Several months ago I was in the gym doing some back squats and felt a twinge in my right knee. I figured it was my form (which is horrible). I racked the bar, readjusted, and plowed through the rest of my work out like a manly man (always a bad idea).
The next day my knee was swollen and painful to walk on. I gave it a couple days and it got a little better but I still wanted to get checked out. I asked around and found a reputable local orthopedic doctor. He performed a brief clinical exam then stated I probably have a meniscal tear. He gave me a script for an MRI and said we would discuss options from there.
Since I'm an MRI technologist getting an appointment was pretty easy. The test took about 30 minutes and, long story short, it revealed I do, in fact, have a medial meniscal tear.
When I went back to the orthopedic he said I have a couple options: physical therapy, a steroid injection, surgery, or do nothing and wait and see. Being that I am a typical busy working class individual and have no time to take off, I chose the do nothing approach. Luckily, in my situation, it worked out. After a couple weeks my knee was close to 100% and I was back at the gym.
Unfortunately, for many patients, knee injuries require more than a "wait and see approach". This is especially true to individuals whose career depends on their physical abilities. Athletes and manual labor jobs are the best examples. A knee injury for these patients can be a game changer.
Take the example of Robert Griffin III; pro football player for the Washington Redskins on the fast track to the hall of fame.
Unfortunately he sustained an ACL tear (Anterior Cruciate Ligament) during a game that some think was poorly diagnosed and managed. Even in the best of circumstances the knee will never be the same. In his case it ended his career as he knew it.
Figure 1A is an MRI example of a normal intact ACL. 1B shows a full ACL tear. Ligaments attach bone to bone so when one is injured it creates substantial pain and instability. A partial ACL tear or stretched ACL may heal with time, physical therapy, and little TLC. For full tears surgical intervention is usually the only path to full recovery.
Meniscal tears are, by far, the most common knee injury we see in medicine. Multiple studies have confirmed that an estimated 60% of adults over 50 have a meniscal tear. Many are unaware and have no symptoms or pain.
Unlike ACL tears, which almost always require surgery, patients can usually find relief in multiple treatment options for meniscal tears including physical therapy, steroid injections, braces, and simply light duty for a while. Unfortunately in some cases, especially with moderate to severe tears, surgery is the only realistic option to relieve pain. With this being said, surgical intervention consistently produces excellent results. After a couple weeks of recovery most patients are pain free . Figure 1A is an MRI study that depicts a normal meniscus. The horizontal white line in Figure 1B is a meniscal tear.
Although meniscal and ACL tears are the most common knee injuries there are others that can cause some grief including medial collateral and lateral collateral ligament injuries, cartilage injuries, posterior cruciate ligament tears, and various tendon injuries.
The best thing we can do to take care of knee injuries is to prevent them from happening in the first place! For example, I could have used proper form for my squats and probably avoided the injury I experienced.
Stretching before strenuous physical activity is always a good idea! Tendon injuries are much more frequent when the muscles are tight.
Although you may look fabulous in those heels... ditch them! Footwear with proper support and cushion is a must to prevent chronic knee injuries. Although you won't experience an acute knee injury from poor footwear, you will be at a significantly higher risk of developing a chronic meniscal tear that will only get worse with time.
It's tough to totally prevent knee injuries during sports but one can take some precautionary measures such as wearing knee braces and not pushing our bodies past what we know is reasonable (this especially applies to us who are getting older but still feel 18!).