FAQ Category: Child

Many young sports athletes are tripped up by their own skeletal system. Traumatic and overuse injuries affecting the physes (growth plates) can result in various injuries. The main reason is an immature skeletal system. The growth plates provide sites of injury that don’t occur in older, fully mature teens and adults.

These growth plates leave space open for the bone to continue growing until the child reaches his or her full height. Until then, shear forces, traction, and the repeated stress of sports activities can cause damage to these areas of growth.

Sometimes the bones get compressed and start to shorten. This happens in the forearms of gymnasts who put weight through their hands and wrists. In other cases, the growth plate actually widens under stress. This can have the opposite effect of making one limb longer than the other.

It’s also possible to put so much force on the tendon as it inserts into the bone, that it ruptures. If it pulls away a piece of bone with it, the injury is called an avulsion fracture.

No one knows exactly why one athlete gets injured when another one doesn’t. With any of these overuse injuries, sports participation with repetitive motions during a growth spurt seem to be the major risk factors. Anatomic variations from the norm may add to the risk. The actions required by certain sports seem to be a part of the equation as well. Knowing that the growing athlete has an increased risk for these types of injuries should alert all who work with them to pay attention to any reports of joint or bone tenderness or pain.

Warm up exercises, stretching, and strengthening may be helpful. When prevention isn’t possible, early diagnosis and immediate treatment are recommended. Early referral to a sports physician or orthopedic surgeon is always advised. The diagnosis isn’t always so easy. There are many sports injuries that can present with the same (or similar) kinds of pain patterns.

A history, physical exam, and clinical tests along with X-rays or other more advanced imaging give the physician clues as to the real problem. The sooner an accurate diagnosis is made and treatment is started, the faster the athlete can recover. Delays in diagnosis extend out the treatment time and can result in further injury and/or deformity.

Sever’s disease, also known as apophysitis of the os calcis is a condition seen most often in gymnasts. Let’s breakdown the terms first. Apophysitis refers to a tuberosity (bony bump) that is stressed when an attaching tendon pulls on it repetitively.

In this case, that bony bump is on the os calcis or heelbone. The offending tendon is usually the Achilles tendon that attaches the calf muscle to the foot. The insertion point is an area of near the place where the bone grows and eventually ossifies or hardens.

Young athletes whose bones have not yet completed growing can develop problems during growth spurts. Gymnasts with Sever’s disease develop heel pain, ankle pain, and sometimes midfoot pain or discomfort.

Conservative (nonoperative) care consists of stretching the calf muscle (called the gastrocnemius), strengthening of the muscles that oppose the gastrocnemius, and orthotics or shoe modifications. Sometimes special cups that fit inside the heel of the shoe are used. Some patients respond well to a heel lift or heel wedge.

The athlete may be told to stop all running activities. With the right program of stretching and strengthening, the condition will slowly get better over a period of one to four weeks. For young athletes who probably won’t cooperate, a short-leg cast may be used to hold the foot and ankle in a static posture until healing takes place.

Clubfoot is a congenital (present at birth) deformity that causes the feet to point down and turn inwards. Left untreated, this condition prevents normal foot and ankle motion needed for walking and running. The Ponseti method developed by Dr. I. Ponseti 50 years ago has become the standard of care for clubfoot deformity. It is used around the world.

The method involves gentle manipulations of the feet and casting. Manipulation and casting refers to moving the bones through the full available motion and then putting a cast on the foot, ankle, and lower leg to hold them in place. Once the soft tissues and bones get used to that position, the cast is removed and the foot and ankle are manipulated (moved) a little further, again putting a cast on to maintain the new position. This process is repeated each week until the deformity is overcome.

After casting and/or tenotomy, the next step is to place the child in a Denis-Browne splint.
This orthotic has a pair of open-toed shoes attached to a bar. The shoes are placed at an angle to hold the correction. The shoe on the corrected side is placed at 70-degrees of external rotation. If the child had bilateral clubfeet (both sides involved), then both shoes were set at this angle. If only one foot was affected, the uninvolved shoe was placed at a 45-degree angle.

Parent/family education is a key element of the Ponseti method. Once the child is in a removable brace of this type, compliance is very important. For best results, the child must wear the Denis-Browne brace everyday (full-time, day and night) for three months.

After that, it can be removed during the day and just put on during naps and nighttime. But this schedule must be kept up until the child is four years old. The family must also bring the child to the clinic on a regular basis for follow-up. This is especially important as the bones of the foot (and the child) grow larger. The examiner can make any adjustments needed or resize the brace as the child grows and changes.

Sometimes children just can’t tolerate wearing the foot brace at night. It’s not really a matter of parental compliance. Early communication with the surgeon is advised in order to head off any problems early and make the treatment more tolerable for the child. Sometimes modifications can be made to the brace to improve the child’s comfort.

If it is a matter of behavior and the temper tantrums of a two-year old, it may be possible to let her go to bed and put the brace on after she falls asleep. She won’t have the brace on as long as the protocol suggests, but it’s certainly better than not at all.

There is a risk of recurrence without proper follow-through. In that case, casting is used again and the process is repeated. Either way, it comes back down to getting the child to wear the splint in order to assure good results in the long-run.

Clubfoot is a congenital condition that affects newborn infants. The medical term for clubfoot is Congenital Talipes Equinovarus. This condition has been described in medical literature since the ancient Egyptians.

Congenital means that the condition is present at birth and occurred during fetal development. The condition is not rare and the incidence varies widely among different races. The condition affects both feet in about half of the infants born with clubfoot. Clubfoot affects twice as many males as females.

The physician has a very good idea of what normal anatomy and full range-of-motion should be for infants and young children. He or she will rely on this understanding of normal to treat the clubfoot. The goal is to restore forefoot, hindfoot, and ankle motion needed to stand and walk.

One thing they look for is whether the forefoot can be moved away from the midline at least 70 degrees. The hindfoot must also be corrected making it possible to move the calcaneus (heel bone) inward, a motion needed for normal walking.

Standard treatment is with a treatment approach called the Ponseti method. The foot is manipulated (moved) to stretch and loosen the tight structures. The foot is then placed in a cast to hold it in a corrected position. This is repeated every one or two weeks until the deformity is corrected.

If the hindfoot does not correct fully, the surgeon can perform a percutaneous tenotomy. This is a release of the Achilles tendon through the skin without doing open surgery. After casting and/or tenotomy. The next step is to place the child in a Denis-Browne splint.

But it sounds like you are just at the beginning of treatment and may not need these next steps in treating clubfoot. Next time you are in the doctor’s office, ask him or her to show you what they are looking for in terms of normal and what it will look like when your child will have the necessary motion.

As mentioned, further treatment might be needed. Don’t miss any of your follow-up appointments. Children can grow and change rapidly. You’ll want to stay on top of any changes that might compromise your child’s results. If at any point you feel that the motion you are getting is less than it was, it’s time to check in with your physician.

Back pain (in adults) is so common, eight out of 10 people will experience it at least once (and often more than once) in their lifetime. Most of the time, no one even knows what’s causing it — the condition is said to be idiopathic. It’s nothing serious and treatment isn’t even needed. The patient is told to stay as active as possible. Recovery occurs in seven to 10 days. But back pain in children is something else altogether.

Idiopathic back pain in children and especially in young athletes is much less common. There is usually a very specific reason for the pain. It could be an infection, tumor, or inflammatory condition. More often, it’s an injury from a traumatic event or from repetitive motion causing microtrauma.

All reports of back pain in children and teenagers should be taken seriously until proven otherwise. A medical examination is usually the best way to find out what’s going on. An early, accurate diagnosis and treatment without delay is often needed to prevent a minor back injury from becoming a major problem.

If a musculoskeletal problem is ruled out, then it might be time to look for social and psychologic reasons for avoiding sports activities.

With posterior element overuse syndrome, too much spinal extension and rotation cause damage to the area where the muscles and tendons connect in the low back. The ligaments, spinal joints, and joint capsules at the level of the repetitive trauma are damaged.

The affected individual develops low back pain because the position of the low back is one of too much lordotic curve. The patient looks like there is a swayback position of the spine.

X-rays and other more advanced imaging such as CT scans, MRIs, or bone scans may be needed to identify the specific vertebral level, location (right or left side), and severity of damage. Fractures, tumors, and infections are ruled out via X-rays.

This condition is the second most common cause of back pain in adolescent athletes. The first symptom is pain when the child extends the spine and/or rotates or twists. The paraspinal muscles alongside the spine are usually tender to touch.

Treatment begins with a cold modality such as ice packs or ice massage. Nonsteroidal antiinflammatory drugs help relieve pain and reduce inflammation. The affected individual (usually a child) is told not to lean back (hyperextend the spine).

Core training to strengthen and coordinate the muscles of the trunk and abdomen is advised. The child is taught how to stand and move without hyperlordosis. Sometimes a brace called an antilordosis brace is prescribed.

The brace is used until the spine is once again pain free, has full motion, and is stable. Athletes with posterior element overuse syndrome must retrain and rehab before returning to their full sports activity. Full pain free range-of-motion and strength are required. Sport-specific training under the supervision of a physical therapist is advised.

Many experts have encouraged players to wait at least six months before returning to full sports activity after anterior cruciate ligament (ACL) surgery. But there’s some new evidence that waiting that long may not be necessary.

One surgeon reported on middle-school and high school athletes who had ACL reconstruction. Out of nearly 3,000 patients who had ACL surgery, 402 basketball and soccer players were studied with just this question in mind. Only athletes (male and female) 17 and younger were included in the study. Many played year-round on school and other travel teams.

They watched to see how long it took the athletes to return to full activity, including team competition. No one was pushed to return to sports before they were ready. And they kept track of how many patients went on to play college sports. After the first year post-op, everyone was followed on an annual (yearly) basis. Any injuries to the other (previously uninvolved) knee were reported.

The players were given goals for rehab and guidelines for progressing through the program. The first goal was to reduce swelling and get full knee motion back. Once they had full range-of-motion, then they could be advanced to a strengthening program. Because basketball and soccer require fast moves, change of direction, pivoting and twisting, agility drills were added to the rehab program. When they were ready, recovering players were progressed to team drills and functional sports drills.

Players were told to pursue the rehab program as tolerated. They were instructed to monitor their own knee range-of-motion, swelling, soreness, pain, and tenderness. Any increase in symptoms or loss of motion was a sign that they should back off from their program and take it easy for a day. In the beginning sports drills and competition were limited to every other day.

It wan’t necessary to wait six months before getting back into action? No. Many players completed the rehab program and returned to their former level of play as early as three months after surgery. And they did so without incurring future injuries. The average time for recovery was five months.

Of course, you’ll want to follow your surgeon’s and coach’s recommendations. Each patient/player is unique with his or her own individual considerations that can make a difference.

Young pitchers can stay healthy and strong by following guidelines set up by the Little League organization. They suggest keeping track of pitch count and pitch type, getting proper rest, and avoiding overparticipation. Equally important is a proper conditioning program.

During the preseason, and between seasons (off-season), a strengthening and conditioning program of exercises is essential. Such a program is the best insurance to reduce the risk of injury to the throwing arm. You will want a fitness program that includes a weight lifting program but one that is appropriate for children and teens who have not yet completed their growth. One type that experts recommend is called a functional conditioning program.

The program is designed in a pyramid form. The basic foundation (at the bottom) is the bulk of the program. This begins with physical fitness. Overall fitness provides stability, flexibility, and balanced posture. The athlete doesn’t progress to the next level until foundational fitness is demonstrated. This concept is important to prevent joint break down when moving to the next level in the pyramid, which is called joint integrity. At this level, plyometrics (e.g., plyoball training) is used to increase endurance during repetitive movements. Plyometrics refers to a type of exercise training designed to produce fast, powerful movements, and improve the functions of the nervous system.

From there the athlete is progressed to machine work to build up speed and power. Free weights are used to further reinforce speed and power. At the top of the pyramid are activities that further enhance speed or velocity.

Throughout the functional conditioning pyramid, there is an effort to train opposing muscle groups equally. The idea is to strive for muscle balance for young pitchers. The act of throwing training requires the coordination of many muscles working together with perfect timing. Problems can develop if even one muscle is fatigued or overloaded.

Yyou don’t want to start any kind of lifting program without proper supervision and guidance. Consider asking your parents to help you find the right kind of program for your age and build. Some sports centers, gyms, and fitness centers provide this kind of help for athetes of all ages.

Young athletes involved in throwing sports are often at risk for arm injuries. Baseball pitchers are especially in danger of experiencing repetitive microtrauma to the soft tissues. Over time, with enough stress, serious damage can be done to the shoulder and arm.

There are known guidelines for injury prevention. The first is: don’t overdo it. Second, players, parents, and coaches must work together to keep track of the number of pitches a pitcher throws per practice, per game, per week, and per season. The maximum number of allowed pitches varies depending on the age of the pitcher.

Throwing is different from pitching. The athlete propels the ball forward but without a windup and without the speed required in pitching. Usually, players throwing the ball are on flat ground rather than a pitcher’s mound. This difference is important because pitching on flat ground places less stress on the pitching arm.

With pitching, as soon as the pitcher moves forward off the mound, there is an increased force of gravity. Taking a maximal stride forward during the wind up adds to the rotational forces placed on the shoulder.

During ball practice, the difference means that year-round throwing is allowed. In fact, sports trainers and coaches use throwing as a form of exercise. It increases the pitcher’s endurance and ease of movement needed for the pitch. On the other hand, year-round pitching is limited to prevent wear and tear on the shoulder.

With three million young children as victims of child abuse in the United States each year, hospital personnel see their fair share of child abuse. They are trained to recognize the most obvious signs. Skull fractures happen to be one of the most common signs of child abuse. Fractures of the long bones of the body are also suspicious.

This includes the femur in the thigh, tibia or fibula of the lower leg, humerus of the upper arm, and radius or ulna of the forearm. More than even fractures, an important physical sign is a contusion. A contusion is a visible bruise or large black and blue mark. Bruises in the shape of hand or finger prints are highly suspicious.

Once the child has been examined and evaluated, medical personnel are obligated by law to report any possible cases of physical injury. It doesn’t always mean the injuries are related to child abuse. Accidents do happen in young children but the majority of injuries in children under the age of two do tend to be abuse-related.

Once the social worker or case worker from Child Protective Services interviews you, you will have a chance to let them know what happened and your concerns. Don’t be afraid to ask what their policies and procedures are in a case like this.

Like you, their interest is in protecting the child. Your concern for your child will alert them to the kind of parents you are. Don’t hesitate to have them check with your pediatrician for records to show that there’s been no record of previous suspicious injuries.

Over three million young children are victims of child abuse in the United States each year. One-third of all child abuse cases will suffer a bone fracture and need to see an orthopedic surgeon. That’s why orthopedic surgeons must be aware of the possibility of child abuse and watch for it. We applaud you in trying to help get this information into the hands of someone who can make a difference.

There was a recent nationally-based study done comparing children with accidental injuries to those with suspected or confirmed child abuse. By comparing various features of the children in both groups, the researchers were able to identify common features that suggest injuries from child-abuse.

This information may help all physicians (but especially orthopedic surgeons) know what to look for that might raise the suspicion of abuse. The strongest predictor of abuse is young age with two groups especially at risk: birth to one year and one year up to two years of age.

The second predictive factor was type or pattern of injury. Fractures affecting the bones of the head, neck, and trunk were most common. But fractures of the long bones of the arms and legs must be closely assessed, too. This includes the femur in the thigh, tibia or fibula of the lower leg, humerus of the upper arm, and radius or ulna of the forearm. The one area of fracture that proved to almost always be accidental was a pelvic fracture. More than even fractures, an important physical sign is a contusion. A contusion is a visible bruise or large black and blue mark.

The third predictive factor of abuse-related injury was the specific period of time when the injury took place. Weekdays and during the winter seemed to be a common pattern for child abuse. Weekends might be less stressful with more adult supervision available. Or possibly the attendance of church services influences behavior.

It was thought that perhaps with colder weather and being indoors more in the winter, children would be more likely to spend time with the caregivers who were the abusers. Being outside less during winter months might also lower the risk of accidental injuries making it seem like there are more cases of injuries from abuse than from accidents during the winter.

The researchers also looked at socioeconomic level to see if there was a link there. They couldn’t use family income as a marker because it wasn’t always reported. So they looked at who was paying for the medical charges. They found that more families on Medicaid than on private insurance were involved in child maltreatment. Medicaid suggests a lower family income.

It isn’t always easy to tell when an injury is accidental or the result of child abuse. But physicians examining children with physical injuries must always keep the possibility of abuse in the back of their minds. Having a few guidelines like these can be helpful when looking for any clues to help in making the diagnosis.

Our understanding of how the very complex structures of the shoulder work has improved tremendously as a result of motion studies of throwing actions. Being able to see (and analyze) movements in slow motion has expanded the understanding of normal and abnormal shoulder function during throwing activities. This information has helped shape today’s injury prevention and rehab programs.

Surgery is not always advised as it is invasive and further disrupts the already damaged soft tissues. Complications from surgery can add to the delay in recovery. Whenever possible, conservative care is advised first. If there’s been no improvement after three months, the athlete is re-evaluated. Further testing may be needed to determine what is wrong and what to do about it. Failure of nonoperative care to restore the athlete may point to the need for surgical repair or reconstruction.

Physical therapy for injuries such as a rotator cuff tear (as well as shoulder laxity and instability, impingement, or ligament tears) is broken down into four phases. The first phase takes place when the injury is new or fresh. This is called the acute phase. The therapist helps the athlete understand the importance of activity modification and giving the injured tissues a chance to heal. Various treatment methods such as neuromuscular facilitation, lymphatic drainage, and rhythmic stabilization exercises are used by the therapist to help promote healing.

Phase two begins when the pain and inflammation of the acute phase have decreased. In this phase, the therapist uses specific exercises to strengthen and re-tune the muscles. Other exercises are used when there’s too much motion or not enough motion in any part of the arc of shoulder movement. The therapist must carefully examine each throwing athlete to identify exactly which soft tissues are affected, why, and what to do about it.

When tests show that the athlete’s shoulder is stable with only a mild loss of motion and no pain, then the program can be stepped up to the third phase. Here the training becomes more intensive with endurance drills, plyometric training for speed, and an interval throwing program. Interval throwing progresses pitches through various distances, speeds, and intensities on and off the baseball mound with plenty of rest periods in between. The player is taught how to regain speed without overtraining before moving to the final phase.

Phase four continues to advance the pitcher through a series of advanced interval throwing exercises, strengthening and conditioning exercises, and a maintenance program at the pre-injury level of performance and play. If all goes well, the athlete is returned to the game. If there has been no improvement (or not enough improvement), then surgery may be advised.

Scoliosis (curvature of the spine) is managed based on the type and severity of curve. A smaller curve (mild scoliosis) can be treated conservatively without surgery. A larger curve (moderate to severe scoliosis) often requires fusion to straighten it as much as possible and keep it from getting worse.

X-rays are used to determine the degree of the main curve. An angle called the Cobb angle is measured and used as a guide to conservative versus surgical treatment. Newer studies have been done using three-dimensional systems to map out the shape of the spine. There is some thinking that not just the size of the curve but also the pattern of curvature must be considered when planning treatment.

This alternative approach zeroes in on the location and amount of rotation of the vertebral bodies. Looking at whether the curve is single, double, to the right, or to the left can be augmented by seeing if it rotates clockwise or counterclockwise. Stereoradiographic X-rays show these patterns by taking pictures from above the patient.

Up until now, the main way to view treatment was based on size of the curve (small versus large). Small curves can be treated conservatively with bracing when needed. Large curves are more likely to require surgery. Although rotation of the curve can’t be used as the only guiding factor, size shouldn’t be the only determining point either.

Treatment or management decisions for all patients with scoliosis are made on a case-by-case basis. There’s no reason not to seek a second opinion. Put together a list of questions about how they make their treatment decisions. Compare it to the first facilities policies and see how they are similar or differ. If both teams make the same recommendation, you may feel better about taking a more aggressive approach than you would otherwise be comfortable with.

Stereoradiography is a technique for producing X-rays that give a three-dimensional view of an internal body structure (in this case, the spine). The stereoradiographs are taken with the patient in the standing position.

Measurements of spinal shape including curvature and rotation can be made from all angles (side, front, top). The spinal axis system technology is advanced enough to make all of the spinal shape measurements digitally by using physical landmarks and three-dimensional coordinates.

Stereoradiographic film studies of the spine are produced by combining two separate X-ray films. Each X-ray is taken from a slightly different angle. The developed films are then viewed through a device that allows the two images to be seen as one three-dimensional (3-D) object.

Using this approach makes it possible for the surgeon to plan more carefully when surgery is needed. By visualizing every angle of the spine, curves and rotations of each vertebral body can be assessed ahead of time. There are even computer programs that allow the surgeon to try different surgical methods before applying it to the patient. This makes it possible to see which one would have the best results.

If your region has stereoradiographic capability, this may be worth the extra time and money. But talk with your surgeon about what he or she sees as the advantage before making the final decision.

Ultrasound can be used right at birth too look at the hips of infants at risk or with suspicious clinical findings. It is safe, does not expose the child to radiation, and seems to be well-tolerated (by the child who is being tested and by the parent who is watching). Such an early diagnosis makes it possible to achieve better results with less treatment.

There are many advantages to having in-office ultrasound studies. Now it’s possible for your doctor to diagnose hip problems earlier than ever before. Ultrasound makes it much easier to confirm the position of the hip. It can even be be done with the child in the harness. Using serial (weekly) ultrasound studies, it is possible to see if the hip is going to stabilize in the Pavlik harness. This is usually clear in the first week of wear.

Serial (once-a-week) in-office ultrasound imaging is recommended for all children who have a dislocating hip that can be reduced (put back in place by hand). Research shows that some children need to wear the harness longer than others. If there is some laxity (looseness) in the joint, then three months of harness wear may not be long enough. Ultrasound testing makes it possible to identify children who need extended time in the harness.

Another potential problem could be ligaments that are too loose so that even with the Pavlik harness, the result would not be good. That child may need a semirigid brace called an abduction orthosis. The use of ultrasound makes it possible to see these things quickly and make necessary changes in the treatment approach.

It’s likely that your grandson has a condition called developmental dysplasia of the hip (DDH). DDH represents a group of hip disorders involving partial or complete dislocation of the femoral head.

The femoral head is a round ball of bone at the top of the femur or thigh bone. Normally, it fits inside the acetabulum (hip socket). But with DDH, the femoral head slips partially or completely out of the socket.

Treatment for this problem begins with the Pavlik harness. This device holds the child’s hips and knees in a position of flexion. The hips are also abducted (held wide apart). While wearing the harness, the child cannot straighten the legs, which means he or she cannot extend the hip. The goal is to keep the femoral head in the socket and keep it from shifting or slipping out of the acetabulum. Studies show that it works. Without it, your grandson may end up needed invasive surgery with all the risks that can go with that.

For best results, the child must wear the Pavlik harness 23.5 hours a day for at least three weeks. It is removed only to bathe the child. At the end of three weeks, ultrasound studies and possibly X-rays are done to see how stable the hip is. If the hip is staying in the hip socket nicely, then the child wears the harness for another three months. If the hip(s) are still stable at the end of 90-days, then the time the harness is on can be slowly reduced until the child is only wearing it at night and for naps. After another couple of months, it can be discontinued altogether.

The success of this program depends on understanding what’s wrong and why this treatment is so important. Parents, grandparents, and other caregivers must be tuned in to what is going on and follow the doctor’s recommendations closely. Using the Pavlik harness correctly and consistently is absolutely essential. It’s only temporary. Anything less can result in complications and problems requiring surgery.

Blount’s disease, also called tibia vara, isn’t a common disease. It’s a disorder of the shin bone (the tibia) and it causes the tibia to bend, much like it might if a child was bowlegged. But, in Blount’s disease, the deformity continues unless something is done to fix it.

Although it isn’t common, it’s not rare either, and it is seen more often in children who are overweight and/or of African American descent.

One method of treating Blount’s disease, tibia vara, is through surgery. Blount’s disease causes the tibia (shin bone) to bend, causing a bowlegged look. Unfortunately, without intervention, Blount’s disease doesn’t get better and can get worse.

Surgery involves a few different techniques, but the gist of it is part of the damaged bone is removed, and the bone is straightened and fastened in a more acceptable way. One of the problems with surgery is that the missing part of the bone and the growth of the bone can affect leg length, and cause uneven legs in the long run. This isn’t a failure of the surgery but an unfortunate complication.

Without knowing that the problem is with your son’s meniscus, it’s hard to say why one type of surgery would be preferred over another. However, sometimes it is a better idea to open the knee with a traditional incision than do an arthroscopic surgery, with the slender, long reaching instruments.

A child’s joint is quite small, leaving not much room to maneuver. It’s possible that the surgeon feels more comfortable doing the open surgery, allowing him to see the entire joint, than try to do it arthroscopically.

Your knee is a complicated joint in that it has the knee cap protecting where the femur (thigh bone) and shin bone (tibia) meet. The knee needs tendons to help move the muscles, and it also needs cartilage – the menisci – to protect the knee. You have two menisci. One is the lateral meniscus (on the outside of your knee) and the other is the medial meniscus (on the inside of the knee).

The menisci attach to the tibia, staying in place with ligaments, sinewy tissue. The menisci are important because they act as shock absorbers, they stabilize the knee, allowing the body weight be distributed evenly across it, rather than on one or two points directly on the knee, and they lubricate the cartilage.

So, the menisci are important parts of your knee and should be treated if there are any injuries.