans – this is another growth related problem that causes problems in the knees of adolescents.
Gout – although not usually a cause of knee pain, the symptoms of gout can spread to the knees.

List Of Common Treatment Options for Knee Pain

Treating knee pain can be difficult, largely because a lot of people just try to live with it. They aren’t sure what’s causing it, and they worry that it might be something serious. Because they worry, they avoid going to their doctor and trying to get it corrected, when it could actually be something simple. Here are some of the most common treatment options for knee pain.

• Surgery – while not something a lot of people want to think about, surgery for knee injuries is quite common. Because of doctors’ ability to go in laproscopically through small incisions, knee surgery is much easier than it’s been in the past. The recovery is faster and there is a lot less pain while the knee heals.
• Medications – arthritis can be treated with medications more easily now than it could in the past. That’s great news for anyone who’s dealing with knee pain as a result of arthritis and who doesn’t really know what else to do in order to feel better.
• Knee braces and over-the-counter pain relievers are also good choices for knee pain.
• Rest is a common treatment for knee pain. One of the only ways that knee pain will heal is if the individual decides to stay off their knees. This might mean that they have to take it easy for a while.
• Physical Therapy is extremely important for many knee injuries because it will build back the strength in the knee area. There are a variety of different techniques that physical therapists use, however most of them are useful at allowing the sufferer to overcome knee pain and be able to walk again without pain.
• Ice and heat are also recommended to reduce inflammation in the knee area. Often, this is the best treatment for knee pain and many patients forget this simple procedure.
• Injections are a powerful medication that will help reduce and even treat inflammation. They are used commonly with people that suffer from knee problems. It is important to talk to the doctor concerning this option before proceding.

Holistic Approach

There are also alternative forms of treatment that may prove beneficial with specific knee pain. Many people choose to go this route, especially because knee pain is a constant problem that often does not disappear overnight. Here are some suggestions.

• Glucosamine and chondrotitin and two substances that aid in knee pain problems. They occur naturally in cartilage and can be purchased over the counter as supplements. They help relieve pain for a wide variety of conditions and can even reduce inflammation. Both are an effective natural remedy.
• Acupuncture is also a top holistic approach for knee pain. Research suggests acupuncture is one of the leading methods to treat knee pain. The needles actually help several people that are suffering with this issue. Most people believe that the pain relief comes from the release of endorphins. It’s always a good idea to ask the doctor about acupuncture possibilities. It is a good option for many cases of knee pain.

When To See A Doctor for Knee Pain

At certain times a doctor’s help may be required to treat knee pain. This is important to recognize. While some knee injuries are basic sprains or bruises that require rest or ice, others may need to be evaluated by the proper medical expert. The sooner it is evaluated the sooner healing will begin. Here are some guidelines to help individuals assess whether or not a doctor is necessary.

• Visit the doctor when it becomes difficult to walk comfortably on the leg that has knee pain.
• See the doctor if the knee pain is combined with a deformity around the joint. This is not normal and should be addressed quickly.
• Go to the doctor for knee pain that happens during the knee or during rest.
• Visit the doctor if the knee locks or becomes difficult or impossible to bend.
• See the doctor if the joint or calf area begins to swell.
• Let the doctor check out the knee if there are signs of infection such as fever, redness, and warmth.
• Go to the doctor if anything unusual occurs with knee pain or if it persists for a long time.

Managing Knee Pain

Since knee pain is difficult to treat unless the injury requires surgery, pain management must be kept up individually. This means that each person should listen to the advice of his or her doctor. What activities do they knee to avoid? What stretches and activities should they incorporate to promote healing? These types of questions will guide them as they seek to overcome the pain they experience from knee issues.

Lastly, pain management can be hard and overlooked. Do not overdo it. Try to avoid activities that place too much pressure on the knees to promote healing and avoid further pain.

Stop your Knee Pain Today. Call us at +65 6471 2744 / Email to: info@boneclinic.com.sg