FAQ Category: Knee

Doctors will use measurements of muscle size, muscle strength, and symptoms as a guide. Each nerve provides information about sensation and controls muscle contraction. Change in either of these functions can signal nerve damage.

Electromyography (EMG) studies can give good information about the condition of the nerve. Serial EMGs (doing more than one) help track recovery over time. Nerve tissue regenerates at a rate of about 1 millimeter each day. This is equal to approximately one-half an inch in a month’s time. If there is no sign of nerve recovery three months after the injury, surgery may be advised.

There are several causes of pain behind the knee. A recent injury can cause pain from a ligament strain or tear. Sometimes a small structure such as a bursa or plica in the knee can become inflamed and cause pain.

You may be describing pain associated with a condition called patellofemoral pain syndrome (PFPS). This is caused by the kneecap sliding up and down over the joint but slightly off center. This kind of tracking misalignment can cause the cartilage behind the knee to get torn or frayed.

PFPS is often characterized by pain when descending stairs. There may also be pain when trying to bend that knee in a partial squat. An orthopedic physician or physical therapist can examine you and determine the cause of your symptoms. 

Today’s health care professionals are being asked to show that the treatment they provide is effective. Questionnaires are one of the most valid and reliable ways to measure the results of treatment.

Health care providers hope treatment improves patients’ function and reduces pain and stiffness. Patient satisfaction and quality of life are also important measures of success. Health care providers want to know whether your quality of life has improved after surgery. If so, they can consider the surgery a success and recommend it to other patients.

Stair climbing is a difficult skill for many people who have had total knee replacement. This is true even one year after surgery. After surgery, the support from leg muscles is only one-third of the strength and force needed to climb stairs.

Bring your concern to your doctor’s attention. A physical therapist can help you begin an exercise program specifically designed to assist you with stairs. If you saw a physical therapist during your recovery from surgery, do not hesitate to contact the therapist and request additional services.

Now more than ever, health care professionals are being asked to show the benefits of the treatment they provide. Insurance companies, employers, and patients are unwilling to pay for or receive treatment unless it has proven effective. The best way to evaluate treatment is to look at the whole picture before and after.

By comparing your function and satisfaction before and after treatment, you can tell whether the treatment is working. In your case, this might be very helpful if you ever need a knee replacement for the other leg or a second replacement for the knee in question.

Test results are also used by doctors to make treatment recommendations for other patients. Ultimately, tests like these help doctors plan better treatment for all patients.

Many studies have looked at knee motion and strength after surgery to repair the knee. There are six different knee motions to consider: flexion (bending), extension (straightening), side-to-side motions, and turning (rotation) in and out.

Three months after surgery, flexion and side-to-side motions start to return to normal. By six months, the other motions also show improvement. After one year, muscle strength in all six directions has improved. The last movement to return to normal is usually extension.

You won’t be able to judge the final outcome for another six months. If there is a big difference between your operated leg and your other leg, talk to your doctor. A physical therapist can test the strength and motion of your legs and offer exercises that may be more appropriate for this phase of recovery.

A recent study showed that knee strength is actually affected by the muscles around the hip. For some motions, the hip muscles add only a small amount of strength to the knee. Other knee motions, such as turning the knee in or out (rotation) depend much more on hip muscles.

ACL injury affects the muscles around the knee, especially the thigh muscle (quadriceps). Hip muscle strength may be affected by ACL injury, too. One study showed that hip strength is reduced after knee surgery on the affected side. This is especially true for hip extension, or unbending the hip. This information suggests that hip exercises can help you achieve the fullest recovery from your injury.

Most people are physically active at work and school after this surgery. There is usually a short period of one to two weeks after the surgery when normal activities are difficult. Check with your doctor about how much you’ll be able to do and how soon after surgery. Sometimes variations in surgical methods make a difference.

This is a topic of considerable debate. From data collected, it does not appear that athletes injure the nondominant leg more often than the dominant leg.

One group of researchers specifically looked at how stiff the knee becomes when the muscles around the knee contract. This knee stiffness reduces the force against the ligamentd inside the knee and prevents injury. In this study, there did not appear to be any difference in knee stiffness or muscle strength between the dominant and nondominant legs.

The ACL is protected in part by the amount of joint stiffness that muscle contraction provides. The stiffer the knee, the less force is placed on the ligaments. If the sudden force of an impact is greater than the strength of the muscles holding and protecting the joint, ligaments will probably be injured.

Sometimes the joint isn’t ready for the impact. For example, if the player jumps up but gets knocked off center, the player may not come down straight. The angled force of the landing can cause ligament injury in the knee.

It is a well-known fact that women athletes suffer more ACL injuries than men in the same sport. The reason for this remains unknown. Although many possibilities have been suggested, no one factor or combination of factors has been identified.

One group of researchers decided to measure the effect of muscle contraction on the knees. They looked at how stiff the knee becomes when the muscles contract in men and women. Knee stiffness protects the ACL. By tightening up the knee, the bones can’t slide enough to tear the ligaments inside.

Surprisingly, the researchers found that men are able to tighten the knee joint to three times its normal stiffness. Women can only double the stiffness. This difference does not appear to be caused by muscle strength, body weight, or height. It may be that men use the muscles around the knee differently than women.

The study also showed that men use the hamstring muscles on the back of the thigh more than the quadriceps muscles in front to get this much knee stiffness. It may be that women can train the hamstrings to react faster and with more force to help protect the knee from injury. Further studies are needed in this area.

The meniscus is a pad of cartilage between the two bones that form the knee. There are actually two menisci in the knee: one on the inside (medial) and one on the outside (lateral).

The menisci act as a support for the knee and bear the load of the weight on the joint. They serve as the contact area between the thigh and leg bones, helping to distribute pressure within the knee joint.

Without the meniscus, there is an immediate increase in joint contact pressure. This change in the distribution of pressure causes changes in the knee joint. The bones become flatter, and the joint space gets smaller. If enough of the meniscus is removed, further changes in the joint can occur with a less favorable outcome.

Early repair can protect the meniscus from tearing more.  For small tears, surgery may be delayed six months to a year. However, if the knee is swelling, feels unsteady, or causes unbearable pain, you may be advised to consider an earlier surgery date. The amount of tear and type of tear make a difference in the final result. Follow your doctor’s advice in this matter to prevent further injury and a worse outcome.

Meniscectomy refers to the removal of cartilage or meniscus in the knee. Total removal takes the entire meniscus out. This includes surfaces all the way around the knee joint–front, side, and back. Partial meniscectomy is the removal of less than half of the meniscus. The edge of the cartilage around the rim of the knee joint is left in place.

There are differences in the results of partial and total meniscectomies. In general, the doctor tries to save as much of the meniscus as possible. This is called tissue conserving. Without the meniscus, the joint space narrows and more stress is placed on the knee. Long-term studies show some functional changes as well.

Shin splints probably aren’t genetic, or passed down from parent to child. The most common risk factors include overuse, poor physical condition, competitive running, female gender, smoking, being flatfooted, and previous injury.

Other risk factors are double heel strikes in ballet dancers, low calcium intake among female athletes, increasing training intensity, and the use of worn shoes on hard surfaces.

If any of your children develop problems, see an orthopedic doctor or podiatrist who specializes in this area. Early treatment can prevent serious injuries.

There is no clear-cut answer to this question. Although some people are helped by surgery for shin splints, surgery is not always successful. Pain is often relieved without surgery.

Other treatment options can be tried before surgery. These include the use of orthotic inserts. Orthotics help stabilize the ankle joint and keep the foot from rolling inward. They can also be designed to help absorb shock. Training for strength, agility, and flexibility before and during the sports season also reduces shin splints among athletes.

Of all the treatment options currently available for shin splints, only one has actually proven effective. This is the use of orthoses. These insoles are inserted into the shoe to absorb shock while supporting the ankle in a good position. This reduces how much the foot rolls onto the arch.

Preseason training also reduces ankle and leg injuries while improving performance. Strength, agility, and flexibility should be part of your training program before and during the running season.

Recent research has shown that the ankle’s sense of position (called proprioception) may affect the knee. Muscular fatigue around the ankle changes the ankle’s sense of position. This in turn changes the firing pattern of muscles around the knee. Injury to the ligaments of the knee may be the final result.

Medial tibial stress syndrome often occurs in athletes as a result of training errors and overuse. Repetitive activity causes inflammation where the tendon attaches to the bone. Sometimes the tendon pulls away from the bone or the bone develops a tiny fracture. Although rest is the first and best treatment, there are other options.

Activity modification and specific rehabilitation can be provided by a physical therapist. The therapist can also evaluate your movement and training program to look for possible causes of your symptoms.

Surgery is performed if swelling in the area puts too much tension on the tissues along the tibia bone. Your doctor is the best one to make this recommendation.

The tibia is the large bone in the lower leg. Pain on the inside of the lower third of the tibia that happens with exercise and sport activities is known as medial tibial stress syndrome, or MTSS. This condition is often called “shin splints.”

The exact cause of MTSS is unknown. Imaging studies show an increase in skeletal metabolism in the area of pain, along with a decrease in the density of the bone. Scientists do not know which comes first: the MTSS or the changes in the bone.

Researchers have discovered that these changes in the bone are present in both legs, even when only one side is painful. This finding suggests that not enough bone is being deposited during the early phases of growth. It seems that exercise triggers the symptoms, but no one knows if exercise causes or just contributes to the changes in bone density. More studies are being done to answer these questions.