How to Heal an MCL Tear

How to Heal an MCL Tear

An MCL tear or rupture can be a debilitating injury, but it often responds well to conservative treatment options like physical therapy. 

The medial collateral ligament (MCL) runs along the inside of the knee and connects the shinbone, or tibia, to the femur, or thighbone. This important ligament allows you to rotate your knee. It also stabilizes the joint by preventing it from bending too far inward.

The MCL is susceptible to sprains or tears, especially if a blow to the outside of the knee stretches it beyond its normal range of motion. MCL injuries are seen most often in athletes who play contact sports, but they can also be caused by an accident or a sudden twisting of the knee while skiing.

If you’ve ruptured your MCL, you’ll likely hear a popping sound in the knee. A tear will also cause pain, swelling, and tenderness. The knee may feel stiff, making it painful to straighten or bend the joint. An MCL injury creates a feeling of instability as well, so it may be difficult to put weight on the knee.

MCL injuries are grouped into three grades, each with a different level of severity. Treatment depends on the type of MCL trauma, but most can be successfully overcome with conservative therapies.

The Types of MCL Injuries

The type of MCL injury dictates the treatment and recovery time. Here’s a rundown of three categories of MCL damage:

Grade I: A Grade I MCL injury refers to a sprain of the ligament, but not a tear. This type of MCL injury heals within a few weeks with conservative therapy centered on resting the joint, reducing swelling with ice packs; and taking anti-inflammatory medications. Patients can strengthen the muscles surrounding the knee with exercises, including:

  • Hamstring Curl: Stand straight on one leg and tighten the stomach muscles. Bend the other knee and slowly raise the heel toward the buttocks. Hold for 30 seconds and repeat with the other leg. You may want to hold onto a chair for balance, if needed.
  • Wall Slide: With a straight back and feet flat on the floor, stand against a wall. Slide down slowly, ending in a squatting position. Hold for 30 seconds, and then rise. Repeat 10 to 15 times.

Grade 2: In a Grade 2 MCL injury, the ligament is partially torn. Treatment is similar to a Grade I trauma, but patients may be advised to stabilize the knee with a brace while they recover.

Grade 3: The most severe MCL injury, a Grade 3 MCL trauma means the ligament is completely torn. It also requires a longer recovery time, typically about three months. In addition to wearing a brace or taking pressure of the knee with crutches, you’ll undergo physical therapy to increase the joint’s range of motion. You can also start walking and pedaling on a stationary bike when the pain subsides.

Is Surgery Necessary?

A total rupture of the MCL usually doesn’t require surgery. Only in cases where the tear hasn’t healed after conservative therapy or other knee ligaments are damaged is surgery recommended. Surgery to repair a torn MCL involves stitching the ends of the ligament together or re-attaching it to the bone.

If you suspect you’ve injured your MCL, the doctors at Comprehensive Orthopaedics can diagnose your condition with a thorough physical exam. We’ll also take X-rays to check for any broken bones as well as an MRI to get a closer look at the ligaments of the knee. We’ll prescribe a therapy program so you can get back to the activities you enjoy as soon as possible. Contact us today for an appointment.

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Health Tip: Joint Popping and Cracking

Health Tip: Joint Popping and Cracking

(HealthDay News) — Most people have popping and cracking of their joints, especially as they age.

Though the reasons behind these sounds are unclear, doctors think they may be caused by ligaments stretching and releasing, or the compression of nitrogen bubbles.

Usually, the phenomenon doesn’t need treatment. However, if these sounds are accompanied by swelling and pain, seeing a doctor is recommended, says Johns Hopkins Medicine.

Copyright ©2017 HealthDay. All rights reserved.
Brisk Walks May Help, Not Harm, Arthritic Knees

Brisk Walks May Help, Not Harm, Arthritic Knees

If you suffer from knee arthritis and worry that walking will only worsen your damaged joint, a new study suggests you put your fears aside, slip on some sneakers, and take a brief but brisk walk.

The researchers estimated that if older adults with the condition added just 5 minutes of brisk walking to their day, their odds of needing knee replacement surgery could dip by 16 percent.

On the other hand, light walking — akin to a “stroll” — may have no impact, said lead researcher Hiral Master, a Ph.D. candidate in biomechanics and movement sciences at the University of Delaware.

Her team reached those conclusions by digging into data from over 1,800 older adults with knee arthritis who wore portable devices that tracked their walking intensities for at least four days.

Over the next five years, 6 percent of the participants had total knee replacement surgery.

The researchers used the data on people’s walking habits to examine the effects of replacing “non-walking” time with time spent walking at different intensities. The findings showed that substituting just 5 minutes of down time with moderate-to-high intensity walking was linked to a 16 percent decline in the odds of needing knee replacement surgery.

The study authors defined “moderate-to-high” intensity as more than 100 steps per minute. In laymen’s terms, Master said, that’s a “brisk” walk that gets your heart rate up — not a stroll around the block.

The findings were presented Saturday at the American College of Rheumatology’s annual meeting, in Chicago. Such research should be considered preliminary until published in a peer-reviewed journal.

Knee osteoarthritis develops when the cartilage cushioning the joint gradually breaks down, which can eventually result in bone scraping on bone.

The condition is common among middle-aged and older Americans. According to the Arthritis Foundation, up to 13.5 percent of men and 19 percent of women aged 45 and older have knee arthritis that’s severe enough to cause pain and other symptoms.

And those patients often wonder whether walking is good or bad for their arthritic joints, said Dr. Paul Sufka, a rheumatologist at the University of Minnesota, in Minneapolis.

“They often ask whether they should minimize their activity, keep doing what they’re doing, or intensify,” said Sufka, who is also with the American College of Rheumatology’s communications committee.

“The general advice we give to patients is to stay active,” Sufka said. But, he added, the truth is there is too little evidence to give patients definitive recommendations.

The new findings do not prove that brisk walking directly lowers the risk of needing knee replacement surgery, Sufka noted.

But, “this gives us some useful information to bring to the discussion,” he added.

Overall, Sufka said, research does suggest it’s better for people with knee arthritis to be active rather than sedentary. And that’s not just for the sake of their knees. Physical activity has a range of health benefits, including lower risks of heart attack and stroke.

Master agreed, and pointed out that exercise can help arthritis patients’ mental well-being, as well as physical.

And it doesn’t take a huge lifestyle change, she explained. The new findings suggest people can benefit from adding a short, brisk walk to their day.

In fact, Sufka said, such incremental shifts may be best.

“The best exercise program is the one you can actually stick with,” he said. “If right now, you’re walking around the block every day, what would be 5 percent or 10 percent more than that? You can gradually build from where you are.”

And what if walking is painful? That’s a tricky question, Sufka acknowledged. Some patients might benefit from physical therapy rather than only exercising on their own, he said.

Beyond aerobic exercise like walking, strengthening exercises for the leg muscles supporting the knees can also be helpful, he suggested.

More information

The Arthritis Foundation has an overview on knee arthritis.

SOURCES: Hiral Master, P.T., M.P.H., Ph.D. candidate, biomechanics and movement sciences, University of Delaware, Newark, Del.; Paul Sufka, M.D., assistant residency director, internal medicine residency program, University of Minnesota, Minneapolis, and member, communications and marketing committee, American College of Rheumatology; Oct. 20, 2018 presentation, American College of Rheumatology annual meeting, Chicago

An In-Depth Guide to Medial Knee Pain: Symptoms, Causes, and Treatment

An In-Depth Guide to Medial Knee Pain: Symptoms, Causes, and Treatment

If you’re experiencing knee pain, you may have a meniscal tear. Our orthopedic experts explain what causes this injury and what you can expect during your recovery.

The meniscus is a key cartilaginous structure in the knee joint. Pain and swelling in the medial, or inside, part of the knee can unfortunately be a sign of tearing, but your treatment options will look different depending on the type of tear, the cause, and the severity. Our guide explains meniscal injuries, and what you can expect when you visit your doctor.

WHAT IS THE MENISCUS?

The meniscus is the C-shaped, rubbery cartilage in the knee that acts as a shock absorber and stabilizer for the joint, distributing the body’s weight and providing a cushion between the femur and tibia bones. The medial meniscus is located on the inner knee, while the lateral meniscus is on the outside. Medial tears are more common, but the symptoms are the same for both injuries.

Meniscal injuries can be classified according to the “zone” of the meniscus that is affected. This allows the physician to determine the amount of blood flow available to aid in the healing process. The red zone is the outer third, which has blood vessels and is more easily repaired by the body. The red-white zone has fewer blood vessels and is less quick to heal. The inner third, the white zone, has poor blood flow and is therefore more difficult to repair.

Meniscal tears also come in a variety of shapes, which may influence the course of treatment. Common shapes include bucket-handle, flap, and radial tears, or complex combinations of the three. A tears is considered “complete” if a piece of tissue has become separated from the meniscus. Degenerative tears, which are generally caused by arthritis, are more typical of older patients. Traumatic tears are common among athletes, who often twist and turn the meniscus.

SYMPTOMS AND CAUSES OF MENISCAL TEARS

The first sign of a meniscal tear may be a “pop” in the joint, and you may continue to feel a popping or clicking sensation with movement. Although you may be able to walk on the knee at first, subsequent pain and swelling can worsen in the days that follow, especially if you continue to use the leg. For a severe tear, the knee may click, lose its full range of motion, or even give way. If a part of the meniscus comes loose, the knee can slip or even lock.

Athletes and young people are especially prone to this injury due to sports trauma or hyper-flexing the joint. A forced twist, especially when the foot is planted, may cause the meniscus to tear. Older people may experience meniscal pain due to arthritis or ordinary degenerative wear to the cartilage. In these cases the pain occurs due to gradual tearing over time, and may present with no trauma to the knee.

KNEE PAIN TREATMENT AND RECOVERY

The first course of action is to follow the rules of “RICE”: rest the knee, ice the area in 20-minute sessions, compress the area, and elevate the leg to reduce swelling. In some cases, the knee may heal with this conservative treatment, but we recommend consulting an orthopedic specialist to examine the joint and monitor your recovery. Your doctor may perform a McMurray test, which includes bending, straightening, and rotating the knee in order to determine if an MRI is necessary. Orthopedic specialists usually will not recommend surgery for older patients, but physical therapy may help you find relief within five weeks.

For younger patients, arthroscopic surgery may actually be a preferred option, as this will help preserve the cartilage and prevent early onset arthritis in the joint. This type of surgery requires only two pinhole incisions. In most cases, when the tear is in the white zone, the fragment is trimmed and the remainder smoothed. Tears in the red zone are usually repaired to retain the full benefits of a complete meniscus. Surgery is often completed in 30 minutes, followed by several days of walking with the assistance of a crutch, or possibly a brace. After a few days you can expect to return to most normal activities. Full recovery, and a return to strenuous activity, can be expected after a few weeks of physical therapy.

Ditch the Golf Cart. Your Aging Knees Won’t Mind

Ditch the Golf Cart. Your Aging Knees Won’t Mind

Golfers with knee arthritis should park the golf cart and walk the links instead, researchers say.

While using a golf cart may seem the obvious choice for golfers with knee problems, a new small study finds that walking provides much greater health benefits. Moreover, it’s not associated with increased pain, inflammation or cartilage breakdown, the researchers said.

“Individuals with knee osteoarthritis are often concerned about pain and may be more likely to use a golf cart,” said lead study author Dr. Prakash Jayabalan. He’s an assistant professor of physical medicine and rehabilitation at Northwestern University Feinberg School of Medicine in Chicago.

However, “this study has shown that golfers with knee osteoarthritis do not need to be concerned about worsening their disease through walking the course. In fact, walking provides the best health benefit,” Jayabalan said in a university news release.

More than 17 million Americans older than 50 golf regularly. Knee osteoarthritis is a leading cause of disability in this age group. The condition causes swelling, pain and difficulty moving the joint.

The study included 10 older golfers with knee osteoarthritis and five without the disease, which is usually caused by wear and tear of the joint.

On one day, the study participants played one round of golf (18 holes) walking the course. On another day, they used a golf cart to play 18 holes. On each occasion, the researchers monitored the participants’ heart rates to determine their level of exercise intensity, and took blood samples to measure markers of knee inflammation and cartilage stress.

On both occasions, the golfers had an increase in these markers, but there was no difference between use of the golf cart and walking, the findings showed.

When walking the course, the heart rates of the golfers with knee problems were in the moderate-intensity zone for more than 60 percent of the time, compared with 30 percent when using a cart.

But even using the cart, golfers met daily exercise recommendations, according to the study authors.

“Bottom line: walking the course is significantly better than using a golf cart, but using a golf cart is still better than not exercising at all,” Jayabalan concluded.

The study was presented recently at the Osteoarthritis Research Society International annual meeting in Liverpool, England. Research presented at meetings is usually considered preliminary until published in a peer-reviewed medical journal.

More information

The Arthritis Foundation has more about osteoarthritis.

SOURCE: Northwestern University, news release, April 28, 2018

ACL Surgery Preparation and Recovery

ACL Surgery Preparation and Recovery

Professional athletes’ speedy recoveries from injuries have nothing to do with superhuman abilities. Instead, it’s all about proper preparation and planning.

It’s no surprise that professional athletes tend to be in much better shape than those of us who don’t play sports for a living — but what might seem more puzzling is that they also seem to recover more rapidly from injuries. Think of D’Angelo Russell, the Brooklyn Nets’ star point guard. After suffering a knee injury in November, he underwent arthroscopic knee surgery and fully recovered in just over two months, returning to the court by the middle of January.

Such a speedy recovery isn’t evidence of superior physical fitness, however, so much as a clear strategy in the wake of an injury. Professional athletes have access to some of the best orthopedic specialist available — and these doctors, trainers, and therapists help them follow strict guidelines throughout the process of rehabilitation, ensuring that they can return to action as soon as possible.

While you might not have a dedicated team of doctors at your disposal, there are many steps you can take to enjoy a similarly quick recovery. ACL tears — a rupture of the anterior cruciate ligament, one of several ligaments that stabilize the knee — are a common injury affecting star basketball players and casual gym-goers alike. Here’s what you can learn from the professional athletes’ approach to ACL rehabilitation.

1. KEEP YOUR BODY HEALTHY

In order to help your body best respond to arthroscopic surgery, you need to stay healthy and hydrated. For at least a week before your surgery, be sure to drink plenty of water and eat a nutritious, wholesome diet rich in antioxidants, both of which can boost your body’s ability to heal.

2. STRETCH AND EXERCISE BEFORE SURGERY

Staying healthy requires more than just eating right, of course. Your preparation for surgery should include regular stretches and massages, which can strength the tissues surrounding the ACL and increase their flexibility. These measures ensure that the knee joint remains relaxed and enjoys proper circulation, both of which foster optimal surgical conditions.

3. DON’T BE AFRAID TO ASK QUESTIONS

Nobody expects an injury, so when these unfortunate events happen, you might not know what to expect. Athletes have a whole team on hand — ranging from surgeons to physical therapists — to guide them through the process, and while you might not have the same resources readily available, you should do your best to stay informed. Your doctor and surgeon are there to help you, so be sure to voice your concerns and ask any questions you may have.

4. FORMULATE AND WRITE DOWN THE RULES

When it comes to recovery, you can’t break the rules. A rehabilitation plan isn’t something you can come up with on the fly, so be sure to consult with your doctor, therapist, and surgeon to formulate a concrete plan centered around defined protocols and regular benchmarks to help you stay motivated and focused.

5. STAY STOCKED UP ON SUPPLIES

Proper recovery requires keeping plenty of tools on hand, such as ice packs and non-steroidal anti-inflammatories. You may struggle to get out of the house while you recover from the procedure, so ensure that you have an ample supply of everything you might need before you undergo surgery.

6. MAINTAIN A POSITIVE MOOD

As a minimally invasive procedure, arthroscopic surgery is designed to shorten recovery timelines, but you’ll still need to spend some time resting immediately after surgery. Since you won’t be able to participate in many of your daily activities, try to have some projects at the ready to keep you happy and occupied. Maintaining a positive mood will help boost your morale, and ultimately assist in recovery.

If you’re considering arthroscopic surgery for an ACL tear, CompOrtho is ready to help. Our team of specialists has decades of combined experience in treating knee injuries, providing every patient with the care and attention they need from the initial diagnosis to the final follow-up. Call us today to schedule a consultation!

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