Whether you consider yourself an athlete, have made a resolution to run your first 10 K in 2016 or, just your average “weekend warrior” out to shoot some hoops with friends there are tips to keep your knees healthy for the New Year. Research has shown several invaluable tips that may prevent an injury to the soft tissue structures of the knee, the ligaments such as the ACL or anterior cruciate ligament as well as to the meniscus, the knee’s cartilage.

Chronic knee conditions such as osteoarthritis or degenerative arthritis can also benefit from exercises focused on strengthening the Quadriceps muscle group of the thigh. Proper strengthening exercises may stave off a total knee replacement (Total Knee Arthroplasty [TKA]) in “fighting gravity” if you will, by elevating the muscles of the thigh as to decrease the degenerative effects of grinding “bone on bone”.

Ultimately, a severely arthritic knee will require surgical replacement however proper physiotherapy will buy additional time, prior to a joint replacement. Maintaining a healthy weight is also important in reduction of sports injuries and symptoms of degenerative arthritis or osteoarthritis of the knees.
If you have had the misfortune of sustaining an injury, you may also benefit from less-invasive therapeutic measures, such as Platelet Rich Plasma injections into the joint once an injury to the meniscus or cartilage has occurred. These injections are rapidly becoming more commonly used in orthopedic applications, as your bodies platelets contain important growth factors which promote healing of the cartilage when injected in the knee as well as other ligaments of the body. (AAOS, http://orthoinfo.aaos.org/topic.cfm?topic=A00358 2015 ).

The Academy of Orthopedic Surgery has also recently recommended yoga and other dynamic stretching exercises for improved strength, balance and coordination.
Proper sleep has also been shown to improve response time in a reduction of injury. If surgery is on the menu for 2016, an array of improved prosthetics should provide confidence if you should you become a candidate for a total knee arthroplasty (Sutton, 2013).
Modern technology has ushered in a host of newer technologies, in the way of fixation buttons and grafts should you require an arthroscopic knee ligament or meniscal repair, as well.

Five Tips to have “Happy Knees” in 2016:

Tip #1. Exercise

A basic understanding of physics will allow you to understand better the forces at play that result in an ACL tears and soft tissue injuries of the knee:

Movements during sports which require sudden deceleration, landing, and pivoting maneuvers being common, increase the anterior shear “loading” forces on the ACL. Female athletes are over twice as common to sustain an ACL injury as compared to their male counterparts (Sutton, 2013).

Physics that play a role in ACL injury are “ground reaction forces” or “GRFs” which refer to the pressure that must be absorbed by the body when the front of our foot hits the ground. With normal walking, the GRF’s are equal to our body weight.

When an athlete lands after a jump, the pressure may be between 2-8 times our body-weight placing shearing force on the knee. The American Academy of Orthopedic Surgeons have recommended specific targeted exercises to decrease the chances of injury and completing a proper “warm-up” routine prior to team sports such as soccer or basketball which are quite prone to knee injury.

Exercises which comprise an excellent regimen will target the thighs, hips and core. One should include a combination of sets of squats and dynamic stretching similar such as walking lunges and also Yoga.
For those who suffer with chronic arthritis specific strengthening of the 4 muscles which comprise the Quadriceps Femoris muscle group: the rectus femoris, vastus medialis, vastus intermedius and vastus lateralis. These exercises can be readily done with static squats and lunges as well as dynamic or walking lunges.

Tip #2. Maintain A Healthy Weight

This is most commonly referred to in terms of our BMI or body mass index.

I know you hear about weight loss all the time, but there is a reason for that. It matters. For each pound of weight that you lose, you unload 4 pounds of force from your knees.

We can calculate our Body Mass Index and find our ideal weight at the link: http://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm.

A Normal or healthy BMI is 18.5 to 24.9. Simply input height and weight in the calculator and will determine your BMI. Obesity is defined a BMI over 30. A diet that is largely comprised of fresh fruits and vegetables with smaller lean proteins, fats and dairy is ideal. It may be worthwhile to consult a nutritionist for a personalized meal plan.

 

Tip #3. Proper Sleep

Ideally individuals require a minimum of 6- 8 hours of quality uninterrupted sleep per night. Lack of sleep not only effects ones level of mental alertness, concentration and mood, but also reaction time, coordination and balance. Secondary benefits are had with an improved immune state and some research even indicates a relationship with sleep deprivation and Alzheimer’s disease (Jeff Illife MD, The Importance of Sleep) WWWTEDMED.com, Sept 2014)

Tip #4. Platelet Rich Plasma Injections

Not something that most of us will use, however this technique involves the use of an individual’s own platelets which usually are thought of for their clotting properties.

These platelets are separated from a patient’s plasma and other cells and injected into the joint as a procedure in itself or at the time of surgery to assist cartilage healing (Kyun, 2015). Several athletes such as Tiger Woods have given their testimonials to the improved rapid healing and return to exercise.

Tip #5. Surgery

Most surgical techniques can be performed through a “keyhole” or arthroscopic technique making them easily performed in outpatient surgery centers and requiring no time in the hospital. For ACL repair, a common injury accounting for 175,000 procedures performed annually there are a host of graft options from donor cadaver graft to native graft options. Total knee replacement options also have expanded of late and choices are largely based on the surgeon’s preference and sophistication with the specific devices.

Ultimately, a proper physical exam, radiographs and often an MRI are required to the definitive source to delineate damage to the knee anatomy and determine treatment options. Orthopedic clinical practice guidelines will determine if non-surgical options are appropriate or if surgery is indicated. The physicians at Finger Lakes Orthopedics in Rochester and the conveniently located satellite locations will share their expertise, outstanding diagnostics and compassionate care to determine the modality most appropriate for you should you experience knee pain the expertise of the physicians of Finger Lakes Orthopedics should aid the athlete in you, whether you are a “soccer mom” or a “weekend warrior” who has sustained an injury.

For those patients who cope with the daily effects of degenerative arthritis, the physicians at Finger Lakes Orthopedics can offer the expertise of an individualized treatment plan for you involving conservative therapies and surgical treatments to bring to optimize functioning and happy knees in 2016!

Citations:

1. Sutton, Karen MD, Bullock JM MD. Anterior Cruciate Ligament Rupture: Differences between males and females. American Journal of Orthopedic Surgery, Jan 2013 Vol 21 (1)

2. Jeff Illife MD. The Importance of Sleep, TEDMED, Life Hacks, series 2 .WWWTEDMED.com, Sept 2014)

3. Kyun Ho Shin,1 Haseok Lee,2 Seonghyun Kang,2 You-Jin Ko,3 Seung-Yup Lee Effect of Leukocyte-Rich and Platelet-Rich Plasma on Healing of a Horizontal Medial Meniscus Tear in a Rabbit Model, Hindawi May 2015 Article ID 17956- 7 pages