Most Knee Cracking Is Normal, Expert Says

Most Knee Cracking Is Normal, Expert Says

SUNDAY, Aug. 16, 2020 (HealthDay News) — If your knees crack when you walk or run, don’t be too worried, an expert says.

“Knee cracking could mean lots of things,” said Harshvardhan Singh, assistant professor in the department of physical therapy at the University of Alabama at Birmingham. “If it is painful, then you should see a health care provider.”

The cause can be a large kneecap that doesn’t fit well into the groove, producing cracking during activities such as running and jogging.

And if the thigh muscle is too tight, it can pull the kneecap, causing an audible crack. Degeneration of knee cartilage can, too.

“The degenerative changes can also lead to pain and/or locking of the knee joint,” Singh said in a university news release. “Typically, degenerative changes are common in older people.”

Scans have shown that the displacement of joint surfaces forming the knee can cause a chain reaction in which natural gas bubbles collapse. The result: knee cracking.

“You should not be worried if your knees crack often as long as it is not associated with pain,” Singh said.

If you have had a recent trauma to the knee and it starts to crack, you should see a doctor even in there’s no pain, he said.

“Do not allow these sounds to make you feel abnormal or mentally stressed, or limit your functional activities,” Singh said. “A knee crack by itself does not indicate presence of any disease.”

It’s normal for knees to crack when you are active and it does not mean you have arthritis, he explained.

“Interestingly, in knee arthritis, knee joint becomes hypomobile and loses its movement to a certain degree, which may lead to no knee crack,” he said. “A knee crack may mean your joint is mobile and lubricated.”

A professional may be able to help quell the cracking, Singh said.

“A physical therapist may be able to help you determine if there are specific movement patterns or any biomechanical alignment which may be leading to knee crack and prescribe you certain exercises to help improve it,” he said.

More information

For more about cracking knees, visit Johns Hopkins University.

SOURCE: University of Alabama at Birmingham, news release, Aug. 10, 2020

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What Jobs Are Toughest on the Knees?

What Jobs Are Toughest on the Knees?

Joint replacements for knee osteoarthritis are becoming more common, and now researchers have identified jobs that may lead to one.

Based on a review of 71 studies that included nearly one million workers, the riskiest occupations include agriculture, construction, mining, service jobs and housekeeping. And jobs that demand excessive kneeling, squatting, standing, lifting and climbing stairs all increase your odds.

A team of researchers from the University of Sydney in Australia, and the Universities of Oxford and Southampton in the United Kingdom found that:

  • Carpenters, bricklayers and floor installers have roughly three times the risk for knee osteoarthritis, compared with sedentary workers.
  • Farm workers have 64% higher odds for the condition, slightly higher than the 63% for builders and construction workers.
  • Housekeeping also carries a risk — with unpaid houseworkers facing up to 93% increased odds for knee osteoarthritis.
  • Some jobs were kinder to the knees, however. Workers in commerce, forestry, fishing, machinists, plumbers, electricians, technicians and postal workers did not have a statistically significant risk for knee osteoarthritis, the study found.

“Knee osteoarthritis is a leading cause of loss of work and disability worldwide and can necessitate invasive surgery including total knee replacement, so preventing occupational hazards is critical,” senior study author Dr. David Hunter said in a news release from the University of Sydney, where he leads the Institute of Bone and Joint Research.

Osteoarthritis develops as cartilage deteriorates and bone comes into contact with bone, causing pain and swelling, and limiting function, which affects lifestyle. It can follow an injury, but most of the time the cause is unknown, according to a New York orthopedic surgeon.

“There is a genetic component, but there’s also a lifestyle component,” said Dr. Jeffrey Schildhorn of Lenox Hill Hospital in New York City, who reviewed the findings. One of the biggest risk factors is being overweight or obese.

“I’ve seen arthritis in every walk of life,” he said.

Osteoarthritis is a disease of aging, so it’s not surprising that more people are suffering from it and that the number of joint replacements is soaring, because people are living longer, Schildhorn said. But, he added, there is no miracle cure.

“The thing with arthritis that makes it difficult to deal with is that cartilage has no true regenerative ability,” he said, suggesting that the best way to prevent it is to eat well and watch your weight. Stretching and exercises like yoga will also help keep joints limber, Schildhorn added.

Treatment can include pain medications, and physical or behavioral therapy. But when these don’t work, a knee replacement may be in order.

“Osteoarthritis is mechanical wear and tear,” Schildhorn said. “Some people have more resilient cartilage than others.” If it is very soft and flaky, no treatment is going to work and it has nothing to do with a person’s lifestyle — or their job, he said.

But employers can help by providing physical therapy and teaching workers how to do their jobs with less stress on their knees, Schildhorn said.

The report was recently published in the journal Arthritis Care and Research.

More information

Learn more about knee osteoarthritis from the American Academy of Orthopaedic Surgeons.

SOURCES: Jeffrey Schildhorn, MD, orthopedic surgeon, Lenox Hill Hospital, New York City; University of Sydney, news release, July 8, 2020; Arthritis Care and Research, July 8, 2020

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Vigorous Exercise Safe for Those at Risk of Knee Arthritis

Vigorous Exercise Safe for Those at Risk of Knee Arthritis

TUESDAY, May 12, 2020 (HealthDay News) — People at high risk for knee arthritis don’t need to avoid jogging and other types of vigorous exercise, a new study suggests.

Some folks hold back on physical activity because they fear it will increase their chances of developing knee arthritis, so researchers from Northwestern University’s Feinberg School of Medicine in Chicago took a closer look.

“Our study findings convey a reassuring message that adults at high risk for knee [arthritis] may safely engage in long-term strenuous physical activity at a moderate level to improve their general health and well-being,” said study author Alison Chang, associate professor of physical therapy and human movement sciences.

The study included nearly 1,200 people from several U.S. cities, ages 45-79, who were at high risk for knee arthritis but had no evidence of the condition.

Obesity, previous joint injury, surgery, aging and chronic knee symptoms increase the risk of developing arthritis of the knee.

Participants were followed for up to 10 years. Chang and her colleagues found that long-term participation in strenuous physical activities such as jogging, swimming, cycling, singles tennis, aerobic dance and skiing was not associated with risk of developing knee arthritis.

In fact, those who did vigorous exercise had a 30% lower risk of knee arthritis, but that’s not considered statistically significant, according to the authors.

Lots of sitting wasn’t associated with either an increased or reduced risk of arthritis.

“People suffering from knee injuries or who had arthroscopic surgical repair of ACL or meniscus are often warned that they are well on the path to develop knee [arthritis],” Chang said in a university news release.

“They may be concerned that participating in vigorous activities or exercises could cause pain and further tissue damage. To mitigate this perceived risk, some have cut down on or discontinued strenuous physical activities, although these activities are beneficial to physical and mental health,” she said.

The bottom line? “Health care providers may consider incorporating physical activity counseling as part of the standard care for high-risk individuals at an early stage when physical activity engagement is more attainable,” Chang said.

The study findings were published May 4 in the journal JAMA Network Open.

More information

The American Academy of Family Physicians has more on arthritis.

SOURCE: Northwestern University, news release, May 4, 2020

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Your Noisy Knees May Be Trying to Tell You Something

Your Noisy Knees May Be Trying to Tell You Something

THURSDAY, Oct. 17, 2019 (HealthDay News) — Ever hear your joints clicking, creaking or crunching? Now, researchers say a new technique that listens closely to knees may help doctors diagnose and monitor osteoarthritis.

In the new study, researchers attached small microphones to participants’ knees, which allowed them to listen for high-frequency sounds as the person repeatedly stood up and sat down again.

Computer analysis of the sounds then provided information about the health of the knee, the study authors explained.

This study is the first to assess this technique in a large number of people with knee osteoarthritis. It was found to distinguish between healthy knees and those afflicted by this “wear-and-tear” form of arthritis.

The findings move the technique a step closer to use by doctors and in research, according to the report published Oct. 16 in the journal PLOS ONE.

“This work is very exciting because it involves scientists and clinicians working together as a team to develop an entirely new approach,” said project leader John Goodacre. He’s an emeritus professor at Lancaster University, in the United Kingdom.

“Potentially, this could transform ways in which knee osteoarthritis is managed. It will enable better diagnosis, and will enable treatments to be tailored more precisely according to individual knee condition. It will also enable faster, bigger and better clinical trials of new treatments,” Goodacre said in a university news release.

The next step for researchers is to develop a non-invasive portable device that health care providers could use to assess whether patients’ knees are changing or are responding to treatment for osteoarthritis.

This technique could provide a quicker, cheaper, more convenient and more accurate assessment than current methods, the study authors said.

More information

The American Academy of Family Physicians has more on osteoarthritis.

SOURCE: Lancaster University, news release, Oct. 16, 2019

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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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Your Noisy Knees May Be Trying to Tell You Something

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.

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