The human body makes thousands of movements a day. Think about the first few minutes after you wake up each day: you engage your legs and back to get out of bed, you bend your knees to put on pants and bend your back as you tie your shoes.
We probably never think about these mundane movements – that is, until something goes wrong. Thankfully, there are medical specialists who are here to help when those situations arise: orthopedic surgeons and sports medicine physicians.
The field of orthopedic medicine involves the many facets of the human musculoskeletal system. That includes bones, ligaments, joints, tendons, muscles and nerves – the body parts that enable mobility and give us the ability to perform a physical task: from the simple, such as walking down the aisle at the grocery store; to the complex, such as playing basketball or dancing in a ballet.
Privia Medical Group North Texas (PMGNTX) includes numerous physicians who specialize in a variety of orthopedic conditions.
“Many of the injuries we see are preventable,” says Dr. Steven Meyers, a sports medicine doctor in Fort Worth. “Whether it’s an athlete injured on the field or someone who is hurt on the job or at home, we can reduce the risk of orthopedic injury through conditioning, training and taking simple precautions.”
Knee Injuries
The knee is the largest – and strongest – joint in the body. It is also one of the most injured. Sometimes these injuries can be resolved by rest and restricted movement; others require surgery.
Kneecap Injuries
The patella, more commonly known as the kneecap, is the knee bone most likely to fracture. A patella fracture can make it impossible to bend or move the knee. It requires a cast to immobilize the knee until the fracture is healed and in the event of a more complex fracture, surgery may be required.
A broken kneecap may result when someone falls from a roof or off a ladder. A motor vehicle collision can also result in a fractured kneecap.
ACL Injuries
A sprain of the Anterior Cruciate Ligament (ACL) is one of the more common knee injuries and can occur when a person stops or changes direction suddenly, slows down when running or lands the wrong way after a jump. That’s why we often hear about ACL injuries in sports such as football, basketball and soccer. They can be serious injuries, which is why they may cause an athlete to miss the rest of the season.
The ACL is found on the inside of the knee and together with the Posterior Cruciate Ligament, controls the back-and-forth motion of the knee. An ACL injury is a sprain, of which there are three categories:
- Grade 1: the ligament is stretched but not torn
- Grade 2: the ligament is partially torn
- Grade 3: the ligament is completely torn in two.
ACL sprains can only be completely healed through surgery, although if the sprain is not too severe and the person is elderly and not very active, a non-surgical solution of restricting activity combined with physical therapy may be an option.
In most cases, a torn ACL cannot simply be stitched back together. The surgeon must replace the damaged ligament with a graft – usually part of a tendon from another part of the body – that serves as the infrastructure for the ligament to regrow on. Because the ligament must be given time to completely regrow, recovery from ACL surgery generally takes six months.
MCL & Meniscus Injuries
The knee also has ligaments that run on the outside of the knee joint, known as collateral ligaments. These ligaments control the sideways motion of the knee and help to brace it. The Medial Collateral Ligament (MCL) can be torn when the knee is pushed sideways. Unlike the ACL, an MCL sprain rarely requires surgery and can be healed through a brace that restricts movement, as well as physical therapy.
Meniscus tears are another common knee injury. The meniscus refers to the cartilage in the knee between the thighbone (femur) and shin bone (tibia). Meniscus tears are a common sports injury and can sometimes occur at the same time as an ACL injury.
Absent an ACL injury, a meniscus tear is characterized by pain, stiffness and swelling that develops over a period of a few days. Depending upon the severity and location of the tear, sometimes a meniscus injury does not require surgery and can be treated through a combination of rest, ice packs, compression bandages and elevation of the leg.
Osteoarthritis of the Knee
Osteoarthritis occurs when the cartilage – the hard and slippery tissue within the joints – wears down. Cartilage helps our bones to glide over one another when we bend our joints. If the cartilage deteriorates completely, the result is bone rubbing against bone. This causes pain, swelling and stiffness. Bone spurs may also result, and if a piece of bone or cartilage breaks off and floats in the joint, additional pain and discomfort may result.
Cartilage in the knee acts as a shock absorber when we walk, run or jump. If the knee cartilage is worn down, there’s nothing to absorb the impact and we experience pain and stiffness with movement.
Osteoarthritis of the knee is more common after age 50. “While osteoarthritis is a byproduct of normal wear and tear as we age, it can also be exacerbated by carrying excess weight,” explains Dr. David Brigati, an orthopedic surgeon with offices in Fort Worth and Weatherford. “In fact, studies have shown that for every 10 lbs. of weight gain, your chance of developing osteoarthritis increases 36%. Maintaining a healthy weight through a balanced diet and regular exercise helps your knees and other joints stay strong and healthy.”
There is not a cure for osteoarthritis, but there are effective treatments available. Over-the-counter anti-inflammatory and pain relief medications, such as ibuprofen and NSAIDs are common treatments. Cortisone injections may be used to treat more serious cases, and stem-cell injection therapy is also an effective treatment.
For patients with severe damage to the knee, replacement surgery may be an option. Knee replacements are very common, with more than 600,000 procedures performed each year. In this procedure, the damaged cartilage, along with a small amount of bone, is removed. Metal implants are inserted to replace the parts of the joint that have been removed. The patella may then be resurfaced. Finally, a plastic pacer is inserted in between the metal parts, creating a gliding surface where the cartilage once was.
Strained Thigh Muscles
Strained or pulled muscles, especially in the legs, are common sports injuries. The thigh includes three sets of muscles that can be susceptible to strain: the hamstring, quadriceps and abductor.
Hamstring muscles are in the back of the thigh. A pulled hamstring may happen when playing any number of sports, in addition to running and dancing.
The quadriceps muscles are located in the front of the thigh. Like the hamstring, these muscles cross both the hip and knee joints. Given the range of movement in both joints that directly affect these muscles, they are at greater risk of strain.
A strained abductor, or groin —the muscle on the inside of the thigh – is another common injury. A strained groin is often associated with baseball, football, soccer and hockey, as it can result from pushing off in a sideways motion.
When any of these muscles are strained, the injury is often characterized by a sudden pain in the thigh, followed by swelling and weakness in the muscle. Bruising may also result.
Thigh muscle strains are categorized depending on how serious they are. A grade 1 strain heals quickly, while a grade 3 strain means the muscle is torn and may take several months to heal completely.
Generally, injuries to the hamstring, quadriceps and groin can be treated through rest, ice packs and use of crutches to keep weight off the injured leg.
Ankle Sprains
Ankle sprains are one of the most common injuries affecting athletes and non-athletes alike. According to the American Academy of Orthopedic Surgeons, 25,000 people a day suffer an ankle sprain!
A sprain occurs when the ligaments in the ankle are stretched beyond their capability. As with the ligaments in the knee, some sprains are so severe they result in the ligament tearing.
Ankle sprains take place when the foot rolls or twists in an abnormal way. To prevent ankle sprains, wear shoes that provide good support, pay attention when taking the stairs or stepping off a curb and always warm up before exercise.
Achilles Tendinitis
Another common ankle condition is Achilles tendinitis. The Achilles tendon is the largest tendon in the body, extending from the calf muscles to the heel bone. Our Achilles tendon is put to work every time we walk, run or jump.
Tendonitis is the inflammation of a tendon, often due to overuse. The condition results in pain and swelling in the tendon. Usually, Achilles tendonitis is the result of repeated overuse and repetitive stress on the tendon. Pushing your body too hard and too fast can lead to Achilles tendonitis. Tight calf muscles can add stress to the tendon. Development of a bone spur can also aggravate the tendon.
Rest, ice and anti-inflammatory medications are usually the first treatments for Achilles tendonitis.
Protect Yourself from Injury
Many common orthopedic injuries can be prevented by taking proper precautions. Here are some of key injury-prevention strategies that doctors recommend:
Around the house:
- If you’re trying to lift something heavy or awkward, get help! Wait until you have a helper before trying to move it.
- Bend your knees when picking up something heavy, lift with your legs, not your back.
- If you must use a ladder, be very careful. Do not extend your body away from the ladder, or you could lose your balance. Do not stand on the top two steps of the ladder.
- Watch your step: many sprains, strains and fractures are a result of tripping over a rug, a pet, a curb or other obstacle. Do not text or look at your phone while walking. Watch where you are going and eliminate fall hazards.
On the field & at the gym:
- Take it slow. If you are just starting an exercise program or taking up a new sport, ease into it. Trying to do too much, too fast, is one of the top reasons people get hurt. You want to build your fitness level over time, gradually increasing the duration, intensity and frequency of your exercise.
- Warm up. Warm up your muscles by stretching and doing some moderate exercise, like a brisk walk or light jog. Not warming up sufficiently is a major cause of muscle strains. If a muscle is tight, it’s much more susceptible to being pulled and strained.
- Use the proper technique. If you are undertaking a strength-training program, make sure you know the proper way to lift a weight or perform an exercise. Improper form can lead to injury.
- Wear the right shoes. Wearing proper footwear that provides support and stability is an important part of improving performance and preventing injury. If you run, consider replacing your shoes after every 300-500 miles of use.
- Cross-train. Mix up your exercise routine so that your body uses different muscle groups at different times. This helps strengthen your body overall and lessens the odds of overuse of certain muscles.
“It’s easy to take for granted the movements we make every single day – that is, until something goes wrong,” says Dr. Brigati. “Take some basic precautions to keep your knees, ankles and leg muscles working the way they should. You’ll be glad you did.”
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