Knee pain is the most common of all sports injuries – and not only for those athletes whose activities involve running flat out and changing direction at speed. Indeed, virtually every sport has its share of knee injuries and related problems.
So if you've played sport for any sustained period of time, chances are you've already experienced at least one bout of knee pain – be it a temporary and mild nuisance you've shrugged off, or a debilitating injury that forced you to seek specialist help. And if not, chances are you're likely to suffer knee pain in the not-too-distant future.
Cartilage Problems: What can you do to avoid, or recover from, this all-too-common injury?
Cartilage tears in the knee are ten a penny among sports people. Some of us remain blissfully untroubled by them, while others experience discomfort, pain and even disability. Happily this is one area where science is moving forward briskly.
Knee Pain: Prevention & Treatment deals with the menisci – what are more commonly known as the 'shock absorbing cartilage' in the knee joint. These two crescent-shaped pads of cartilage are present in both knees. The pad on the inner side of the knee is the 'medial meniscus', while the outer one is the 'lateral meniscus'.
Together they act in four different ways to improve knee function:
- they spread load across the joint. In standing, this is up to 50% of the supported load; in flexion (bending at the knee) it increases to 90%
- they improve joint congruency or stability
- they increase the contact surface area of the main leg bones, helping to spread the weight of the body across a greater area of articular cartilage
- they help to circulate synovial (joint) fluid around the knee.
Crucially, the menisci have limited healing potential as their blood supply only reaches the outermost 10% to 30% of each meniscus. Within this region tears may heal. But more centrally-located tears have very little chance of healing.
Patellar Tendinitis: which athletes are most at risk of injury – and why?
Patellar tendinitis is the most common knee disorder found among competitive athletes. Known as 'jumper's knee', it is most likely to affect you if you play high impact sports involving bursts of intense or repeated stress, notably basketball and volleyball (these sports demand twisting on the spot, deep knee bends and sprinting).
However, anyone from the casual jogger to contact sport players may develop the condition – all too often with far-reaching consequences. One study has estimated that more than half of athletes diagnosed with patellar tendinitis were forced to retire from their sporting activity.
Classically patellar tendinitis has been explained as chronic inflammation of the tendon connecting the kneecap (patella) to the main shin bone (tibia), at the point of connection to the kneecap. Recent research has, however, revised our understanding of the condition.
The depth at who is most at risk of getting patellar tendinitis – and why. identify both the intrinsic (specific to the individual) and extrinsic (environmental) factors. the findings of a recent American study of 138 athletes that sheds new light on intrinsic causes – and suggests what individual athletes can do to reduce their likelihood of suffering the injury.
Self-Diagnosis for Athletes: how to diagnose and fix your own niggling knee injuries
Sporting injuries to the knee can affect people at any stage of their lives. Often the injury is directly related to the activity itself, as in the golfer who experiences a catching pain in the knee during the follow-through phase of the swing, or the tennis enthusiast whose knee gives way after being wrong-footed.
In other cases the cause of the injury may be unclear. Take for example the runner whose knee gradually tightens until it becomes painful during a seemingly innocuous run. There are likely to be many influencing factors relating to this kind of scenario. Footwear, running technique, and stretching (or lack of it) would be a few things to consider.
And non-sporting factors can have a strong bearing on what seems to be a sports injury. A nurse who has had a busy duty may take certain elements of fatigue into her run; a desk-bound office worker may have postural issues that affect good running technique.
Deep inside the knee joint, two little ligaments provide crucial stability to help our knees cope with the tremendous forces that many sports subject them to. One of these ligaments – the anterior cruciate ligament or ACL – has achieved celebrity status, mainly because of the tendency of sporting celebrities (especially footballers) to injure it.
The second ligament – the posterior cruciate or PCL – is hardly ever in the spotlight, and because it is less commonly injured, our understanding of how to treat it is less advanced than for the ACL.
Acute PCL injuries are often overlooked, sometimes because the physician misses them, other times because the affected individual does not realise they might have done some serious damage and so delays seeking treatment.
Note: sportsmen frequently get PCL injuries when NOT in training or competition – so causes with extra care…
Glucosamine: is there any proof that this popular supplement really works?
Glucosamine is a rare example of an 'alternative' supplement that has gained widespread mainstream credibility among both the general public and medical practitioners.
Either by itself or in combination with chondroitin, glucosamine is used commonly by older people to help relieve pain from arthritic joints, and is also often advocated by therapists for clients recovering from soft-tissue injuries, in the belief that it promotes cartilage repair.
But how much evidence is there that this popular, and expensive, supplement actually works?
The report on the findings of several recent clinical trials, and a meta-analysis (research overview) of a number of previous studies. The findings were far more complex than many enthusiasts – and Glucosamine vendors – would have you believe.
It's not that you should stop taking Glucosamine altogether. More that you need to pay very careful attention to which form of the supplement you're taking, when you're taking it – and why…
ACL Injuries: why are women far more likely than men to suffer – and what can they do about it?
The anterior cruciate ligament (ACL) is the most commonly damaged ligament of the knee, accounting for up to half of all knee ligament injuries. But among women ACL injury rates are four to eight times higher than for men. In the US alone, 38,000 women a year injure an ACL.
Moreover, it seems that women are not damaging their ACLs through contact injuries, the kinds you would expect when you take part in sport, and especially team sports. Instead, the leading causes are non-contact mechanisms such as landing badly, heavy impacts and rapid decelerations.
The report on the findings of a recent US study which set about developing and testing out a 'prehab' (preventive) training programme to help reduce non-contact ACL injuries. Twenty-eight women were randomly assigned into control and treatment groups. The treatment group took part in two 'prehab' training sessions a week for nine weeks, while the control group did nothing.
From this research, the sports scientists developed a special 9-week programme on exercise
Joint Replacement: how injured athletes of any age can get a new lease of life
In the past 20 years there has been an explosion in the number of total joint replacements performed throughout the world.
Hips and knees are the most commonly replaced joints, but shoulders, elbows and ankles can all be done, too.
With increasing confidence, hip and knee replacements are being given to an ever younger population, who are much more likely to outlast the expected life of their replacement joint and who also place demands on the implants that the original designers would not have considered.
So what's the best advice for pursuing a healthy lifestyle if you are facing or have gone through a total joint replacement? Are you going to be better off stopping all exercise, or is it a case of being able to do some kinds of activity but not others?
Patellofemoral Pain: two radical strategies for alleviating this common problem
Patellofemoral pain, which used to be more commonly called 'anterior knee pain', is often associated with the atrophy of the vastusmedialis obliquus (VMO) muscle: part of the quadriceps group located on the inner side of the lower thigh, just above the kneecap.
Numerous studies have shown the importance of developing appropriate levels of VMO strength as part of the successful treatment of knee disorders.