(65) 64712744|info@boneclinic.com.sg

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.

Seek Professional Opinion about your ACL Injury. Call +65 6471 2744 or SMS to +659235 7641 For Appointment

Osteoarthritis (Knee Pain Clinic)

Are you looking for effective way to manage and cure Osteoarthritis? You are at the right place. Stop your Knee Pain today! Call us at +65 6471 2744 or SMS to +65 92357641 to schedule for an appointment.

The most common form of arthritis, Osteoarthritis (OA) affects an estimated 40% of the adult population. Of these, only 10% seek medical advice and only 1% are severely disabled.

Knee Osteoarthritis

Knee Osteoarthritis

Causes

Osteoarthritis (OA) means inflammation of the joints although it is better known as a degenerative disease due to the inflammation of the joints with thinning of the articular cartilage. The cartilage in our joints allows for the smooth movement of joints. When it becomes damaged due to injury, infection or gradual effects of ageing, joints movement is hindered. As a result, the tissues within the joint become irritated causing pain and swelling within the joint.

Symptoms

In OA, you will have no problem in the morning on arising but as the day progresses your discomfort will increase.

In the evening, there will be a dull ache in the area of the affected joint.

Other symptoms include:

  • Pain
  • Swelling of the affected joints
  • Changes in surrounding joints
  • Warmth – The arthritic joint may feel warm to the touch
  • Crepitation – A sensation of grating or grinding in the affected joint caused by the rubbing of damaged cartilage surfaces
  • Cysts – In OA of the hand, small cysts may develop, which may cause the ridging or dents in the nail plate of the affected finger

The changes associated with degenerative arthritis tend to involve similar joints. Whereas in post-traumatic degenerative arthritis where there is a history of acute or chronic trauma, the changes tend to be isolated to the specific joints injured.

Risk Factors

Old age
As a person grows older, it becomes more likely that the cartilage may be worn away. OA is uncommon in people below 40 years of age.

Gender
Women are more likely to suffer from OA, especially after menopause.

Previous joint injury
Someone with a previous injury to the cartilage within the joint, e.g. after a fracture involving the joint or after a sporting injury to the joint will have a higher risk of developing OA later in life.

Weight
A greater than normal body weight puts more stress on the weight-bearing joints such as the hip and knee, increasing the likelihood of developing OA in these joints.

Bone deformities
People born with deformed joints or abnormal cartilage have an increased risk of OA.

Other diseases that affect the joints
Bone and joint diseases that increase the risk of OA include other arthritic conditions such as rheumatoid arthritis and gout.

Genetics
Genetic factors may predispose to the development of OA.

Diagnosis

The specialist will begin by taking a detailed history of your problem and past medical problems, followed by a physical examination. He may then proceed to other tests, such as:

X-rays
This is the most commonly performed test to evaluate the status of the affected joint and the alignment of the joint. Normal x-rays are safe, simple and pain-free.

Blood tests
Depending on the clinical findings, blood may be drawn for special testing, to rule out other causes of joint pain, e.g. due to rheumatoid arthritis, gout or infection.

Joint aspiration
Occasionally, especially when the joint is very swollen, the doctor may choose to suck some fluid out of the swollen joint for special testing. Removal of joint fluid also sometimes relieves pain.

Treatment Options

The goals for treatment for osteoarthritis are:

i. Pain relief
ii. Maintenance of function
iii. Prevention of associated deformities
iv. Patient education

The treatment for OA depends on the severity of the disease and the patient’s own lifestyle expectations.

Early cases of OA can generally be treated with:

  • Rest and lifestyle modification, such as weight loss and cessation of smoking
  • Use of aid (e.g. a walking stick). Use of good shoes is also helpful for relieving symptoms in some
    cases of OA
  • Exercise and physiotherapy to strengthen muscles and improve joint flexibility
  • Medication

In OA of the hand, rest can be accomplished by selectively immobilising the joint in a splint. Splinting is initially done for a period of 3 – 4 weeks, during which the splint is worn continuously.

This is usually combined with non-steroidal anti-inflammatory medication (NSAIDs) taken at the same time. If there is improvement in symptoms, use of the splint during the day is progressively diminished over the course of the coming month/s.

Use of NSAIDS
Gastrointestinal intolerance remains one of the major factors limiting the prolonged use of NSAIDs and may require temporary or permanent discontinuation of the anti-inflammatory agent. Concomitant use of H2 blockers, omeprazole, or misoprostol, a prostaglandin analogue that counteracts the mucosal effects of NSAIDs, may mitigate some of the gastrointestinal effects. Nephrotoxicity is a well-known complication of NSAIDs, and patients with pre-existing renal insufficiency should not take NSAIDs for extended periods.

Types of medication
There is presently no medication that can cure OA or regrow the cartilage in osteoarthritic joints.

The most commonly prescribed medications are painkillers. The type of painkiller prescribed depends on
the severity of the pain. For early disease with mild and occasional pain, simple painkillers, although more severe pain may require the use of non-steroidal anti-inflammatory drugs (NSAID’s) for relief. Analgesic (painkillers) creams and adhesive patches can also be used.

Glucosamine, with or without chondroitin, has also become a popular drug treatment in recent
years. It can be purchased without a doctor’s prescription.

However, it is ineffective in many patients, especially those with severe OA. The duration of its symptomatic relief also tends to be temporary. There is no evidence that glucosamine or chondroitin is able to result in cartilage repair.

Injections
For the treatment of OA, your doctor may sometimes recommend a lubricant injection to coat the cartilage and stimulate the healing process.

Surgery
Surgery is usually only offered for severe disease that has not responded to conservative treatments mentioned. Both the type of surgery and the decision for surgery are made following careful discussions between you and your doctor.

For many joints in the hands, arthodesis or fusion of the joint is the method of choice. In joint fusion, the arthritic surface is removed and bones on either side of the joint are fused to eliminate movement from the problem joint.

There may be some loss of movement but the pain ablation and stability may functionally improve the joint that is severely affected by the degenerative joint disease.

STOP YOUR KNEE PAIN TODAY. CALL US AT +65 6471 2744 Or SMS TO +65 92357641 FOR APPOINTMENT

Patient Guide to Knee Pain

Knee pain is a common complaint that affects people of all ages. Knee pain may be the result of an injury, such as a ruptured ligament or torn cartilage. Medical conditions — including arthritis, gout and infections — also can cause knee pain.

Many types of minor knee pain respond well to self-care measures. Physical therapy and knee braces also can help relieve knee pain. In some cases, however, your knee may require surgical repair.

Symptoms

The location and severity of knee pain may vary, depending on the cause of the problem. Signs and symptoms that sometimes accompany knee pain include:

  • Swelling and stiffness
  • Redness and warmth to the touch
  • Weakness or instability
  • Popping or crunching noises
  • Inability to fully straighten the knee

When to see a doctor
Call your doctor if you:

  • Can’t bear weight on your knee
  • Have marked knee swelling
  • Are unable to fully extend or flex your knee
  • See an obvious deformity in your leg or knee
  • Have a fever, in addition to redness, pain and swelling in your knee
  • Feel as if your knee is unstable or your knee “gives out”

Causes

Knee pain can be caused by injuries, mechanical problems, types of arthritis and other problems.

Injuries
A knee injury can affect any of the ligaments, tendons or fluid-filled sacs (bursae) that surround your knee joint as well as the bones, cartilage and ligaments that form the joint itself. Some of the more common knee injuries include:

  • ACL injury. An ACL injury is the tearing of the anterior cruciate ligament (ACL) — one of four ligaments that connect your shinbone to your thighbone. An ACL injury is particularly common in people who play basketball, soccer or other sports that require sudden changes in direction.
  • Torn meniscus. The meniscus is formed of tough, rubbery cartilage and acts as a shock absorber between your shinbone and thighbone. It can be torn if you suddenly twist your knee while bearing weight on it.
  • Knee bursitis. Some knee injuries cause inflammation in the bursae, the small sacs of fluid that cushion the outside of your knee joint so that tendons and ligaments glide smoothly over the joint.
  • Patellar tendinitis. Tendinitis is irritation and inflammation of one or more tendons — the thick, fibrous tissues that attach muscles to bones. Runners, skiers, cyclists, and those involved in jumping sports and activities are prone to develop inflammation in the patellar tendon, which connects the quadriceps muscle on the front of the thigh to the shinbone.

Mechanical problems
Some examples of mechanical problems that can cause knee pain include:

  • Loose body. Sometimes injury or degeneration of bone or cartilage can cause a piece of bone or cartilage to break off and float in the joint space. This may not create any problems unless the loose body interferes with knee joint movement, in which case the effect is something like a pencil caught in a door hinge.
  • Iliotibial band syndrome. This occurs when the ligament that extends from the outside of your pelvic bone to the outside of your tibia (iliotibial band) becomes so tight that it rubs against the outer portion of your femur. Distance runners are especially susceptible to iliotibial band syndrome.
  • Dislocated kneecap. This occurs when the triangular bone (patella) that covers the front of your knee slips out of place, usually to the outside of your knee. In some cases, the kneecap may stay displaced and you’ll be able to see the dislocation.
  • Hip or foot pain. If you have hip or foot pain, you may change the way you walk to spare these painful joints. But this altered gait can place more stress on your knee joint. In some cases, problems in the hip or foot can refer pain to the knee.

Types of arthritis
More than 100 different types of arthritis exist. The varieties most likely to affect the knee include:

  • Osteoarthritis. Sometimes called degenerative arthritis, osteoarthritis is the most common type of arthritis. It’s a wear-and-tear condition that occurs when the cartilage in your knee deteriorates with use and age.
  • Rheumatoid arthritis. The most debilitating form of arthritis, rheumatoid arthritis is an autoimmune condition that can affect almost any joint in your body, including your knees. Although rheumatoid arthritis is a chronic disease, it tends to vary in severity and may even come and go.
  • Gout. This type of arthritis occurs when uric acid crystals build up in the joint. While gout most commonly affects the big toe, it can also occur in the knee.
  • Pseudogout. Often mistaken for gout, pseudogout is caused by calcium-containing crystals that develop in the joint fluid. Knees are the most common joint affected by pseudogout.
  • Septic arthritis. Sometimes your knee joint can become infected, leading to swelling, pain and redness. There’s usually no trauma before the onset of pain. Septic arthritis often occurs with a fever.

Other problems
Chondromalacia patellae (patellofemoral pain syndrome) is a general term that refers to pain arising between your patella and the underlying thighbone (femur). It’s common in athletes; in young adults, especially those who have a slight misalignment of the kneecap; and in older adults, who usually develop the condition as a result of arthritis of the kneecap.

Risk factors

A number of factors can increase your risk of having knee problems, including:

  • Excess weight. Being overweight or obese increases stress on your knee joints, even during ordinary activities such as walking or going up and down stairs. It also puts you at increased risk of osteoarthritis by accelerating the breakdown of joint cartilage.
  • Biomechanical problems. Certain structural abnormalities — such as having one leg shorter than the other, misaligned knees and even flat feet — can make you more prone to knee problems.
  • Lack of muscle flexibility or strength. A lack of strength and flexibility are among the leading causes of knee injuries. Tight or weak muscles offer less support for your knee because they don’t absorb enough of the stress exerted on the joint.
  • Certain sports. Some sports put greater stress on your knees than do others. Alpine skiing with its rigid ski boots and potential for falls, basketball’s jumps and pivots, and the repeated pounding your knees take when you run or jog all increase your risk of knee injury.
  • Previous injury. Having a previous knee injury makes it more likely that you’ll injure your knee again.

Complications

Not all knee pain is serious. But some knee injuries and medical conditions, such as osteoarthritis, can lead to increasing pain, joint damage and disability if left untreated. And having a knee injury — even a minor one — makes it more likely that you’ll have similar injuries in the future.

Preparing for your appointment

You’re likely to start by seeing your family doctor. Depending upon the cause of your problem, he or she may refer you to a doctor specializing in joint diseases (rheumatologist), joint surgery (orthopedic surgeon) or sports medicine.

What you can do
Before your appointment, you may want to write a list of answers to the following questions:

  • When did you begin experiencing symptoms?
  • Did a specific injury make your knee start to hurt?
  • Have your symptoms been continuous or occasional?
  • How severe are your symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
  • What medications and supplements do you take regularly?

What to expect from your doctor
Your doctor may ask some of the following questions:

  • Do you exercise or play sports?
  • Do you experience any swelling, instability or locking of the knee?
  • Are you experiencing symptoms in other areas, or just in your knee?
  • Have you ever had knee pain before? If so, do you know what the cause was?

Tests and diagnosis

During the physical exam, your doctor is likely to:

  • Inspect your knee for swelling, pain, tenderness, warmth and visible bruising
  • Check to see how far you can move your lower leg in different directions
  • Push on or pull the joint to evaluate the integrity of the structures in your knee

Imaging tests
In some cases, your doctor might suggest tests such as:

  • X-ray. Your doctor may first recommend having an X-ray, which can help detect bone fractures and degenerative joint disease.
  • Computerized tomography (CT) scan. CT scanners combine X-rays taken from many different angles, to create cross-sectional images of the inside of your body. CT scans can help diagnose bone problems and detect loose bodies.
  • Ultrasound. This technology uses sound waves to produce real-time images of the soft tissue structures within and around your knee, and how they are working. Your doctor may want to maneuver your knee into different positions during the ultrasound, to check for specific problems.
  • Magnetic resonance imaging. MRI uses radio waves and a powerful magnet to create 3-D images of the inside of your knee. This test is particularly useful in revealing injuries to soft tissues such as ligaments, tendons, cartilage and muscles.

Lab tests
If your doctor suspects an infection, gout or pseudogout, you’re likely to have blood tests and sometimes arthrocentesis, a procedure in which a small amount of fluid is removed from within your knee joint with a needle and sent to a laboratory for analysis.

Treatments and drugs

Treatments will vary, depending upon what exactly is causing your knee pain.

Medications
Your doctor may prescribe medications to help relieve pain and to treat underlying conditions, such as rheumatoid arthritis or gout.

Therapy
Strengthening the muscles around your knee will make it more stable. Training is likely to focus on the muscles on the front of your thigh (quadriceps) and the muscles in the back of your thigh (hamstrings). Exercises to improve your balance are also important.

Arch supports, sometimes with wedges on one side of the heel, can help to shift pressure away from the side of the knee most affected by osteoarthritis. In certain conditions, different types of braces may be used to help protect and support the knee joint.

Injections
In some cases, your doctor may suggest injecting medications directly into your joint. Examples include:

  • Corticosteroids. Injections of a corticosteroid drug into your knee joint may help reduce the symptoms of an arthritis flare and provide pain relief that lasts a few months. The injections aren’t effective in all cases. There is a small risk of infection.
  • Supplemental lubrication. A thick fluid, similar to the fluid that naturally lubricates joints, can be injected into your knee to improve mobility and ease pain. Relief from one or a series of shots may last as long as six months to a year.

Surgery
If you have an injury that may require surgery, it’s usually not necessary to have the operation immediately. Before making any decision, consider the pros and cons of both nonsurgical rehabilitation and surgical reconstruction in relation to what’s most important to you. If you choose to have surgery, your options may include:

  • Arthroscopic surgery. Depending on your injury, your doctor may be able to examine and repair your joint damage using a fiber-optic camera and long, narrow tools inserted through just a few small incisions around your knee. Arthroscopy may be used to remove loose bodies from your knee joint, remove or repair damaged cartilage, and reconstruct torn ligaments.
  • Partial knee replacement surgery. In this procedure (unicompartmental arthroplasty), your surgeon replaces only the most damaged portion of your knee with parts made of metal and plastic. The surgery can usually be performed with a small incision, and your hospital stay is typically just one night. You’re also likely to heal more quickly than you are with surgery to replace your entire knee.
  • Total knee replacement. In this procedure, your surgeon cuts away damaged bone and cartilage from your thighbone, shinbone and kneecap, and replaces it with an artificial joint made of metal alloys, high-grade plastics and polymers.

Lifestyle and home remedies

Over-the-counter medications — such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve, others) — may help ease knee pain. Some people find relief by rubbing their knees with creams containing a numbing agent, such as lidocaine or capsaicin, the substance that makes chili peppers hot.

Self-care measures for an injured knee include:

  • Rest. Take a break from your normal activities to reduce repetitive strain on your knee, give the injury time to heal and help prevent further damage. A day or two of rest may be all you need for a minor injury. More severe damage is likely to need a longer recovery time.
  • Ice. Ice reduces both pain and inflammation. A bag of frozen peas works well because it covers your whole knee. You can also use an ice pack wrapped in a thin towel to protect your skin. Although ice therapy is generally safe and effective, don’t use ice for longer than 20 minutes at a time because of the risk of damage to your nerves and skin.
  • Compression. This helps prevent fluid buildup in damaged tissues and maintains knee alignment and stability. Look for a compression bandage that’s lightweight, breathable and self-adhesive. It should be tight enough to support your knee without interfering with circulation.
  • Elevation. To help reduce swelling, try propping your injured leg on pillows or sitting in a recliner.

Alternative medicine

  • Glucosamine and chondroitin. Study results have been mixed about the effectiveness of these supplements for relieving osteoarthritis pain. People who have moderate to severe arthritis pain appear to get the most benefit from these supplements.
  • Acupuncture. Research suggests that acupuncture may help relieve knee pain caused by osteoarthritis. Acupuncture involves the placement of hair-thin needles into your skin at specific places on your body.

Prevention

Although it’s not always possible to prevent knee pain, the following suggestions may help forestall injuries and joint deterioration:

  • Keep extra pounds off. Maintain a healthy weight; it’s one of the best things you can do for your knees. Every extra pound puts additional strain on your joints, increasing the risk of injuries and osteoarthritis.
  • Be in shape to play your sport. To prepare your muscles for the demands of sports participation, take time for conditioning. Work with a coach or trainer to ensure that your technique and movement are the best they can be.
  • Get strong, stay limber. Because weak muscles are a leading cause of knee injuries, you’ll benefit from building up your quadriceps and hamstrings, which support your knees. Balance and stability training helps the muscles around your knees work together more effectively. And because tight muscles also can contribute to injury, stretching is important. Try to include flexibility exercises in your workouts.
  • Be smart about exercise. If you have osteoarthritis, chronic knee pain or recurring injuries, you may need to change the way you exercise. Consider switching to swimming, water aerobics or other low-impact activities — at least for a few days a week. Sometimes simply limiting high-impact activities will provide relief.

STOP YOUR KNEE PAIN TODAY. CALL +65 6471 2744 OR SMS TO +65 92357641 FOR APPOINTMENT

Knee Pain Clinic

Most athletes will experience some knee pain from time to time. Overuse, long training days or bumps and bruises from contact sports often result in minor knee pain that heals within a day or two with some rest and ice. But there are some clues that indicate more serious knee pain and injuries that may need to be seen by a doctor for a complete evaluation and treatment plan.

When to See a Doctor for Knee Pains

You should see a doctor for your knee pain if you have any of the following warning signs:

  • Pain that lasts more than 48 hours
    If you have knee deep within the knee joint for more than a day or two your should get checked by a doctor. The knee joint isn’t covered by muscle so pain here is rarely of muscular origin.
  • Swelling that lasts more than 48 hours
    The first thing that happens after an acute injury is swelling around the site of the injury. When soft tissue is damaged, it swells or possibly bleeds internally. This swelling causes pain and loss of motion, which limits use of the muscles or joints. Swelling is usually obvious and can be seen, but occasionally you may just feel as though something is swollen even though it look normal. Swelling within a joint often causes pain, stiffness, and may produce a clicking sound as the tendons snap over one another after having been pushed into a new position from the swelling.
  • Loss of range-of-motion in the joint
    Reduced range-of-motion can indicate significant internal swelling, as well as other joint injuries. If you have limited range-of-motion for more than a day, you should contact your doctor.
  • Instability: feeling that the knee will give out
    Any instability in the knee joint or any sensation that the knee may give out or collapse may indicate a ligament injury to the knee. The knee ligaments provide support and stability to the joint and instability; if they are stretched or torn due to an injury, instability is one of the most obvious warning signs.
  • Inability to put your full weight on the leg
    A difference in your ability to support your full body weight on one leg,compared to the other, is another tip-off to an injury that requires attention.
  • Deformity of the knee joint
    If the knee joint looks deformed compared to the pain-free side, you should see a doctor. A fracture, patella tracking injury or a dislocating kneecap might sound obvious, but there are varying degrees of injury.
  • Knee joint pain in an active child
    If a child has knee pain it should be checked out be a doctor to rule out Osgood-Schlatter Disease.

Find the Right Doctor for Knee Pain

If you have any of these signs, you may want to see a specialist for a complete evaluation and treatment plan.

Get your Knee Injury checked and cured today. Call +65 6471 2744 or SMS to +65 9235 7641 for Appointment (24 Hours)

Preventing Football Sports Injury

Football is one of the most popular sports played by young athletes, and it leads all other sports in the number of injuries sustained.

WHAT TYPES OF INJURIES ARE MOST COMMON IN FOOTBALL?

Injuries occur during football games and practice due to the combination of high speeds and full contact. While overuse injuries can occur, traumatic injuries such as concussions are most common. The force applied to either bringing an opponent to the ground or resisting being brought to the ground makes football players prone to injury anywhere on their bodies, regardless of protective equipment.

COMMON INJURIES IN FOOTBALL PLAYERS:

Traumatic Injuries:

Knee injuries in football are the most common, especially those to the anterior or posterior cruciate ligament (ACL/PCL) and to the menisci (cartilage of the knee). These knee injuries can adversely affect a player’s longterm involvement in the sport. Football players also have a higher chance of ankle sprains due to the surfaces played on and cutting motions.

Shoulder injuries are also quite common and the labrum (cartilage bumper surrounding the socket part of the shoulder) is particularly susceptible to injury, especially in offensive and defensive linemen. In addition, injuries to the acromioclavicular joint (ACJ) or shoulder are seen in football players.

Overuse Injuries:

Low-back pain, or back pain in general, is a fairly common complaint in football players due to overuse. Overuse can also lead to overtraining syndrome, when a player trains beyond the ability for the body to recover. Patellar tendinitis (knee pain) is a common problem that football players develop and can usually be treated by a quadriceps strengthening program.

Concussions:

Football players are very susceptible to concussions. A concussion is a change in mental state due to a traumatic impact. Not all those who suffer a concussion will lose consciousness. Some signs that a concussion has been sustained are headache, dizziness, nausea, loss of balance, drowsiness, numbness/tingling, difficulty concentrating, and blurry vision. The athlete should return to play only when clearance is granted by a health care professional.

Heat Injuries:

Heat injuries are a major concern for youth football players, especially at the start of training camp. This usually occurs in August when some of the highest temperatures and humidity of the year occur. Intense physical activity can result in excessive sweating that depletes the body of salt and water.

The earliest symptoms are painful cramping of major muscle groups. However, if not treated with body cooling and fluid replacement, this can progress to heat exhaustion and heat stroke — which can even result in death. It is important for football players to be aware of the need for fluid replacement and to inform medical staff of symptoms of heat injury.

How can Football Injuries be Prevented:

  • Have a pre-season health and wellness evaluation
  • Perform proper warm-up and cool-down routines
  • Consistently incorporate strength training and stretching
  • Hydrate adequately to maintain health and minimize cramps
  • Stay active during summer break to prepare for return to sports in the fall
  • Wear properly fitted protective equipment, such as a helmet, pads, and mouthguard
  • Tackle with the head up and do not lead with the helmet
  • Speak with a sports medicine professional or athletic trainer if you have any concerns about football injuries or football injury prevention strategies

Having Football Injuries? Call +65 6471 2744 or SMS to +65 9235 7641 for professional treatment and consultation

Common Cycling Injuries

Since the 1800s when bicycles first made their appearance, cycling has become popular for commuting, recreation, exercise, and sport. Studies estimate that large numbers of these cyclists experience physical problems: 48 percent in their necks, 42 percent in their knees, 36 percent in the groin and buttocks, 31 percent in their hands, and 30 percent in the back. No matter why they use a bicycle, young people can follow some basic safety principles to avoid common cycling injuries.

WHAT ARE THE MOST COMMON CYCLING INJURIES AND HOW CAN THEY BE PREVENTED?

Knee Pain

The knee is the most common site for overuse injuries in cycling. Patellofemoral syndrome (cyclist’s knee), patella and quandriceps tendinitis, medial plica syndrome, and iliotibial band friction syndrome are a few of the more common knee overuse injuries. The first four injuries mentioned involve pain around the kneecap, while the last condition results in outer knee pain. Shoe implants, wedges beneath the shoes, and cleat positions may help prevent some overuse injuries.

Head Injuries

One of the most common injuries suffered by cyclists is a head injury, which can be anything from a cut on the cheek to traumatic brain injury. Wearing a helmet may reduce the risk for head injury by 85 percent. The majority of states have no laws governing the use of helmets while riding a bicycle, but helmets are readily available for purchase and typically low in cost.

Neck/Back Pain

Cyclists most likely experience pain in the neck when they stay in one riding position for too long. An easy way to avoid this pain is by doing shoulder shrugs and neck stretches that help relieve neck tension. Improper form also leads to injuries. If the handlebars are too low, cyclists may have to round their backs, thus putting strain on the neck and back. Tight hamstrings and/or hip flexor muscles can also cause cyclists to round or arch the back, which causes the neck to hyperextend. Stretching these muscles on a regular basis will create flexibility and make it easier to maintain proper form. Changing the grip on the handlebars takes the stress off of over-used muscles and redistributes pressure to different nerves.

Wrist/Forearm Pain or Numbness

Cyclists should ride with their elbows slightly bent (never with their arms locked or straight). When they hit bumps in the road, bent elbows will act as shock absorbers. This is also where changing hand positions will help reduce pain or numbness. Two common wrist overuse injuries, Cyclist’s Palsy and Carpal Tunnel Syndrome, can be prevented by alternating the pressure from the inside to the outsides of the palms and making sure wrists do not drop below the handlebars. In addition, padded gloves and stretching the hands and wrists before riding will help.

Urogenital Problems

One common complaint from male riders who spend a lot of time riding is pudendal neuropathy, a numbness or pain in the genital or rectal area. It is typically caused by compression of the blood supply to the genital region. A wider seat, one with padding, a seat with part of the seat removed, changing the tilt of the seat, or using padded cycling shorts will all help relieve pressure.

Foot Numbness and Tingling

Foot numbness and tingling are common complaints, and shoes that are too tight or narrow are often the cause. In addition, foot numbness can be due to exertional compartment syndrome. This arises from increased pressure in the lower leg and resulting compression of nerves. The diagnosis is made by pressure measurements and is treated with surgical release.

Get professional consultation and treatment about your Cycling Injury. Call +65 6471 2744 or SMS to +65 9235 7641 for Appointment

Knee Ostearthritis

Osteoarthritis (OA) of the Knee is one the most common knee joint disorder, which is due to aging and wear and tear on the knee joint.

Causes, incidence, and risk factors

Osteoarthritis of the knee is a normal result of aging. It is also caused by constant ‘wear and tear’ on the knee joint.

  • Cartilage is the firm, rubbery tissue that cushions your bones at the joints, and allows bones to glide over one another.
  • If the cartilage breaks down and wears away, the bones rub together. This causes pain, swelling, and stiffness around your knee.
  • Bony spurs or extra bone may form around the knee joint. The ligaments and muscles around the knee joint become weaker and stiffer which cause discomfort.

Often, the cause of Osteoarthritis of the knee is unknown. It is mainly related to aging.

The symptoms of Osteoarthritis of the knee usually appear in middle age. Almost everyone has some symptoms by age 70. However, these symptoms may be minor.

Before age 55, Osteoarthritis of the knee occurs equally in men and women. After age 55, it is more common in women.

Other factors can also lead to Osteoarthritis of the knee

  • Osteoarthritis of the knee tends to run in families.
  • Being overweight increases the risk of Osteoarthritis of the knee joints because extra weight causes more wear and tear.
  • Fractures or other joint injuries can lead to OA later in life. This includes injuries to the cartilage and cruciate ligaments in your knee joints.
  • Jobs that involve kneeling or squatting for more than an hour a day put you at the highest risk. Jobs that involve lifting, climbing stairs, or walking also put you at risk.
  • Playing sports that involve direct impact on the joint (such as football), twisting (such as basketball or soccer), or throwing also increase the risk of arthritis.

Medical conditions that can lead to Osteoarthritis of the knee include:

  • Bleeding disorders that cause bleeding in the joint, such as hemophilia
  • Disorders that block the blood supply near a joint and lead to avascular necrosis
  • Other types of arthritis, such as chronic gout, pseudogout, or rheumatoid arthritis

Symptoms

Pain and stiffness in the knee joints are the most common symptoms. The pain is often worse after exercise and when you put weight or pressure on the joint.

If you have Osteoarthritis of the knee, your knee joints probably become stiffer and harder to move over time. You may notice a rubbing, grating, or crackling sound when you move the knee joint.

The phrase “morning stiffness” refers to the pain and stiffness you may feel when you first wake up in the morning. Stiffness usually lasts for 30 minutes or less. It is improved by mild activity that “warms up” the joint.

During the day, the pain may get worse when you’re active and feel better when you are resting. After a while, the pain may be present when you are resting. It may even wake you up at night.

Some people might not have symptoms, even though x-rays show the changes of Osteoarthritis of the knee.

Signs and tests

A physical exam can show:

  • Joint movement may cause a cracking (grating) sound, called crepitation
  • Joint swelling (bones around the joints may feel larger than normal)
  • Limited range of motion
  • Tenderness when the joint is pressed
  • Normal movement is often painful

No blood tests are helpful in diagnosing Osteoarthritis of the knee.

An x-ray of affected joints will show a loss of the joint space. In advanced cases, there will be a wearing down of the ends of the bone and bone spurs.

Treatment

Osteoarthritis of the knee will most likely get worse over time. However, your Osteoarthritis of the knee symptoms can be controlled.

You can have surgery, but other treatments can improve your pain and make your life much better. Although these treatments cannot make the arthritis go away, they can often delay surgery.

MEDICATIONS

Over-the-counter pain relievers, which you can buy without a prescription, can help with Osteoarthritis of the knee symptoms. Most doctors recommend acetaminophen (Tylenol) first, because it has fewer side effects than other drugs. If your pain continues, your doctor may recommend nonsteroidal anti-inflammatory drugs (NSAIDs). Types of NSAIDs include aspirin, ibuprofen, and naproxen.

Other medications or supplements that you may use include:

  • Corticosteroids injected right into the joint to reduce swelling and pain
  • Over-the-counter remedies such as glucosamine and chondroitin sulfate
  • Capsaicin (Zostrix) skin cream to relieve pain
  • Artificial joint fluid (Synvisc, Hyalgan) can be injected into the knee to relieve pain for 3 – 6 months

LIFESTYLE CHANGES

Staying active and getting exercise helps maintain joint and overall movement. Ask your health care provider to recommend an appropriate home exercise routine. Water exercises, such as swimming, are especially helpful.

Other lifestyle recommendations include:

  • Applying heat and cold
  • Eating a healthy, balanced diet
  • Getting rest
  • Losing weight if you are overweight
  • Protecting the joints

As the pain from your Osteoarthritis of the knee becomes worse, keeping up with everyday activities may become more difficult or painful.

  • Sometimes making changes around the home will take some stress off your joints, and relieve some of the pain.
  • If your work is causing stress in certain joints, you may need to adjust your work area or change work tasks.

SURGERY

Severe cases of Osteoarthritis of the knee might need surgery to replace or repair damaged joints. Surgical options include:

  • Arthroscopic surgery to trim torn and damaged cartilage
  • Changing the alignment of a bone to relieve stress on the bone or joint (osteotomy)
  • Surgical fusion of bones, usually in the spine (arthrodesis)
  • Total or partial replacement of the damaged joint with an artificial joint (knee replacement, hip replacement, shoulder replacement, ankle replacement, elbow replacement)

Expectations (prognosis)

Every person with Osteoarthritis of the knee is different. Pain and stiffness may prevent one person from performing simple daily activities, while others are able to maintain an active lifestyle that includes sports and other activities.

Your movement may become very limited over time. Doing everyday activities, such as personal hygiene, household chores, or cooking may become a challenge. Treatment usually improves function.

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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.

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Cycling Knee Problems

Cycling is a great low-impact aerobic activity. Cyclists are usually more efficient on both hills and flat terrain when they pedal quickly (at about 80-85 rpm) rather than at slower cadences. Although cycling is considered a knee-sparing exercise because it does not require impact with the ground, the repetitive motion of pedalling can lead to a variety of overuse knee injuries. The majority of cycling injuries are indeed caused by overuse, which leads to cumulative tissue microtrauma and consequent symptoms. In overuse injuries the problem is often not acute tissue inflammation, but chronic degeneration.

Cycling is obviously very repetitive: during one hour of cycling a rider may average up to 5000 pedal revolutions. But which cyclists sustain overuse knee injuries? Basically, cyclists of every ability level are at risk: riding too hard, too soon and too far is the usual recipe for numerous knee problems. Touring cyclists often develop a knee overuse injury during or after one specific usually long ride. These sporadic high-mileage riders often do not train adequately. Patellar pain is the most frequent problem (for more information see our Patellofemoral problems page), followed by Iliotibial Band Syndrome. Bicycle maladjustments are also frequent in this group and amongst recreational cyclists.

Cyclists vs. Runners

Cycling and Running are two very popular sports, but compared to cycling, running seems to be a better way do build up leg bone density, while cycling regularly will improve on upper limb bone density. Runners have a bit less developed arm muscles. Apart from that, it seems that cycling and running have similar effects on body composition: participants in both have approximately 10% more leg muscle than the exercise abstainers.

Knee Pain

The knee is the most common site of overuse injury in the cyclist, with an estimated 40% to 60% of riders experiencing knee pain. Like other cyclists, mountain bikers can suffer overuse injuries. Such injuries have been studied little in mountain bikers. In one study involving 265 off-road cyclists, 30% had recently experienced knee pain associated with mountain biking, and 37% reported low-back pain while riding; wrist pain and hand numbness were each reported by 19% (4).

Overuse injuries: in chronic cases, continued activity produces degenerative changes that lead to weakness, loss of flexibility, and chronic pain. Thus, in overuse injuries, the problem is often not acute tissue inflammation, but chronic degeneration (hence, for example, patella tendinosis instead of tendinitis). Pain in overuse injuries typically has insidious onset, but it may have an acute-on-chronic presentation. Overuse injuries most likely occur when an athlete changes the mode, intensity, or duration of training.

When evaluating knee pain it is very important to consider cyclists and bicycle anatomy, seasonal variations (early cycling season), training distance and intensity, and numerous human anatomical factors such as inflexibility, muscle imbalance, patellofemoral malalignment, leg-length discrepancy, etc. Do check the leg length: if the difference is up to 10 mm you can correct it by putting spacers under one cleat. If one leg is shorter by more than 10 mm you should try a shorter crank arm on the short leg side. Generally using shorter cranks keeps pedal speed up and knee stress down. Too long crank arms increase forces on the entire knee, but patellar and quadriceps tendons are most affected.

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About Knee

How is the knee designed, and what is its function?

The knee is a joint that has three compartments. This joint has an inner (medial) and an outer (lateral) compartment. The kneecap (patella) joins the femur to form a third compartment called the patellofemoral joint. The thigh bone (femur) meets the large shinbone (tibia) forming the main knee joint.

The knee joint is surrounded by a joint capsule with ligaments strapping the inside and outside of the joint (collateral ligaments) as well as crossing within the joint (cruciate ligaments). These ligaments provide stability and strength to the knee joint.

The meniscus is a thickened cartilage pad between the two joints formed by the femur and tibia. The meniscus acts as a smooth surface for motion and absorbs the load of the body above the knee when standing. The knee joint is surrounded by fluid-filled sacs called bursae, which serve as gliding surfaces that reduce friction of the tendons. Below the kneecap, there is a large tendon (patellar tendon) which attaches to the front of the tibia bone. There are large blood vessels passing through the area behind the knee (referred to as the popliteal space). The large muscles of the thigh move the knee. In the front of the thigh, the quadriceps muscles extend the knee joint. In the back of the thigh, the hamstring muscles flex the knee. The knee also rotates slightly under guidance of specific muscles of the thigh.

The knee functions to allow movement of the leg and is critical to normal walking. The knee flexes normally to a maximum of 135 degrees and extends to 0 degrees. The bursae, or fluid-filled sacs, serve as gliding surfaces for the tendons to reduce the force of friction as these tendons move. The knee is a weight-bearing joint. Each meniscus serves to evenly load the surface during weight-bearing and also aids in disbursing joint fluid for joint lubrication.

What injuries can cause knee pain, and what other symptoms may accompany knee pain? How is knee pain diagnosed?

Injury can affect any of the ligaments, bursae, or tendons surrounding the knee joint. Injury can also affect the ligaments, cartilage, menisci (plural for meniscus), and bones forming the joint. The complexity of the design of the knee joint and the fact that it is an active weight-bearing joint are factors in making the knee one of the most commonly injured joints.

Ligament injury

Trauma can cause injury to the ligaments on the inner portion of the knee (medial collateral ligament), the outer portion of the knee (lateral collateral ligament), or within the knee (cruciate ligaments). Injuries to these areas are noticed as immediate pain but are sometimes difficult to localize. Usually, a collateral ligament injury is felt on the inner or outer portions of the knee. A collateral ligament injury is often associated with local tenderness over the area of the ligament involved. A cruciate ligament injury is felt deep within the knee. It is sometimes noticed with a “popping” sensation with the initial trauma. A ligament injury to the knee is usually painful at rest and may be swollen and warm. The pain is usually worsened by bending the knee, putting weight on the knee, or walking. The severity of the injury can vary from mild (minor stretching or tearing of the ligament fibers, such as a low grade sprain) to severe (complete tear of the ligament fibers). Patients can have more than one area injured in a single traumatic event.

Ligament injuries are initially treated with ice packs, immobilization, rest, and elevation. It is generally recommended to avoid bearing weight on the injured joint, and crutches may be required for walking. Some patients are placed in splints or braces to immobilize the joint to decrease pain and promote healing. Arthroscopic or open surgery may be necessary to repair severe injuries.

Surgical repair of ligaments can involve suturing alone, grafting, and synthetic graft repair. These procedures can be done by either open knee surgery or arthroscopic surgery (described in the section below). The decision to perform various types of surgery depends on the level of damage to the ligaments and the activity expectations of the patient. Many repairs can now be done arthroscopically. However, certain severe injuries will require an open surgical repair. Reconstruction procedures for cruciate ligaments are increasingly successful with current surgical techniques.

Meniscus tears

The meniscus can be torn with the shearing forces of rotation that are applied to the knee during sharp, rapid motions. This is especially common in sports requiring reaction body movements. There is a higher incidence with aging and degeneration of the underlying cartilage. More than one tear can be present in an individual meniscus. The patient with a meniscal tear may have a rapid onset of a popping sensation with a certain activity or movement of the knee. Occasionally, it is associated with swelling and warmth in the knee. It is often associated with locking or an unstable sensation in the knee joint. The doctor can perform certain maneuvers while examining the knee which might provide further clues to the presence of a meniscal tear.

Routine X-rays, while they do not reveal a meniscal tear, can be used to exclude other problems of the knee joint. The meniscal tear can be diagnosed in one of three ways: arthroscopy, arthrography, or an MRI.

Arthroscopy is a surgical technique by which a small diameter video camera is inserted through tiny incisions on the sides of the knee for the purposes of examining and repairing internal knee joint problems. Tiny instruments can be used during arthroscopy to repair the torn meniscus.

Arthrography is a radiology technique whereby a contrast liquid is directly injected into the knee joint and internal structures of the knee joint thereby become visible on X-ray film.

An MRI scan is another radiology technique whereby magnetic fields and a computer combine to produce two- or three-dimensional images of the internal structures of the body. It does not use X-rays and can give accurate information about the internal structures of the knee when considering a surgical intervention. Meniscal tears are often visible using an MRI scanner. MRI scans have largely replaced arthrography in diagnosing meniscal tears of the knee. Meniscal tears are generally repaired arthroscopically.

Tendinitis

Tendinitis of the knee occurs in the front of the knee below the kneecap at the patellar tendon (patellar tendinitis) or in the back of the knee at the popliteal tendon (popliteal tendinitis). Tendinitis is an inflammation of the tendon, which is often produced by a strain event, such as jumping. Patellar tendinitis, therefore, also has the name “jumper’s knee.” Tendinitis is diagnosed based on the presence of pain and tenderness localized to the tendon. It is treated with a combination of ice packs, immobilization with a knee brace as needed, rest, and anti-inflammatory medications. Gradually, exercise programs can rehabilitate the tissues in and around the involved tendon. Anti-inflammatory injections, which can be given for tendinitis elsewhere, are generally avoided in patellar tendinitis because there are reports of risk of tendon rupture as a result of corticosteroids in this area. In severe cases, surgery can be required. A rupture of the tendon below or above the kneecap can occur. When it does, there may be bleeding within the knee joint and extreme pain with any knee movement. Surgical repair of the ruptured tendon is often necessary.

Fractures

With severe knee trauma, such as motor vehicle accidents and impact traumas, bone breakage (fracture) of any of the three bones of the knee can occur. Bone fractures within the knee joint can be serious and can require surgical repair as well as immobilization with casting or other supports.

What are diseases and conditions that can cause knee pain, and what is the treatment for knee pain?

Pain can occur in the knee from diseases or conditions that involve the knee joint, the soft tissues and bones surrounding the knee, or the nerves that supply sensation to the knee area. In fact, the knee joint is the most commonly involved joint in rheumatic diseases, immune diseases that affect various tissues of the body including the joints to cause arthritis.

Arthritis is inflammation within a joint. The causes of knee joint inflammation range from noninflammatory types of arthritis such as osteoarthritis, which is a degeneration of the cartilage of the knee, to inflammatory types of arthritis (such as rheumatoid arthritis or gout). Treatment of the arthritis is directed according to the nature of the specific type of arthritis. Many people suffer from arthritis; the pain and discomfort can be so limiting that some patients may require a total knee joint replacement. Knee replacement surgery often allows the patient to regain much of their mobility.

Swelling of the knee joint from arthritis can lead to a localized collection of fluid accumulating in a cyst behind the knee. This is referred to as a Baker cyst and is a common cause of pain at the back of the knee.

Infections of the bone or joint can rarely be a serious cause of knee pain and have associated signs of infection including fever, extreme heat, warmth of the joint, chills of the body, and may be associated with puncture wounds in the area around the knee. These infections are often diagnosed by aspirating joint fluid accumulations with a needle (joint aspiration) and examining the fluid microscopically and with microbial culture techniques. Treatment is done with antibiotics.

Tumors involving the joint are extremely rare (for example, synovial sarcomas, and giant cell tumors). They can cause ambulatory problems with local pain. Treatment usually involves surgery; a few individuals may require amputation of the knee and lower leg. Treatments and surgery depend on the tumor type.

The collateral ligament on the inside of the knee joint can become calcified and is referred to as Pellegrini-Stieda syndrome. With this condition, the knee can become inflamed and can be treated conservatively with ice packs, immobilization, and rest. Infrequently, it requires a local injection of corticosteroids.

Chondromalacia refers to a softening of the cartilage under the kneecap (patella). It is a common cause of deep knee pain and stiffness in younger women and can be associated with pain and stiffness after prolonged sitting and climbing stairs or hills. While treatment with anti-inflammatory medications, ice packs, and rest can help, long-term relief is best achieved by strengthening exercises for the quadriceps muscles of the front of the thigh.

Bursitis of the knee commonly occurs on the inside of the knee (anserine bursitis) and the front of the kneecap (patellar bursitis, or “housemaid’s knee”). Bursitis is generally treated with ice packs, immobilization, and anti-inflammatory medications such as ibuprofen (Advil, Motrin) or aspirin and may require local injections of corticosteroids (cortisone medication) as well as exercise therapy to develop the musculature of the front of the thigh.

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