Torn meniscus overview & Contacts

What Is It?

A meniscus is a disk-shaped piece of cartilage that acts as a shock absorber inside a joint. Each knee has one lateral meniscus under the outer knob of the thighbone and one medial meniscus under the inner knob of the thighbone. Each meniscus acts as a natural cushion between the thighbone (femur) and shinbone (tibia). The two cushions prevent excess wear and tear inside the knee joint by keeping the ends of the two bones from rubbing together. Each meniscus also absorbs much of the shock of jumps and landings and helps to distribute joint fluid evenly to lubricate and nourish the knee.

In the United States, a torn meniscus is the most common reason for knee surgery; 850,000 operations for meniscal tears are performed in the United States each year.

Symptoms

The symptoms of a torn meniscus can include:
Knee pain, usually on one side of your knee
Tenderness at the side of the joint
Knee swelling within the first 12 hours after injury
A "locked" knee that can't be bent
A knee that catches during movement, or can't be fully straightened
A click, pop or grinding inside your knee when you move it
A knee that buckles, gives way or feels generally weak

Diagnosis

Your doctor will inspect both your knees to compare your injured knee with your uninjured one. He or she will check your injured knee for signs of swelling, tenderness and fluid inside the knee joint. If your knee is not locked, the doctor will bend your injured knee and check for clicks, snaps and "catches" within the joint. Your doctor also will evaluate your knee's range of motion and will maneuver your knee to see whether your meniscus is sensitive to pressure. For example, in the "McMurray test," the doctor bends the leg at the knee, and then rotates it inward or outward while straightening it. If you feel pain during this test or if there is a "click" sound as your leg rotates, there is a good chance that your meniscus is torn.
If the results of your exam suggest you have a torn meniscus, you may need more tests, including:

Knee X-rays to check for bone injuries, including fracture, that can cause symptoms similar to a torn meniscus

A magnetic resonance imaging (MRI) scan or computed tomography (CT) scan — Nine out of 10 times, a torn meniscus will show up on one of these tests.

Arthroscopy (camera-guided surgery) to look inside the knee joint and examine the meniscus — When arthroscopy is used for diagnosis, the problem often can be treated during the same surgery.

Expected Duration

If you have arthroscopic surgery to treat your torn meniscus and your job involves sedentary work (mostly sitting), you may be able to return to work one to two weeks after surgery, with full recovery in about four to eight weeks. If you are an athlete or your job requires a lot of physical activity, it may take three to four months after surgery before you feel like you have as much function in your knee as you require.

Prevention

Although it's hard to prevent accidental knee injuries, you may be able to reduce your risks by:
Warming up and stretching before participating in athletic activities
Exercising to strengthen the muscles around your knee
Avoiding sudden increases in the intensity of your training program
Wearing comfortable, supportive shoes that fit your feet and your sport

Treatment

There are several options for treating a torn meniscus:
Nonsurgical — This may include a temporary knee brace and rehabilitation to keep the knee muscles strong while the knee is not bearing as much weight. This approach is most effective for small tears (5 millimeters or less) near the edge of the meniscus, where healing is usually good, or for people who are not good candidates for surgery.

Surgery to repair the tear — If the tear is large (1 to 2 centimeters), but it involves a portion of the meniscus where there is enough blood supply for healing, the doctor may be able to repair it with stitches.

Surgery to remove part of the meniscus (partial meniscectomy) — If the tear involves a part of the meniscus where healing is poor, the surgeon may trim away ragged edges along the tear to allow the joint to move smoothly.

Surgery to remove the entire meniscus (total meniscectomy) — This option is used for tears that cannot be treated any other way. Doctors try to avoid this, because it leaves the knee without a meniscus and greatly increases the wear on the ends of the femur and tibia. In the long run, this also increases the risk of arthritis in the knee.

If you need surgery to correct a torn meniscus, it usually can be done using arthroscopy (camera-guided surgery) as a same-day procedure. After the procedure, you will begin physical therapy to help strengthen your knee muscles, reduce pain and swelling, and return the knee's full range of motion.

When To Call A Professional

Call your doctor to schedule an evaluation whenever an injured knee:
Locks, catches or can't be fully extended
Becomes very painful or swollen
Makes a click, pop or grinding sound when you move it
Buckles, gives way or feels generally weak

Prognosis

In most cases, the outlook is very good. If your torn meniscus has been repaired surgically or partially removed, you probably will be able to resume your normal athletic activities once you've finished physical therapy.

According to long-term studies, most people who have had a meniscus repaired feel very satisfied with the results of their surgery, even 10 or 11 years after the procedure. However, some people with meniscus injuries eventually develop arthritis in the injured knee. Typically, arthritis develops many years after the injury. The highest risk is among those who've had a part or all of the meniscus removed, because these surgeries take away some or all of the cushioning effect of the meniscus.

Additional Info

National Institute of Arthritis and Musculoskeletal and Skin DiseasesInformation ClearinghouseNational Insitutes of Health1 AMS CircleBethesda, MD 20892-3675Phone: (301) 495-4484Toll-Free: (877) 226-4267Fax: (301) 718-6366TTY: (301) 565-2966E-Mail: niamsinfo@mail.nih.govhttp://www.niams.nih.gov/

National Rehabilitation Information Center (NARIC)4200 Forbes Blvd.Suite 202Lanham, MD 20706Phone: (301) 459-5900Toll-Free: (800) 346-2742TTY: (301) 459-5984E-Mail: naricinfo@heitechservices.comhttp://www.naric.com/

American Orthopaedic Society for Sports Medicine6300 North River RoadSuite 500 Rosemont, IL 60018 Phone: (847) 292-4900 Toll-Free: (877) 321-3500 Fax: (847) 292-4905 E-Mail: aossm@aossm.orghttp://www.sportsmed.org/

National Athletic Trainers' Association2952 Stemmons FreewayDallas, TX 75247Phone: (214) 637-6282Fax: (214) 637-2206http://www.nata.org/

American Physical Therapy Association1111 North Fairfax St. Alexandria, VA 22314-1488 Phone: (703) 684-2782 Toll-Free: (800) 999-2782 TTY: (703) 683-6748Fax: (703) 684-7343 E-Mail: public-relations@apta.orghttp://www.apta.org/

Loose weight and reduce stress on knees

While the torn meniscus has been going on, I have been particpating in a doctor prescribed diet plan.

Since starting the plan I have lost around 5o pounds in the last 2 1/2 months. One of the comments the doctor made regarding stress on the knees was that the knees will last considerably longer when weight is taken off of them.

I guess I started the weight loss program a little to late to help with my knee. When I injured the knee, I was up to 239.5 lbs, and have weighed in at 187 with in the last week.

2 Months since suregery

Its been two months since surgery.

My knee is doing real well, I am able to jog on it, take swings with a bat using a pitching machine, and field groung balls.

At times I stand on it for 3 hours at a time and have no ill effects.

Stairs still put a strain on it, more so than coming down vs going up.

More Knee Excercises

Knee Arthroscopy Exercise Guide

Regular exercise to restore your knee mobility and strength is necessary. For the most part this can be carried out at home. Your orthopaedic surgeon may recommend that you exercise approximately 20 to 30 minutes two or three times a day. You also may be advised to engage in a walking program. Your orthopaedist may suggest some of the following exercises. The following guide can help you better understand your exercise or activity program that may be supervised by a therapist at the direction of your orthopaedic surgeon. As you increase the intensity of your exercise program, you may experience temporary set-backs. If your knee swells or hurts after a particular exercise activity, you should lessen or stop the activity until you feel better. You should Rest, Ice, Compress (with an elastic bandage), and Elevate your knee (R.I.C.E.). Contact your surgeon if the symptoms persist.

Initial Exercise Program

Hamstring Contraction, 10 Repetitions - No movement should occur in thisexercise. Lie or sit with your knees bent to about 10 degrees. Pull your heel into the floor, tightening the muscles on the back of your thigh. Hold 5 seconds,then relax.Repeat 10 times.
Quadriceps Contraction, 10 Repetitions - Lie on stomach with a towel roll under the ankle of your operated knee. Push ankle down into the towel roll. Your leg should straighten as much as possible. Hold for 5 seconds. Relax. Repeat 10 times.

Straight Leg Raises, 10 Repetitions - Lie on your back, with uninvolvedknee bent, straighten your involved knee. Slowly lift about 6 inches and hold for 5 seconds. Continue lifting in 6-inch increments, hold each time. Reverse the procedure, and return to the starting position. Repeat 10 times. Advanced: Beforestarting, add weights to your ankle, starting with 1 pound of weight and buildingup to a maximum of 5 pounds of weight over 4 weeks.
Buttock Tucks, 10 Repetitions - While lying down on your back, tightenyour buttock muscles. Hold tightly for 5 seconds. Repeat 10 times.

Straight Leg Raises, Standing, 10 Repetitions - Support yourself, ifnecessary, and slowly lift your leg forward keeping your knee straight. Return tothe starting position. Repeat 10 times Advanced: Before starting, add weightsto your ankle, starting with 1 pound of weight and building up to a maximumof 5 pounds of weight over 4 weeks.

Intermediate Exercise Program

Terminal Knee Extension, Supine, 10 Repetitions - Lie on your backwith a towel roll under your knee. Straighten your knee (still supported by theroll) and hold 5 seconds. Slowly return to the starting position. Repeat 10 times.Advanced: Before starting, add weights to your ankle, starting with 1 poundof weight and building up to a maximum of 5 pounds of weight over 4 weeks.

Straight Leg Raises, 5 Sets, 10 Repetitions - Lie on your back, withyour uninvolved knee bent. Straighten your other knee with a quadriceps musclecontraction. Now, slowly raise your leg until your foot is about 12 inches fromthe floor. Slowly lower it to the floor and relax. Perform 5 sets of 10 repetitions.Advanced: Before starting, add weights to your ankle, starting with 1 poundof weight and building up to a maximum of 5 pounds of weight over 4 weeks.
Partial Squat, with Chair, 10 Repetitions - Hold onto a sturdy chair orcounter with your feet 6-12 inches from the chair or counter. Do not bend all theway down. DO NOT go any lower than 90 degrees. Keep back straight. Holdfor 5-10 seconds. Slowly come back up. Relax. Repeat 10 times.

Quadricep Stretch - Standing, 10 Repetitions - Standing with the involvedknee bent, gently pull heel toward buttocks, feeling a stretch in the front of the leg.Hold for 5 seconds. Repeat 10 times.

Advanced Exercise Program

Knee Bend, Partial, Single Leg - Stand supporting yourself with the backof a chair. Bend your uninvolved leg with your toe touching for balance as necessary.Slowly lower yourself, keeping your foot flat. Don't overdo this exercise. Straightenup to the starting position. Relax and repeat 10 times.

Step-ups, Forward, 10 Repetitions - Step forward up onto a 6-inch highstool, leading with your involved leg. Step down, returning to the starting position.Increase the height of the platform as strength increases. Repeat 10 times.

Step-ups, Lateral, 10 Repetitions - Step up onto a 6-inch high stool,leading with your involved leg. Step down, returning to the starting position.Increase the height of the platform as strength increases. Repeat 10 times.

Terminal Knee Extension, Sitting, 10 Repetitions - While sitting in a chair,support your involved heel on a stool. Now straighten your knee, hold 5 seconds andslowly return to the starting position. Repeat 10 times.

Hamstring Stretch, Supine, 10 Repetitions - Lie on your back. Bend yourhip, grasping your thigh just above the knee. Slowly straighten your knee until youfeel the tightness behind your knee. Hold for 5 seconds. Relax and repeat 10 times.Repeat with the other leg. If you do not feel this stretch, bend your hip a little more,and repeat. No bouncing! Maintain a steady, prolonged stretch for the maximumbenefit.

Hamstring Stretch, Supine at Wall, 10 Repetitions - Lie next to adoorway, with one leg extended. Place your heel against the wall, and, with yourknee bent, move your hips toward the wall. Now begin to straighten your knee.When you feel the tightness behind your knee, hold for 5 seconds. Relax andrepeat 10 times. The closer you are to the wall, the more intense the stretch.Repeat with the other leg.

Exercise Bike - If you have access to an exercise bike, set the seat high so yourfoot can barely reach the pedal and complete a full revolution. Set the resistance to"light" and progress to "heavy." Start pedaling for 10 minutes a day. Increase theduration by one minute a day until you are pedaling 20 minutes a day.

Walking - An excellent physical exercise activity in the middle stages of yourrecovery from surgery (after 2 weeks).

Running should be avoided until 6-8 weeks because of the impact and shock forcestransmitted to your knee. Both walking and running activities should be graduallyphased into your exercise program.

Just waiting to use the stairs.

My knee does not swell with usage, and it does not seem to get tender after long periods of usage. The only time I can tell that it is not as strong as it should be is still using the stairs.

I am reording the glucosamine supplement for the cartlidge support, and do believe the nutrients, minerals, and vitamins have helped.

1 1/2 Months from Surgery

It has been almost one and 1/2 months since my surgery. I have been doing all of my activities, mowing, coaching, etc.. everyday after working 9 hours, and am experencing some swelling on the right side of my right knee. I am no longer taking physical therapy, or limiting any acitivy.

I do notice a little pain if I shift my knee certain ways. I am not sure if this is normal, or will pass with time. I still do no stairs, and I am continuing to take the cartlidge supplements for my knee.

Knee Exercise

Have you given thought to the amount of wear and tear that an average knee undergoes for an adult? Climbing stairs, bending, running and athletics - all of these take a toll on the delicate knee joint. Athletes and pregnant women need to take special care of their knees with suitable knee strengthening exercise. Maintaining a healthy body weight is vital for keeping your joints especially knees in good condition. Shedding off a few extra pounds will go a long way in reducing the pressure on the knee joint. Include a few simple knee exercises into your fitness regimen.
Knee exerciseThe knee joint is made up of 4 crucial ligament groups:

Anterior cruciate ligament (ACL)
Posterior cruciate ligament (PCL)
Medial collateral ligament (MCL)
Lateral collateral ligament (LCL)

The ACL and MCL are more prone to injury and account for most knee problems. Knee ailments are noticed more often among women than men. While many a time this is attributed to onset of osteoarthritis, it may have to do with physical activity levels too. Studies have noticed that older people have significantly thinner overall knee cartilage. But this age-related thinning was more pronounced in the case of women.One possible reason could be the effect of hormones on cartilage cell synthesis. Another observation was that quadriceps-muscle size in men reduced at a much slower rate for older men as compared to older women. It has also been seen that there are higher instances of ACL injuries among women athletes as compared to men athletes. The pressure on the knee joint is increased in women who don't bend their knees when landing from a jump. Women also turn and pivot in a more erect position, which also strains the ACL. An important tip is to learn to bend at the knees and hips so as to reduce the stress on the ACL.
Knee exercise programThe right kind of exercise has shown benefits to joints damaged by osteoarthritis. It can also boost overall fitness levels. The right workout for joints such as knee exercises can improve the motion of the joint, reduce stiffness and prevent further damage. A gentle warming up is the key to avoiding many knee injuries while working out. The purpose of any warm-up or exercise program is to improve performance and help prevent serious injuries. Build your stamina gradually. Challenge your body but do not push it too hard. Knee strengthening exercises will improve muscle strength in the thigh and stomach muscles. Once you are comfortable, you can gradually use weights too.

Hamstring Stretch - Lie or sit with your knees bent to about 10 degrees. Pull your heel into the floor and tighten the muscles of the back of the thighs. Hold for about 7 seconds and relax. Repeat this knee exercise 10 times for both knees.

Lunge - Stand with your feet together and your back straight. With your hands on your hips, take a large step forward. Bend both the knees such that the front shin is in a straight line with the ankle. The back knee should be nearly on the floor. Slowly position yourself back to standing posture by pushing your front foot up. Remain steady throughout this knee exercise. Repeat with the other leg.

Quadriceps stretch - Stand a little away from a wall and place left hand on the wall for support. Grasp the top of the left foot with the right hand. Pull heel toward you. Hold for about 15 seconds. Repeat with other leg.

Knee strengthening exerciseIt is essential to include some knee strengthening exercises into your fitness regimen. Knee strengthening exercises will go a long way in improving muscle control and joint motion and stability. Consult your physician before you embark on any fitness exercise program. Those who are recovering from knee surgery will be put on a knee strengthening exercise program to help the knee regain its strength. But this requires specific exercises that require the guidance of a physical therapist.

Does ultrasound therapy work to treat osteoarthritis of the knee?

Does ultrasound therapy work to treat osteoarthritis of the knee?
This Cochrane review looked at the studies done to date on ultrasound therapy. Three studies tested 294 people with osteoarthritis of the knee or hip. The studies compared people who were given either ultrasound therapy, fake therapy or another type of electric current therapy, such as short wave diathermy or galvanic current.

What are osteoarthritis and ultrasound therapy?Osteoarthritis (OA) is the most common form of arthritis that can affect the hands, hips, shoulders, knees and feet. The tissue (cartilage) that protects the ends of the bones breaks down and causes pain and swelling. Drug and non-drug therapies can relieve pain and/or swelling. Ultrasound is a non-drug therapy given by physical therapists that uses pressure waves or vibrations. There are two types of ultrasound waves: pulsed (on and off) and continuous (non-stop). The pulsed waves do not produce heat, but they may decrease swelling. The continuous waves, however, produce heat that can soothe inflamed joints. It is not clear whether ultrasound therapy can be used to reduce the symptoms of osteoarthritis.

How well does ultrasound therapy work?Based on these studies, our best guess is that the effect of having 12 sessions of ultrasound therapy over 4-6 weeks on pain, range of motion of the joints, or speed while walking is about the same as the effect of having fake therapy.
Two studies comparing ultrasound therapy to other types of electric current therapy show that the effect of ultrasound on pain, disease activity and function is about the same as the effect of the other types of electric current therapy. In this case, therapy was provided for either 1 session or 10 sessions over 3 weeks.

There is no evidence about whether ultrasound therapy works on the wrists or hands. Unfortunately, the studies do not say whether the ultrasound therapy is pulsed or continuous, which makes it hard to give conclusions about whether pulsed or continuous therapy is better.
How safe is ultrasound therapy?Side effects were not given in any of the studies.

What is the bottom line

There is “silver” level evidence that ultrasound therapy does not improve the symptoms of osteoarthritis of the hip or knee. The effect of ultrasound therapy on osteoarthritis of the wrists and hands is not known.
Better studies need to be done to determine if ultrasound should be used to treat osteoarthritis.
Based on Robinson VA, Brosseau L, Peterson J, Shea BJ, Tugwell P, Wells G. Therapeutic ultrasound for osteoarthritis of the knee. The Cochrane Database of Systematic Reviews, 2001, Issue 3.

Arthritis Advice

Arthritis Advice
“Arthritis” is not just a word doctors use when they talk about painful, stiff joints. In fact, there are many kinds of arthritis, each with different symptoms and treatments. Most types of arthritis are chronic. That means they can go on for a long period of time.
Arthritis can attack joints in almost any part of the body. Some forms of arthritis cause changes you can see and feel—swelling, warmth, and redness in your joints. In some the pain and swelling last only a short time, but are very bad. Other types cause less troublesome symptoms, but still slowly damage your joints.
Common Kinds of Arthritis
Arthritis is one of the most common diseases in this country. Millions of adults and half of all people age 65 and older are troubled by this disease. Older people most often have osteoarthritis, rheumatoid arthritis, or gout.
Osteoarthritis (OA) is the most common type of arthritis in older people. OA starts when cartilage begins to become ragged and wears away. Cartilage is the tissue that pads bones in a joint. At OA’s worst, all of the cartilage in a joint wears away, leaving bones that rub against each other. You are most likely to have OA in your hands, neck, lower back, or the large weight-bearing joints of your body, such as knees and hips.
OA symptoms can range from stiffness and mild pain that comes and goes with activities like walking, bending, or stooping to severe joint pain that keeps on even when you rest or try to sleep. Sometimes OA causes your joints to feel stiff when you haven’t moved them in a while, like after riding in the car. But the stiffness goes away when you move the joint. In time OA can also cause problems moving joints and sometimes disability if your back, knees, or hips are affected.
What causes OA? Growing older is what most often puts you at risk for OA. Other than that, scientists think the cause depends on which part of the body is involved. For example, OA in the hands or hips may run in families. OA in the knees can be linked with being overweight. Injuries or overuse may cause OA in joints such as knees, hips, or hands.
Rheumatoid Arthritis (RA) is an autoimmune disease. In RA, that means your body attacks the lining of a joint just as it would if it were trying to protect you from injury or disease. For example, if you had a splinter in your finger, the finger would become inflamed—painful, red, and swollen. RA leads to inflammation in your joints. This inflammation causes pain, swelling, and stiffness that lasts for hours. This can often happen in many different joints at the same time. You might not even be able to move the joint. People with RA often don’t feel well. They may be tired or run a fever. People of any age can develop RA, and it is more common in women.
RA can attack almost any joint in the body, including the joints in the fingers, wrists, shoulders, elbows, hips, knees, ankles, feet, and neck. If you have RA in a joint on one side of the body, the same joint on the other side of your body will probably have RA also. RA not only destroys joints. It can also attack organs such as the heart, muscles, blood vessels, nervous system, and eyes.
Gout is one of the most painful forms of arthritis. An attack can begin when crystals of uric acid form in the connective tissue and/or joint spaces. These deposits lead to swelling, redness, heat, pain, and stiffness in the joint. Gout attacks often follow eating foods like shellfish, liver, dried beans, peas, anchovies, or gravy. Using alcohol, being overweight, and certain medications may also make gout worse. In older people, some blood pressure medicines can also increase your chance of a gout attack.
Gout is most often a problem in the big toe, but it can affect other joints, including your ankle, elbow, knee, wrist, hand, or other toes. Swelling may cause the skin to pull tightly around the joint and make the area red or purple and very tender. Your doctor might suggest blood tests and x-rays. He or she might also take a sample of fluid from your joint while you are having an attack.
Other forms of arthritis include psoriatic arthritis (in people with the skin condition psoriasis), ankylosing spondylitis (which mostly affects the spine), reactive arthritis (arthritis that occurs as a reaction to another illness in the body), and arthritis in the temporomandibular joint (where the jaw joins the skull).
Warning Signs
You might have some form of arthritis if you have:
Lasting joint pain,
Joint swelling,
Joint stiffness,
Tenderness or pain when touching a joint,
Problems using or moving a joint normally, or
Warmth and redness in a joint.
If any one of these symptoms lasts longer than 2 weeks, see your regular doctor or a rheumatologist. If you have a fever, feel physically ill, suddenly have a swollen joint, or have problems using your joint, see your doctor sooner. Your health care provider will ask questions about your symptoms and do a physical exam. He or she may take x rays or do lab tests before suggesting a treatment plan.
Treating Arthritis
Each kind of arthritis is handled a little differently, but there are some common treatment choices. Rest, exercise, eating a healthy, well-balanced diet, and learning the right way to use and protect your joints are key to living with any kind of arthritis. The right shoes and a cane can help with pain in the feet, knees, and hips when walking. You can also find gadgets to help you open jars and bottles or to turn the door knobs in your house more easily.
In addition, there are also medicines that can help with the pain and swelling. Acetaminophen can safely ease arthritis pain. Some NSAIDs (nonsteroidal anti-inflammatory drugs), like ibuprofen and naproxen, are sold without a prescription. Other NSAIDs must be prescribed by a doctor. But in 2005, the U.S. Food and Drug Administration (FDA) warned people about the possible side effects of some NSAIDs, both those sold with or without a prescription. You should read the warnings on the package or insert that comes with the drug. Talk to your doctor about if and how you should use acetaminophen or NSAIDs for your arthritis pain. You can also check with the FDA for more information about these drugs.
Some treatments are special for each common type of arthritis.
Osteoarthritis. Medicines can help you control OA pain. Rest and exercise will make it easier for you to move your joints. Keeping your weight down is a good idea. If pain from OA in your knee is very bad, your doctor might give you shots in the joint. This can help you to move your knee and get about without pain. Some people have surgery to repair or replace damaged joints.
Rheumatoid Arthritis. With treatment, the pain and swelling from RA will get better, and joint damage might slow down or stop. You may find it easier to move around, and you will just feel better. In addition to pain and anti-inflammatory medicines, your doctor might suggest antirheumatic drugs, called DMARDs (disease-modifying antirheumatic drugs). These can slow damage from the disease. Medicines like prednisone, known as corticosteroids, can ease swelling while you wait for DMARDs to take effect. Another type of drug, biologic response modifiers, blocks the damage done by the immune system. They sometimes help people with mild-to-moderate RA when other treatments have not worked.
Gout. If you have had an attack of gout, talk to your doctor to learn why you had the attack and how to prevent future attacks. The most common treatment for an acute attack of gout uses NSAIDs or corticosteroids like prednisone. This reduces swelling, so you may start to feel better within a few hours after treatment. The attack usually goes away fully within a few days. If you have had several attacks, your doctor can prescribe medicines to prevent future ones.
Exercise Can Help
Along with taking the right medicine and properly resting your joints, exercise is a good way to stay fit, keep muscles strong, and control arthritis symptoms. Daily exercise, such as walking or swimming, helps keep joints moving, lessens pain, and makes muscles around the joints stronger.
Three types of exercise are best if you have arthritis:
Range-of-motion exercises, like dancing, relieve stiffness, keep you flexible, and help you keep moving your joints.
Strengthening exercises, such as weight training, will keep or add to muscle strength. Strong muscles support and protect your joints.
Aerobic or endurance exercises, like bicycle riding, make your heart and arteries healthier, help prevent weight gain, and improve the overall working of your body. Aerobic exercise also may lessen swelling in some joints.
The National Institute on Aging (NIA) has a free 80-page booklet on how to start and stick with a safe exercise program. The Institute also has a 48-minute companion video. See the last panel of this Age Page for more information. Before beginning any exercise program, talk with your doctor or health care worker.
Other Things to Do
Along with exercise and weight control, there are other ways to ease the pain around joints. You might find comfort by applying heat or cold, soaking in a warm bath, or swimming in a heated pool.
Your doctor may suggest surgery when damage to your joints becomes disabling or when other treatments do not help with pain. Surgeons can repair or replace these joints with artificial (man-made) ones. In the most common operations, doctors replace hips and knees.
Unproven Remedies
Many people with arthritis try remedies that have not been tested or proved to be helpful. Some of these, such as snake venom, are harmful. Others, such as copper bracelets, are harmless, but also unproven.
How can you tell that a remedy may be unproven?
The remedy claims that a treatment, like a lotion or cream, works for all types of arthritis and other diseases,
Scientific support comes from only one research study, or
The label has no directions for use or warning about side effects.
Areas for Further Research
Recent studies suggest that Chinese acupuncture may ease OA pain for some people. Others try dietary supplements, such as glucosamine and chondroitin. Research now shows that these two dietary supplements may help lessen your OA pain. Scientists are studying alternative treatments, such as these two supplements, to find out how they work and if they keep the joint changes caused by arthritis from getting worse. More information is needed before anyone can be sure.
Talk to Your Doctor
Most importantly, do not take for granted that your pain and arthritis are just part of growing older normally. You and your doctor can work together to safely lessen the pain and stiffness that might be troubling you and to prevent more serious damage to your joints.
For More Information
Here are other resources about arthritis:
National Center for Complementary and Alternative MedicineNCCAM ClearinghouseP.O. Box 7923Gaithersburg, MD 208981-888-644-6226 (toll-free)1-866-464-3615 (TTY/toll-free)www.nccam.nih.gov
National Institute of Arthritis and Musculoskeletal and Skin DiseasesNIAMS Information Clearinghouse1 AMS CircleBethesda, MD 20892-36751-877-22-NIAMS 1-877-226-4267 (toll-free)1-301-565-2966 (TTY)www.niams.nih.gov
American College of Rheumatology/Association of Rheumatology Health Professionals1800 Century PlaceSuite 250Atlanta, GA 30345-43001-404-633-3777www.rheumatology.org
Arthritis FoundationP.O. Box 7669Atlanta, GA 30357-0669 1-800-568-4045 (toll-free) or check the telephone directory for your local chapterwww.arthritis.org
To get the NIA’s exercise book or video or for more information on health and aging, call or write:
National Institute on Aging Information CenterP.O. Box 8057Gaithersburg, MD 20898-80571-800-222-2225 (toll-free)1-800-222-4225 (TTY toll-free)
To order publications (in English or Spanish) or sign up for regular email alerts, visit: www.niapublications.org.
The National Institute on Aging website is www.nia.nih.gov.
Visit NIHSeniorHealth.gov (www.nihseniorhealth.gov), a senior-friendly website from the National Institute on Aging and the National Library of Medicine. This simple-to-use website features popular health topics for older adults. It has large type and a ‘talking’ function that reads the text out loud.

Torn Cartlidge in knee is improving steadily

Torn and reparied meniscus is improving steadily.

I feel very comfortable playing baseball, turning and stoping for the ball. I still do not put over 60% of my weight on the knee when using it in these situations. I do let some balls go that would call for a full weight bearing turn on the knee. I am able to mow and play ball with out limping on the knee now, but it still swells slightly. I do not use stairs, as this still puts presure on the knee when it bends from step to step (I do go up and down a flight of stairs about once daily).

I will be posting artilces about knee pain, prevention, and products that I have reviewed and feel they will benefit the reader.

If you've ever injured your knee, you're not alone. Knee injuries have actually become pretty common. One of the main reasons they're common is that with so many teens playing sports, knees can be overused, leading to several types of injuries, some of which can't be repaired. So what are some of these knee injuries and what can you do to prevent them?
What's in a Knee?To understand knee injuries, first you have to understand the knee. The knee is a joint, which means it sits between the area where bones connect. It's actually the largest joint in the body. Your knees provide stability and flexibility for your body and allow your legs to bend, swivel, and straighten. The knee is made up of several body parts like bones, cartilage, muscles, ligaments, and tendons, all working as one. So when we talk about a knee injury, it could be stress or damage to any of these parts.
Bones and CartilageThe knee sits in the middle of three bones: the tibia (your shin bone), the femur (your thigh bone), and the patella (the knee cap). The patella is a flat, triangular bone that protects the knee joint.
The ends of the femur and the patella are covered in articular cartilage. Articular cartilage acts like a cushion and to keep the femur, patella, and tibia from grinding against each other. On the top of the tibia, extra pads of cartilage called menisci help absorb the body's weight (if you're talking about one, it's called a meniscus). Each knee has two menisci - the inside (medial) meniscus and the outside (lateral) meniscus.

MusclesThe muscles in the knee include the quadriceps, a large muscle at the front of the thigh, and the hamstring, which is located at the back of the thigh. The quadriceps muscle helps you straighten and extend your leg, and the hamstring helps you bend your knee.
Tendons and LigamentsSeveral tendons and ligaments work together to help the knee move naturally.

Tendons are like cables of strong tissue that connect muscles to bones. The tendons in the knee are the quadriceps tendon and the patellar tendon. The quadriceps tendon connects to the top of the patella (kneecap) and allows you to extend your leg. The patellar tendon connects to the bottom of your kneecap and attaches to the top of the tibia (shinbone).
Ligaments are like cables of strong tissue that connect bones to bones or cartilage to bones. There are four ligaments in the knee that help connect the femur to the tibia and keep your legs stable:

medial collateral ligament (MCL) - The MCL connects your femur to your tibia along the inside of your knee. It keeps the inner part of your knee stable and helps control the sideways motion of your knee, like keeping it from bending inward.

lateral collateral ligament (LCL) - The LCL connects your femur to your tibia along the outside of your knee. It keeps the outer part of your knee stable and helps control the sideways motion of your knee, like keeping it from bending outward.

anterior cruciate ligament (ACL) - The ACL connects your femur to your tibia at the center of the knee. It helps control forward motion and rotation, like keeping your shinbone from sliding out in front of your thighbone.

posterior cruciate ligament (PCL) - The PCL connects your femur to your tibia at the back of the knee. It helps control the knee's backward motion, like keeping the shinbone from sliding out under the thighbone.

Types of Knee InjuriesNow that you know all about its working parts, you probably realize that there are a bunch of ways to injure a knee. Common causes for injuries are overuse (from repetitive motions, like in many sports), sudden stops or twists, or direct blows to the knee. Here are some of the more common injuries:

SprainsA sprain means you've stretched or torn a ligament. Common knee sprains usually involve damage to the ACL and/or MCL. The most serious sprains involve complete tears of one or more of the knee ligaments. Symptoms of knee sprains include:
a popping or snapping sound in the knee at the time of injury
pain that seems to come from within the knee, especially with movement
not being able to put any weight on that leg, swelling, fluid behind the kneecap,
the knee feels loose or unstable.

StrainsA strain means you've partially or completely torn a muscle or tendon. With knee strains, you may feel symptoms similar to a sprain and may see bruises around the injured area.
TendinitisTendinitis happens when a tendon gets irritated or inflamed. It is often caused by overuse. A person with tendinitis might have pain or tenderness when walking, or when bending, extending, or lifting a leg.

Meniscal TearsDamage to the menisci is a really common sports injury, especially in sports where sudden changes in speed or side-to-side movements can cause them to tear. Meniscal injuries often occur together with severe sprains, especially those involving the ACL. Meniscal injuries can cause tenderness, tightness, and swelling around the front of the knee. Sometimes fluid collects around the knee (this is called effusion).

Fractures and DislocationsA fracture is a cracked, broken, or shattered bone. You may have trouble moving that bone and it's likely there's a lot of pain. Patellar dislocation happens when the patella (the kneecap) is knocked off to the side of the knee joint, by twisting or some kind of impact. Sometimes it will go back to its normal position by itself, but usually it will need to be put back into place by a doctor. Symptoms include swelling and a lot of pain at the front of your knee. There will usually be an abnormal bulge on the side of your knee, and you may be unable to walk. Cartilage InjuriesSometimes a small piece of bone or cartilage softens or breaks off from the end of a bone, causing long-term knee pain. This is called osteochondritis dessicans (OCD). Symptoms of OCD include pain, swelling, an inability to extend the leg, and stiffness, catching, or popping sensations with knee movement. Treatment can include resting the knee, wearing a cast for a couple of months, and sometimes surgery in older teens. Chondromalacia happens when the cartilage in the knee joint softens because of injury, muscle weakness, or overuse, and the patella and the thighbone may rub together. This causes pain and aching, especially when a person walks up stairs or hills. Treatment may involve surgery.

Other Conditions of the Knee

BursitisA bursa is a sac filled with fluid located near a joint. If a bursa in the knee becomes inflamed and swollen from overuse or constant friction, it can develop into a condition called bursitis. Symptoms of bursitis in the knee include warmth, tenderness, swelling, and pain on the front of the kneecap.

Osgood-Schlatter DiseaseOsgood-Schlatter disease is a painful disorder caused by repetitive stress on the front end of the tibia where the patellar tendon connects to the bone. It happens most frequently in young athletes between the ages of 10 to 15 years. Symptoms include a bump below the knee joint that's painful to the touch and is also painful with activity. Pain is relieved with rest.

What Do Doctors Do?There are different things a doctor may do to figure out whether you have a knee injury. Treatment for a knee injury usually depends on the type of injury you have.
First, your doctor will ask you questions about your symptoms, including what your usual activities are, especially any sports you play. The doctor will also want to know about other health conditions that lead to knee pain.

The doctor will then examine the different parts of your knee, checking the bones, ligaments, and tendons for any signs of injury. The doctor will probably bend, twist, and turn your knee to look for any signs of an unstable knee joint. Don't be surprised if you're asked to get off the exam table and walk, bend over, or squat so your doctor can get a better look at your knee. Sometimes an X-ray of your knee is needed to get a good picture of your bones. A CAT scan or MRI may also be recommended so doctors can get a better three-dimensional picture.
For injuries like mild sprains, strains, and overuse, resting your knee may be one of the first treatments your doctor recommends. Remember RICE:

Rest
Ice
Compression
Elevation

If your doctor recommends RICE, you should rest your knee as much as possible, use ice packs for a couple of days to bring down swelling, use compression (ACE) bandages, and elevate the leg on pillows or other soft objects. For inflammation and pain, your doctor may prescribe anti-inflammatory medications like ibuprofen.

Other treatment for knee injuries may involve using a knee immobilizer (kind of like a brace or a sleeve that you wrap around your leg to keep it from moving too much), or having to wear a cast for a few weeks or months. You may also have to use crutches to get around for awhile.
For more serious knee injuries, your doctor might recommend you see an orthopedic surgeon, a doctor specially trained in the care of bone and joint diseases (also called an orthopedist). Orthopedists take care of many kinds of knee injuries, especially those involving sports and different types of accidents. He or she will know how to treat the injury and follow your progress as it heals.

ArthoscopyIf necessary, an orthopedist will perform arthroscopy, a type of surgery that takes a direct look at the inside of your knee joint.
During arthroscopy, the orthopedist first makes a small opening in the knee and inserts an arthroscope, a tiny tube-like tool, into the joint capsule. The arthroscope contains a lighted video camera on the end, and is wired to a television screen that the surgeon watches while moving the scope to pinpoint the exact knee problem. Most of the time, the doctor is able to fix the problem during the procedure, like repairing a torn ACL ligament.

Arthroscopy is often used to treat knee injuries such as ligament and meniscal tears, as well as other types of serious knee injuries. An orthopedist can also perform open surgery on the knee, which allows him or her to see the injury without the aid of a television screen.
Physical TherapyDepending on the type of knee injury you have, your doctor may recommend rehabilitative physical therapy. Working with a physical therapist, you'll do specific exercises designed to take your knee joint through its range of motion to prevent stiffness and scarring as your knee heals. You may also need to do regular exercises to strengthen the muscles surrounding the knee. Physical therapy is commonly used to help a person recover after surgery.

You may be anxious for your knee to heal so you can get back to your sport and your normal life. But trying to rush your recovery after an injury or surgery can put you at risk for future injury and may further extend the healing process. Take your doctor or physical therapist's instructions seriously, and don't put your health in jeopardy by returning to your normal activities before you get the go-ahead from a health pro.

Preventing Knee InjuriesPreventing knee injuries from the start is a lot less painful and a lot less hassle than undergoing surgery. If you play sports, always wear appropriate protective equipment during practices and competitions. Kneepads and shin guards (as well as helmets and other protective gear) will help to protect you from injury. You'll also want to make sure you wear supportive shoes that are in good condition and are appropriate your sport.

When it comes to your workouts, always warm up and cool down, and remember to work up to your training program slowly. Suddenly increasing the intensity or duration of your workouts can lead to overuse injuries. Try weightlifting to strengthen your muscles and stretching and yoga to improve your flexibility because strong, flexible muscles help support and protect joints. If you play only one sport, try conditioning and training year-round - even if it's at a lower intensity than during your competitive season - to maintain coordination and balance. That way you'll be less likely to injure yourself during your competitive season.

In growing kids and teens, imbalances in muscle flexibility and strength can lead to injuries and inflammation from overuse. Regular stretching can help. After an injury or surgery has healed, it is also important to continue a regular stretching or conditioning program to prevent another injury.

The way you move can also help you prevent knee injuries. If your sport involves a lot of jumping, make sure to bend your knees when you land, which takes pressure off of the ACL. Do you have to cut laterally or pivot frequently in your sport? Use your joints to crouch and bend at the knees and hips, reducing your chance of a ligament injury.

Remember, if you experience any symptoms of knee injuries or knee pain, don't hesitate to tell your coach, parent, or doctor. Limit your activities until you can get treatment or a diagnosis.
Reviewed by: Barbara P. Homeier, MDDate reviewed: January 2006Originally reviewed by: Suken Shah, MD