Home Treatments – Knee Sprains

A knee sprain is a painful but relatively mild leg injury that can be treated at home. However, if the pain is moderate to severe, seek medication advice as there could be more serious problems than just a sprain. Otherwise, for minor sprains, these are the ways you can manage the pain and accelerate recovery.

R.I.C.E

For most leg and ankle injuries, the first step you should do is to apply the R.I.C.E method – Rest, Ice, Compression, Elevation.

Rest: Stop all activities that would put stress on the knee and try to find a place to rest as soon as possible.

Ice: Use an ice pack or a pack of frozen vegetables to ice the wound for 10 to 20 minutes to reduce pain and swelling. Do not apply heat pack or take hot showers within the first 48 hours after injury as the heat might increase swelling.

Compression: Wrap the injury tightly with a bandage but ensure that it is not too tight that it cuts off circulation.

Elevation: Use a pillow to prop up the injured leg through the whole treatment. After these steps are completed, let the wound rest for 20 to 30 minutes and repeat the process for at least 3 times.

Massage

A light massage on the wounded area would promote blood circulation and ease the pain. However, do not rub with too much force as this would aggravate the injury. Stop the massage if there is too much pain.

Stretching

Doing light stretching exercises helps to regain flexibility and prevent the muscles from stiffening up. Stretch the hamstrings by lying down with one leg on a wall or a stable support. Make sure your knee is straight and hold it there for a minute. There should be a slight tension running down the back of your leg.

Another exercise is the knee-to-chest stretch. Lying down and keeping knees bent while the feet are flat, bring one knee towards the chest with your hands and hold for half a minute before switching to another knee.

Do not carry out any of these exercises if they cause too much pain. Limit to just a light stretch.

Things to avoid

During the course of injury, keep off alcohol as it would increase swelling. Also, avoid smoking as it decreases blood supply and slows tissue repair. Try to avoid activities that would aggravate the injury until the pain and swelling have completely subsided.

How to Prevent Common Swimming Injuries

Swimming injuries usually involve the shoulders, knees, hips and back. The area of injury depends on the swim stroke that the swimmer practices most often. It is important to perform the strokes correctly and get adequate rest to prevent injuries.

Causes

Most swimming injuries are caused by overuse and improper stroke techniques. Pro swimmers who go through vigorous training periods for competitions are at higher risk of injury because of the excessive repetitive motions and inadequate rest for the muscles to heal. Fatigue would also cause swimmers to perform poor stroke techniques, causing constant micro-trauma and leading to injuries.


Types and Symptoms of Common Swimming Injuries

Swimmer’s Shoulder

One of the most common types of swimming injuries is the Swimmer’s Shoulder. Due to the perpetual stress on the upper body to propel forward during swimming, the rotator cuff of the shoulder blade is often overworked. The joint and muscles are weakened over time and activity, resulting in shoulder instability, inflammation, tears, ligament and cartilage damage.

Patients with Swimmer’s Shoulder may experience:

  • Pain along the back of the shoulder and sometime salong the front of the shoulder as well
  • Inflammation in the tendons and muscles
  • Pain worsens with activity


Breaststroker’s Knee

Breaststroker’s Knee makes 25% of all swimming injuries and is caused by the motion of kicking to generate speed through the water. If the movement is not done correctly, tension would build up inside the knee and injuring the tendons, ligaments and muscles.

Patients with Breaststroker’s Knee may experience:

  • Pain and swelling of the knee
  • Inflammation in the ligament, tendons and muscles
  • Pain worsens with activity
  • Knock-knees or bow-leggedness

 

Prevention

At every swim session, ensure that proper warm up and cool down are done. When swimming, make sure that proper techniques are used. The arms should be raised high enough to complete each full stroke without the “lazy elbow” syndrome. Legs should be kicking correctly without subjecting the knees to external rotations. It is advisable to seek guidance from a coach to improve on swim techniques.

Swimmers should get adequate rest to avoid straining themselves and allow the muscles to recover. If symptoms of an injury have surfaced, stop all activities and ice the affected area to decrease inflammation. Seek a doctor’s advice if the symptoms do not subside even after plenty of rest.

Osgood-Schlatter Disease: Symptoms & Treatment

Osgood-Schlatter disease (OSD) is a medical condition resulting from the inflammation of bones, cartilage or tendons in the tibia. The result of this are growth spurts that specifically affects the knee. It is much more common in growing teenagers between the ages of 10 to 15. It also affects people who are more active in sports involving frequent jumping and running.

OSD will affect growing teenagers at the beginning of their growth spurts. Growth spurts provide the most ideal condition for OSD as different components of the body is growing but at a different rate. For example, the bone grows much faster than soft tissues such as tendons and cartilage and this will create a lot of stress on the growth plate, causing a bony lump. This lump is caused by traction tendinitis and is due to the hardening of the bone at the top of the tibia.

What are the symptoms?

OSD is a medical condition that can be felt due to the tension on the patella tendon by the surrounding muscles. This will result in painful inflammation of the tibia, affecting the patellar tendon all the way to the shinbone. The result is extreme pain, swelling and tenderness which is visible with an x-ray diagnosis. There are other possible symptoms and these include:

  • Pain that gets worse after periods of activeness
  • Pain goes away after periods of rest
  • Swelling under the knee and shinbone
  • Tightness of hamstring and quadriceps muscles

 

How can OSD be treated?

OSD will usually go away on its own after the growth spurt periods and this is usually by the age of 18. If symptoms persist after that, treatment is then required:

  • Icing the affected area for three times a day or as required, especially after sports
  • Over-the-counter (OTC) pain relievers such as ibuprofen to reduce swelling and pain
  • Reduction of high impact activities
  • Using a knee immobiliser such as a knee brace
  • Stretching before and after any activity
  • Physiotherapy to strengthen the surrounding muscles

 

Shock absorbent insoles are recommended if the patient is going back to high impact activities or prolonged periods of walking. However, patients are recommended to stop participating in sports to facilitate healing. Non-impact sports such as swimming are still allowed though.

There are no known long-term complications of OSD and only in rare cases are there patients with persistent swelling. In some patients, there are also persistent lumps appearing on the shinbone but this is extremely rare.

Experienced Orthopaedic Specialists Onboard Our Clinic

We like to thank all our patients for the support so far and to better serve you, we now have 2 experienced orthopaedic specialists onboard.

Dr. Ambrose Yung who is a specialist orthopaedic consultant with experience in partial knee replacement, complex primary total knee replacement, revision knee replacement, minimal invasive knee and shoulder sports surgery.

Dr. Fong Shee Yan who is an experienced Spine-specialised Orthopaedic Consultant in Singapore practising Minimally Invasive Spine Surgery.

Join us in welcoming Dr. Ambrose & Dr. Fong and feel free to contact us if you’d like to understand more about our Clinic

 

Knee Cartilage Injuries: Cause & Symptoms

Located in our knee are cartilage tissues that act as shock absorbers. These shock absorbers are tough but yet flexible tissues that are located throughout our body, covering all the surfaces of our joint in order to facilitate the smooth gliding motion of our bones. It is because of these cartilage tissues that we are able to jump and run without experiencing pain. One downside of it is that the tissues do not have their own blood supply. This means that once they are injured or damaged, the healing process is extremely slow. Someone who has a damaged cartilage tissue will then experience pain during periods of motion. One of the most common places of injury is the knee and we will look into the causes and symptoms in this article.

Causes:

Knee cartilage injuries are usually articular cartilage damages. The articular cartilage is a soft and springy type of cartilage located between the joints and is a common yet serious form of damage. The result is swelling, pain and loss of mobility in the knee. Injuries can occur mainly from three main forms – osteoarthritis, osteochondritis dissecans and a sudden trauma. Osteoarthritis is a form of long-term damage and is especially targeted towards patients who have had their knee meniscus removed or are overweight. Osteochondritis dissecans occur when a part of the cartilage and a piece of attached bone breaks away from the joint. Lastly, trauma occurs during high impact activities such as sports. Sports players are at a higher risk due to the high levels of risk they face.

Symptoms:

The symptoms for a damaged knee cartilage are pretty similar to most forms of knee injuries. The first and foremost symptom is the onset of pain. This pain is increased when an attempt to straighten the knee is made, resulting in the inability to walk properly and bear full body weight on the knee itself. Swelling will also happen due to the increase in blood flow to the knee in order to combat infection. There may also be a creaking or cracking sound when you are moving the knee joint.

Cartilage damage is common among people and most people with mild damages do not seek medical help. The number of patients with this form of injury is most prevalent in patients under the age of 35 as that age group leads the most active lifestyle, with men at a much higher risk than women.

Ligament Tear: Symptoms & Treatments

Our knee is supported by 4 main ligaments – anterior ruciate ligament (ACL), medial collateral ligament (MCL), lateral collateral ligament (LCL) and the posterior cruciate ligament (PCL). Each of the ligament plays a different role in ensuring the stability of the knee. However, due to various reasons, the ligaments can be torn. Rupture of the ligament can be a partial one or a full one and this will affect the treatment administered. A ligament tear will also bring about instability in the knee and the inability for it to bear weight, causing problems when walking. In this article, we will look at some of the symptoms and treatments for ligament tears.

The role of each ligament differs:

  • The role of the ACL is to stabilise the knee joint by restriciting forward back backwards movement of the knee. It is designed to prevent the tibia bone from moving in front of the femur.
  • The role of the MCL is to protect the knee against any sudden and/or unwanted forces that is directed at the side of the knee. It restricts the sideway movement of the knee.
  • The LCL works in conjunction with the MCL to restrict sideway movement and it protects against sudden forces that is directed at the inside of the knee.
  • Lastly, the PCL works together with the ACL to control forward and backward movements of the knee.

An injured ligament will bring about symtoms that are similar to each other:

  • As a general rule of thumb, a partially torn ligament will not bring about a pop sound while a fully ruptured one will produce a pop sound. A fully torn one will also create instant instability and the knee will give way.
  • Swelling will occur and the injured knee may start to turn purple due to the lack of proper blood flow to the area. Swelling occurs due to a build up of blood from the injured ligament.
  • The knee will be unable to function properly and you may feel that you are unable to control it.
  • Tenderness will onset when you touch the knee.

The first step in treatment is to pay the PRICE:

  • Protect the knee from further movements
  • Resting the knee immediately following injury for at least 48 hours. If you need to move around, consider using crutches or walkers to prevent bearing weight on the injured knee.
  • Ice will bring down swelling and reduce inflammation. Always try to ice the area every hour by using a cold compress or simply by wrapping knee in a towel and applying it locally.
  • Compress the knee with a bandage to reduce swelling and prevent excessive movements.
  • Elevate the knee to above your heart level to reduce swelling. This will cause excessive blood to flow away due to gravity towards your heart.

Symptoms And Treatments For Osteoarthritis Of The Knee

Knee osteoarthritis is one of the most common forms of musculoskeletal pain and disorder. Our knee is one of the most used joint in the whole body. Every single action of us will require the use of it. Like all well used joint, the knee requires constant lubrication of the joint. Have you ever experienced an old hinge that creaks when you use it? The remedy action taken by you would be to lubricate it with oil. The same theory applies to the knee as well. However, it is lubricated automatically with a fluid known as the synovial fluid. This is aided by the fact that the femur and tibia are covered with a smooth surface and a shock absorber known as the menisci. When these natural protective features are gone due to wear and tear or injuries, the knee will start to experience problems and one of it is osteoarthritis.

Symptoms

The most common symptom of osteoarthritis is the experiencing of pain in the knee during periods of activity and inactivity. This is aggravated after long periods of rest such as upon waking up where the pain will be the most severe. Swelling might also is present in some patients. During simple activities such as walking, there may be a decrease in the mobility of the knee causing actions such as climbing over a low wall difficult to accomplish. In serious cases, creaking sounds may be heard from the knee.

Treatment

There are several treatment options for osteoarthritis classified mainly into surgical and nonsurgical means. Different patients will be assigned different forms due to factors such as the cost, age and health condition.

Nonsurgical treatment

The most effective way of nonsurgical treatment is weight loss and exercise. One of the contributing factors is excessive weight on the knee and this is amplified when you jump. By losing weight, you are lessening the load on the knees. Exercising the knee and strengthening it will increase the load bearing capabilities of the knee. Doctors will also prescribe medication to reduce inflammation and ease the pain. In serious cases, corticosteroids and hyaluronic acid may be injected directly into the knee to reduce inflammation and provide lubrication to the joint.

Surgical treatment

Chondroplasty is a technique that smoothens the articulate cartilage. A smooth surface will help to reduce friction and reduce pain and swelling.  This is often done in conjunction with hyaluronic acid injection, which provides lubrication to the joint.

How Can I Manage Pain After My Total Knee Replacement Surgery?

Pain is an unavoidable side effect of any surgery, not just a knee replacement surgery. While patients are anxious to undergo surgery in order to regain back a wholesome quality life, they are often unaware and uneducated about how to manage pain post surgery. The pain is definitely here to stay for awhile and knowing how to manage pain will help you set reasonable recovery goals. In this article, we will talking about how you can manage pain better after your total knee replacement surgery.

Rest

Our body repairs itself only when we are at rest. Surgery is an extremely taxing procedure for our body. Imagine all those stresses and trauma to not just the surgical site but also to the surrounding soft tissues. Therefore, plenty of rest post surgery is extremely important for the body. As a rule of thumb, expect to be immobile for a week post knee surgery. The mass of the surrounding muscles will start to decrease in a medical phenomenon known as muscular atrophy while the knee will be unable to bear your body’s weight. Therefore, do nothing but rest during the first week.

Icing

It is also during this period where pain will be at its max. Therefore, icing is crucial in helping to manage pain. Ice helps to decrease swelling and relief inflammation of the knee. It constricts the blood vessels and reduces blood flow to the area. Icing is convenient and can be done almost everywhere. When you are icing your knee, remember to elevate your knee to above your heart.

Compression

Compression stockings are important as they help to create pressure and increase blood flow in order to prevent blood clots from forming. Compression stockings will also help to relief achiness in the leg.

Medicine

As much as you think you are Hercules, you still need pain relief medication to tide you through the initial tough period. Pain relief medications help to bring down the swelling and provide you relief during periods when you are sleeping. You do not want to lose your sleep constantly due to the pain, do you? However, do not depend too much on the medicine. When the pain gets more bearable, ditch the medication and increase your icing times.

Managing pain post total knee replacement surgery is not difficult if you follow the simple steps listed above. Be mindful not to rush through your recovery process and it may lead to long term complications.

Knee Dislocation Surgery

Dislocation of the knee or more specifically the patella is a common knee injury that is typically caused by a sudden trauma in the form of a twist or direct hit on the knee, causing the patella to pop out of its usual position in the femoral groove towards the end of the femur. Knee dislocation will be accompanied by a sudden acute pain followed by periods of immobility leading to disability. In order to treat it, open or arthroscopy surgery will be required to repair the damages.

Almost immediately following injury, the extent of injury will be unable to be determined accurately due to the swelling and pain present. Therefore, surgery will not be recommended until a few weeks later. In the mean time, physical therapy will need to be performed in order to strength the thigh and quad muscles to provide a better support and prevent muscle wastage. Once the injured knee is strengthened and swelling has subsided, knee dislocation surgery can then be carried out and there are many types out there:

Bone realignment

In mild cases where the extent of injury is not severe and there is not much damage to the ligaments and tissues, bone realignment may be all that is needed. The tibial tubercle which is at the shin bone will simple have to be shifted and this will cause the position to be pulled towards the inner part of the knee.

Lateral Release

Lateral release is a common type of knee surgery performed to stabilise the patellar. When the knee is dislocated, it pulls the knee cap to the outside of the knee. Lateral release surgery seeks to cut the retinaculum in order to centre the knee cap back into the grooves.

Reefing

Reefing or medical imbrications is a surgical procedure performed with the intention to tighten the soft tissues that are located towards the inner portion of the knee. It is often done in conjunction with Lateral Release with the latter loosening the exterior part while the former tightening the interior part.

Trocheleoplasty

Trocheleoplasty is a less common surgery which works by deepening the grooves on the femur for the patellar. This will require the removal of some bone and increasing the depth of the grooves in which the patellar can then be held firmly in place with the aid of biodegradable stitches which will be reabsorbed into the body after a period of time.

Patellar dislocations can still happen after surgery but this is less than 5% of all cases. Patients are usually able to return to pre-injury level of activities after a couple of months if a disciplined recovery plan is followed religiously.