What Are the Red Flags for Knee Pain

Article featured on The Noyes Knee Institute

Knee pain can result from overexertion, injury, or medical conditions like arthritis. This pain hinders daily activities like walking, decreasing your overall productivity. At Noyes Knee Institute, we’ll treat your knee pain to improve your quality of life. Here are some red flags that necessitate seeing an orthopedic knee surgeon:

Sudden Severe Pain

Sudden severe pain with no apparent cause can indicate a serious knee injury. This could include a meniscus tear, torn ligament, fractured bone, or a dislocated kneecap. Seek immediate professional help if the sudden severe pin limits your movement or ability to bear weight on the affected knee.

At Noyes Knee Institute, we have decades of experience helping patients with severe knee pain. We’ll identify the root cause of your pain and create a personalized treatment plan to get you back to your active lifestyle.

Buckling of the Knee

Knee buckling may signal instability in the knee joint or a ligament tear. Ligament tears like anterior cruciate ligament (ACL) tears can make the knee unstable. This results in a sensation of the knee giving way during weight-bearing activities.

At Noyes Knee Institute, we’ll ask questions about the buckling sensation and order imaging tests to determine if you have a torn ACL. We have a 95% rehabilitation success rate, having conducted over 5,000 ACL reconstruction surgeries. You’ll be in safe hands if you need ACL reconstruction surgery.

Swelling and Warmth

Swelling and warmth around the knee joint can indicate an inflammatory condition like arthritis or an infection. Inflammation can cause the knee joint to become painful and warm to the touch. Sometimes the swelling may be accompanied by a limited range of motion and joint stiffness.

At Noyes Knee Institute, we’ll determine the root cause of the swelling by conducting a physical examination and ordering blood tests. The examination allows us to determine whether your range of motion has been affected. Blood tests will enable us to identify underlying systemic conditions like infections or rheumatoid arthritis.

Knee Locking

Healthy knees are flexible. You should be able to rotate your knees slightly and bend them up and down. Their flexibility allows you to perform daily living activities like standing and sitting. If you can’t, you may be dealing with a locked knee.

Locked knees fall into two categories: true-locked knee and pseudo-locked knee. You can’t move your knee in any direction with a true-locked knee. A pseudo-locked knee occurs when pain in the knee joint is too severe to move the knee. True-locked knees can occur because of limited blood supply to the knees. Pseudo-locked knees can occur because of a tear in the ligament cushioning the knee joint, knee joint dislocation, or fractures.

At Noyes Knee Institute, we’ll conduct imaging tests like MRIs and CT scans to determine whether you have a true or pseudo-locked knee. Our orthopedic knee surgeon, Dr. Noyes, may recommend surgery to remove the obstruction limiting blood supply in the knee joints if our tests determine that you have a true-locked knee. If you have a pseudo-locked knee, we’ll recommend conservative treatments like activity modification and medication.

Persistent Pain

Persistent knee pain that doesn’t improve with rest, ice, compression, and elevation (RICE) or doctor-prescribed conservative treatments like pain medications can signal a serious underlying condition. Seek professional help if your pain progresses over time to find an effective solution.

At Noyes Knee Institute, we’ll conduct a joint aspiration to understand your condition. This involves removing a fluid sample from the knee joint to determine if there’s an infection, inflammation, or other underlying condition before recommending treatment.

Consistent Knee Pain After Surgery

It’s normal for patients to feel knee pain for a few weeks after surgery. The pain should wear off as your knee heals. Your surgery may have failed if you continue experiencing pain, swelling, and bruising around your knee months after surgery. This calls for revision surgery.

At Noyes Knee Institute, we only use grafts from FDA-approved tissue banks for our surgeries and take patients through an active rehabilitation program after their procedures. This, combined with Dr. Noyes’s expertise in orthopedic surgery, improves your chances of having a successful revision surgery.


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Joints That Are Most Commonly Affected by Arthritis

Article featured on Healthgrades

Arthritis is a long-term (chronic) condition that causes joint inflammation. When you’re living with arthritis, a simple task, such as tying your shoe or buttoning your shirt can become a challenging one. Not only does the swelling and aching interfere with work and daily living activities, it can also be painful and sometimes debilitating.

There are more than 100 different types of arthritis, but the most common include rheumatoid arthritis (an autoimmune disease) and osteoarthritis (a “wear-and-tear” condition related to aging, injury or obesity). Both cause joint stiffness, pain and decreased range of motion, and can affect many different joints throughout the body.

1. Knee

The knee is one of the most common joints affected by osteoarthritis. This happens when there’s a breakdown of cartilage, which cushions the ends of the bones where they meet the joints. Symptoms of knee arthritis include stiffness, swelling, and pain, which can make it hard to walk and get in and out of chairs and bed. In severe cases, osteoarthritis in the knees can lead to disability.

2. Hand

When you have arthritis in your hands, it usually includes aching, stiffness or numbness in the fingers or at the base of the thumb joint, making it difficult to pinch or grip items. Small, bony knobs may appear on the middle or end joints (those closest to the fingernails) of the fingers, which can become enlarged and gnarled. This type of arthritis in the hands seems to run in families.

3. Hip

The hip is also a common arthritis site. You may have pain and stiffness in your hip joint, but some people also notice pain in the groin, buttocks, lower back, or front or inner thigh. Or they may have pain in only one of these areas. This type of hip arthritis can affect your ability to move or bend, and make daily activities a challenge.

4. Spine, Neck and Back

Arthritis in the spine usually results in stiffness and pain in the neck or lower back, but in some cases, it may not lead to any pain at all. Arthritis changes can also cause pressure on the nerves where they exit the spinal column, leading to weakness, tingling or numbness of the arms and legs. Since these symptoms can often seem like other health conditions, always check with your doctor for a diagnosis.

5. Foot and Ankle

Arthritis can also cause swelling and pain in the foot and ankle. It most often affects the joint at the base of the big toe, which can make walking difficult. The swelling can also lead to bunions on the toes, which can sometimes make the pain and deformity of the foot worse. With rheumatoid arthritis, the same joints on both sides of the body (such as both feet or both ankles) are usually affected.

6. Elbow

Joint inflammation can also be to blame for elbow pain or loss of function. Rheumatoid arthritis is the most common type of arthritis in the elbow, and if one elbow is affected, the other likely will be, too. While elbow osteoarthritis is more common in weight-bearing joints, such as the knee and hip, it can also occur in the elbow, and is often the result of overuse or an injury, such as in the case of a tennis or baseball player.


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

What is Knock Knees?

 Article featured on Nationwide Childrens’
Genu valgum (knock-knees) is a common lower leg abnormality that is usually seen in the toddler, preschool and early school age child. In genu valgum, the lower extremities turn inward, causing the appearance of the knees to be touching while the ankles remain apart. Knock knees usually is first seen in late toddlerhood. Often parents may have noticed the knees bowing out (genu varum) when the child first started walking but by age 3, the child has developed knock knees. Genu valgum is most severe by age 3 but then usually resolves on its own by age 7-8. Knock knees are slightly more common in girls than boys.

Types of Knock Knees (Genu Valgum)

  • Physiologic (normal growth and development) variant (MOST COMMON)
  • Pathologic
    • Rickets
    • Previous metaphyseal (shaft) fracture of the proximal tibia or sometimes called “Cozen’s Phenomenon”
    • Multiple epiphyseal dysplasia (bone and cartilage disorder affecting ends of leg bones)

Clinical Findings

While standing, the child’s knees will touch or be closer together then the ankles which are further apart.

Diagnostic Studies

No x-rays or other imaging studies are done to diagnosis physiologic genu valgum.

What Is the Treatment for Knocks Knees (Genu Valgum)?

No special type of brace, shoes, or other orthotic devices has been found to improve or speed up the resolution of knock-knees. The only treatment for genu valgum is time and normal growth and development.

Majority of children with genu valgum resolve on their own but if the knock-knees increase in severity or does not improve by age 10, then further evaluation and testing may be warranted.


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

What is a Torn MCL Recovery Time?

Article featured on Summit Orthopedics

MCL stands for medial collateral ligament. It’s a ligament on the inside of the knee. Like all ligaments, the MCL is a strong, tough band of tissue that connects one bone to another bone.

What is an MCL tear?

Although an MCL tear can happen to anyone, athletes are most at risk. It can happen when an athlete suddenly twists or changes direction. It can also happen when something hits the athlete’s knee. Sports like football, basketball, rugby, volleyball, and skiing can result in MCL tears. MCL tears are the most common knee ligament injury.

MCL tears are classified as “partial” or “complete.” In a partial MCL tear, the ligament has torn partway, but some of the ligament’s fibers remain attached. In a complete tear, the ligament has snapped, fully separating into two pieces.

What are the symptoms of an MCL tear?

Symptoms of an MCL tear include:

  • Pain and tenderness in the knee
  • Stiffness and swelling in the knee
  • A feeling of instability, as if your knee might give out

What is a torn MCL treatment and recovery time?

If you suspect you’ve torn or damaged your MCL, the first thing to do is to get it evaluated by an orthopedic specialist. Your provider will conduct a physical exam and may order imaging tests, like an X-ray, ultrasound, or MRI, to confirm the diagnosis.

Surgery is not always required, and in fact, many people recover from a torn MCL with conservative measures. Treatment options for a torn MCL include:

  • RICE, which stands for rest, ice, compression, and elevation, is a cornerstone of conservative care for an MCL injury.
  • Devices to help immobilize your knee, like a knee brace, and devices to keep your weight off the knee, like crutches. Whether you need to use these depends on how severe your injury is, so talk with your provider for specific recommendations.
  • Anti-inflammatory medicines, like ibuprofen (Advil) or naproxen (Aleve) to help with the swelling and inflammation after the injury.
  • Physical therapy — anyone can benefit from physical therapy after a knee injury, including an MCL tear. If you’re an athlete who wants to heal fully after an MCL tear and return to your full strength in your sport, physical therapy is essential. It can make the difference between long-term stiffness or instability and a full return to your former strength, agility, and flexibility.

MCL tear recovery time varies depending on how severe the tear is and whether or not you had surgery to repair the tear:

  • Minor MCL tears can heal in one to three weeks.
  • More severe MCL tears can take six weeks to heal, and some can take longer.
  • If you have MCL surgery, you can expect to need eight to 16 weeks to heal completely.

Your specific recovery time will depend on your unique injury.


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Painful Knee Caps: What Causes Them?

Article featured on The Noyes Knee Institute

Pain in the knee caps (patella) is caused by several factors, ranging from old age and overuse to injury and infection. A strenuous activity during the day can cause mild discomfort around the knee, which heals with rest and sleep. Knee cap pain can also be persistent and chronic, calling for the services of an experienced orthopedic knee surgeon. Here’s an overview of the five leading causes of knee cap pain:

1. Knee Overuse

The patella is a knee joint bone structure that suffers wear and tear. Your knee supports walking, jogging, running, jumping, kneeling, and squatting. Straining the knee joint through overuse can result in pain and discomfort around the patella. Knee cap pain resulting from overuse may stop if the strenuous activity is ceased or moderated. Other cases trigger a degenerative process with intermittent and worsening pain.

2. Knee Injury

The knee cap protects the rest of the knee joint structures, including ligaments, cartilages, and muscles. A traumatic blow to the front of the knee area is likely to hurt the patella first, resulting in severe pain. A knee injury can result from falling, participation in sports, a car crash, or other situation strenuous situations. Pain from injury may go away with functional medicine and physical therapy, but occasionally requires knee surgery to repair the damage.

3. Chondromalacia Patellae

Knee cap pain can stem from Chondromalacia, a condition in which the cartilage found behind the patella softens. Normal cartilage is tough and flexible to protect the ends of the joint bones from rubbing on each other. When the cartilage becomes soft, the shinbone and thighbone can move too close to each other or even touch. Chondromalacia weakens cushioning and shock absorption capabilities, resulting in pain around the knee joint, including the patella. With rest and treatment, this condition can heal.

4. Patellofemoral Pain Syndrome (PFS)

PFS or runner’s knee is a widespread condition highlighted by pain behind the knee cap area. It develops when the knee joint moves abruptly. PFS also results from knee overuse through running, cycling, climbing, and other strenuous activities. Pain levels vary from mild to severe and are felt around the front of the knee (patella). Runner’s knee is common among athletes and starts as dull recurring pain. This condition is reversible.

5. Muscle Imbalances & Tendonitis

The knee joint relies on the thigh, hip, and knee muscles, which work in tandem to ensure proper movement and support. Injury or imbalance can result in the wrong movements and reflexes, causing pain and inflammation. Conditions like tendonitis inflame the patellar tendons and quadriceps tendons, causing stiffness, tenderness, swelling, and knee pain. Injury, disease, or infection on one of the connected muscles and tendons can cause pain.

Working With a Trusted Orthopedic Knee Surgeon

Knee cap pain can be reversed with rest and sleep, but some conditions are severe and require proper medical attention. Others will need a corrective operation from a licensed orthopedic knee surgeon.


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Common Dance Injuries and Prevention Tips

Article featured on Johns Hopkins Medicine

Dance may look effortless, but it requires a lot of strength, flexibility and stamina. It also comes with a high risk of injuries. Whether you are a dancer, the parent of a dancer or a dance teacher, you should be aware of the most common dance injuries and learn how to avoid them.

Johns Hopkins performing arts physical therapists Andrea Lasner and Amanda Greene share valuable information about dance injury treatments and prevention tips. Lasner and Greene, both dancers, have turned their love for the art into a means of helping injured dancers.

What are some common dance injuries?

A few studies that looked into dance injuries found that injuries from using your joints and muscles too much (overuse injuries) are the most common in dancers. The majority of these overuse injuries involve an ankle, leg, foot or lower back. Some common dance injuries are:

  • Hip injuries: snapping hip syndrome, hip impingement, labral tears, hip flexor tendonitis, hip bursitis and sacroiliac joint dysfunction
  • Foot and ankle injuries: Achilles tendonitis, trigger toe and ankle impingement
  • Knee injuries: patellofemoral pain syndrome
  • Stress fractures: metatarsals, tibia, sesamoids and lumbar spine
  • Dancers are also likely to develop arthritis in the knee, hip, ankle and foot

Generally, dancers have a much lower rate of anterior cruciate ligament (ACL) injuries than other athletes. One explanation could be that dance training involves much more intense jumping from an earlier age than other sports, which helps improve muscle control.

How do I know if the pain is from an injury?

In most cases, the pain you experience after dancing is muscle soreness that usually subsides within 24 to 48 hours. Sometimes, it takes a few days for muscles to get sore, which is also normal. However, if you experience the following types of pain, you may have suffered an injury:

  • Pain that wakes you up at night
  • Pain that is present at the start of an activity
  • Pain that increases with an activity
  • Pain that makes you shift your weight or otherwise compensate your movements

If you experience such pain, consult with a medical specialist — preferably a physical therapist or physician with experience in treating dancers. They will be able to determine whether additional testing is needed and will formulate an appropriate treatment plan.

Why do dance injuries happen?

Dance is a physically demanding activity. Dancers perform repetitive movements for several hours a day. Studies have shown that dancing five hours a day or longer leads to an increased risk of stress fractures and other injuries.

On top of the intensive training, many dancers get little time to recover between the sessions and have no “offseason.” Restrictive diets and unhealthy body weights may also contribute to dance injuries. Proper nutrition is important for dancers of all ages.

How do dancers get ankle sprains?

Ankle sprains are the number one traumatic injury in dancers. Traumatic injuries are different from overuse injuries as they happen unexpectedly. When an ankle is sprained, ligaments on the inside or outside of your foot get twisted or overstretched and may experience tears. Ankle sprains often happen due to improper landing from a jump, misaligned ankles (when they roll in or out) or poorly fitted shoes. Torn ligaments never heal to their preinjury condition. Once you’ve sprained your ankle, you are at risk of doing it again. It’s important to build muscle strength to prevent further injuries.

Dance Injury Prevention

How can dance injuries be prevented?

The majority of overuse injuries and even some traumatic dance injuries can be prevented. Follow these guidelines to reduce your risk of injury:

  • Eat well and stay hydrated before, during and after class.
  • Get enough rest and avoid overtraining.
  • Do cross-training exercises to build strength and endurance in all parts of your body.
  • Always wear proper shoes and attire.
  • Always warm-up before training or performances.
  • Lead a healthy lifestyle and get to know your body.

When injuries happen, address them immediately and get advice from a doctor or physical therapist.

What are good cross-training exercises for dancers?

Core and hip strengthening exercises like Pilates and stability-based yoga are great for dancers. And so are aerobic and cardiovascular activities, such as running, swimming or biking. They get your heart rate up and help build stamina for long performances.

Many dancers don’t do enough cardio during their regular training. Just 30 minutes three to four times a week is usually enough to improve your endurance. As always, do this in moderation and in short intervals to avoid stressing your joints. Being screened by a physical therapist with experience treating dancers will help you identify individual areas of weakness to address with specific exercises.

How much rest should a dancer get?

While many experts stress the importance of proper rest, there are no specific guidelines on the frequency and amount of rest. However, we know that dancing five hours a day or longer is linked to an increased risk of injury. It is also known that intense activity leads to microdamage, which peaks in recovery 12 to 14 hours after a workout. So it would make sense to take the next day off after a high-intensity activity. Dancers should work at their highest intensity a couple of times per week and then take at least two days off, preferably in a row. Also, a three- to four-week period of rest after the season is ideal for recovery.

Dance Injury Treatment

Should I ice or heat after a dance injury?

If it’s a sudden injury, it’s best to apply ice first to reduce swelling and inflammation. RICE treatment is a common approach that involves rest, ice, compression and elevation. After a few days, you can switch to heat to increase blood flow to the area and promote healing. However, every person is different. If you feel that ice helps you better than heat, then there is nothing wrong with continuing to ice. But be careful not to ice before dancing or stretching, because you want those muscles to be warmed up to prevent re-injury.

What are my treatment options for a dance injury?

It depends on the type of injury, your level as a dancer and many other factors. For example, for traumatic injuries like ankle sprains, your doctor may recommend RICE, joint protection and physical therapy. For stress fractures you may need to limit weight on your foot by using crutches, wearing a leg brace or walking boots. Surgery is typically used as the last resort. It is best to discuss your treatment options with a doctor who specializes in dance injuries. And if you are working with a physical therapist, make sure he or she is experienced in treating dancers. A big part of physical therapy is correcting the training technique that led to the injury. Otherwise, you risk hurting yourself again by making the same mistake.

What should be in the first aid kit for dance injuries?

Your regular first aid kit might already have many of the essentials for handling a medical emergency. However, when it comes to common dance injuries, you may want to include a few additional items, such as:

  • Instant cold pack
  • Pre-wrap and athletic tape (if qualified providers are available to apply)
  • Elastic bandages (to be used only for compression, not support while dancing)
  • Crutches
  • Topical pain reliever

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Common ACL Tear Symptoms & When to Seek Treatment

Article featured on The Noyes Knee Institute

If you experience pain around your knee area, it is advisable to contact an orthopedic knee surgeon as soon as possible. The pain may stem from a torn anterior cruciate ligament (ACL). Such situations may call for surgery to prevent further damage to your knee joint.

The ACL is one of four ligaments in your knee. It is located behind the patella (kneecap) and connects the thigh bone to the shin bone. The posterior cruciate ligament (PCL), medial collateral ligament (MCL), and lateral collateral ligament (LCL) are the other three ligaments.

ACL Tear Symptoms

ACL stabilizes the knee when you rotate and can get torn when you make sudden stops or changes in direction. Injuries can also result from high-impact sports and maneuvers such as jumping and landing. A torn ACL has many signs, depending on the severity of the injury. Popular symptoms include:

1. Popping Sounds

A loud popping sound is the most common symptom of a torn anterior cruciate ligament. You will hear the popping sound at the moment of injury. Silent pops may also occur when you try to stand or move the knee joint. ACL tears can also result in a painful grinding feeling of your kneecap and bones.

2. Pain and Swelling

A popping sound may indicate other issues but is often a result of torn ACL, especially when accompanied by pain and swelling. The pain is severe at the moment of injury and becomes sharper when you try to get up or put pressure on the knee. In most cases, the pain is quickly accompanied by inflammation/swelling of the knee area.

3. Inability to Bear Weight

You will barely be able to stand a few minutes after an ACL tear. The anterior cruciate ligament is responsible for stabilizing your knee when you move or change directions. Tears in the band of tissue compromise this function, making it difficult to bear your weight or continue with any activity.

4. Lost Range of Motion

ACL tears can result in loss of range of motion, making it impossible to bend, walk, or sprint. Lost range of motion usually stems from excruciating pain. Your knee surgeon will test the range of motion to determine the severity of your pain and injury. Regaining range of motion is also a good sign during ACL tear recovery.

When to Seek Treatment

The knee is one of the most complex joints and harbors ligaments, tendons, tissues, and bones. It is crucial to seek a medical diagnosis immediately if you experience the symptoms of an ACL tear. Proper diagnosis will reveal the scale of injury and determine the best remedy.

Some cases can resolve with rest and rehabilitation. Others require medication, physical therapy, or surgery to remove the damaged parts. Diagnosis involves reviewing your medical history and symptom patterns.

The physician will also conduct a physical examination and may use X-ray scans or request an MRI to assess damage to bones, cartilage, and menisci. After diagnosis, the knee doctor will determine whether you need non-surgical or surgical treatment.

Working With an Orthopedic Knee Surgeon

The first assessment will determine if knee surgery is essential. If such is the recommendation, you should immediately seek an experienced orthopedic knee surgeon. There are various types of surgeries used to treat ACL tears.


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

9 Things You Didn’t Know About Runner’s Knee

Article featured on Healthgrades

Runner’s knee, the common term for patellofemoral pain syndrome, is a knee problem that affects many people. It happens when your kneecap (patella) is either misaligned because of a defect, or your knee is stressed, causing it to be out of alignment. Although it is painful, runner’s knee is usually not a serious knee injury, although it can have a significant impact on your life by limiting your activity. How much do you know about runner’s knee? Here are some facts about the condition that might surprise you.

1. You don’t need to be a runner to get runner’s knee.

Patellofemoral pain syndrome is called runner’s knee because it affects a lot of runners. However, many people who never run anywhere also develop runner’s knee. It’s like people who don’t golf can get golfer’s elbow, or those who don’t play tennis can get tennis elbow. Anyone who participates in an activity that bends the knee and puts a lot of strain on it is at risk of developing runner’s knee. This includes cycling, walking, jumping or climbing up and down stairs.

2. Repetitive movements can irritate your knee.

Do you have a job that requires you to bend and squat a lot? When you squat repeatedly, your knee makes the same movement and carries your body’s weight in the same places over and over again. You could be squatting to lift boxes, pick items off the floor, or reach lower shelves. Even parents of young children who have to pick them or their playthings off the floor are at risk of irritating their knees to the point of developing runner’s knee.

3. Your hamstring could be causing runner’s knee.

Your hamstrings are really three muscles in the back of your thigh. They help you extend and retract your leg. You may feel your hamstrings pull if you bend at your waist without bending your knees or you straighten your legs in front of you while sitting on the floor. When your hamstrings are too tight, they cause extra stress on your knees and could cause runner’s knee. Exercises and stretches to loosen the hamstrings can help reduce knee pain and keep it from coming back.

4. Your glutes can also cause runner’s knee.

Like your hamstrings, your gluteus medius, a muscle in your buttocks, may also be the culprit behind your runner’s knee. Instead of being too tight, like the hamstrings, if your gluteus medius, or glutes, are not tight enough, the rest of your leg tries to compensate. This puts stress on your knee. The gluteus medius is responsible for helping to pull your leg away from your body and rotate it externally. This is called hip abduction. If the muscle isn’t strong enough, the other muscles respond by trying to pull the leg inward instead.

5. Flat feet can equal knee pain.

Your feet play a vital role in your knees’ health. If you have flat feet, a low arch, or no arch at all, this puts your feet in an unnatural position when you step forward, particularly when you run. The impact of walking or running without arch support can cause extra tension on the muscles in your legs and pull on the knee, causing misalignment and stress. Wearing appropriate shoes and orthotics in your shoes can help fix how your foot lands when you take a step, taking stress off your legs and knees.

6. Where you exercise could cause runner’s knee.

Concrete and asphalt are unforgiving surfaces. If you’re running or playing sports on these hard surfaces, the stress on your legs and knees could cause runner’s knee. The solution is to run or play on more forgiving surfaces, like synthetic tracks, grass or dirt. This is also where good shoes appropriate for the activity are beneficial. They can help absorb some of the shock of running and jumping, taking away some of the stress on your knees.

7. Women are more prone to developing runner’s knee.

Doctors aren’t entirely sure why more women than men develop runner’s knee, but overall women do develop more knee problems. A woman’s pelvis is wider than a man’s. This wider pelvis affects how a woman stands and places a different type of pressure and strain on the knee. As well, women tend to have looser ligaments, the tough fibrous tissue that connects bones. Women also land on their feet differently when they run or jump, adding to the difference in knee stress.

8. Runner’s knee can be easy to treat.

Once you know what is causing your runner’s knee, it can be fairly easy to treat. If it is caused by improper foot support, good shoes or orthotics will help. If it’s caused by too tight ligaments or muscles, physical therapy and exercise can ease the pain and reduce the risk of it returning. Muscles too weak? Strengthening them at home or in a gym will help. Running on a hard surface? Switch locations for a gentler landing when you run or jump. The key is working at it and staying consistent.

9. Surgery is rarely necessary for runner’s knee.

Doctors only consider surgery for runner’s knee if you have tried non-surgical treatment for 24 months and you still have pain. It’s rarely necessary. If you have runner’s knee and you have faithfully tried all the exercises and changes recommended by your doctor or physical therapist, an orthopedic surgeon will assess you to see if surgery will help.


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

6 Ways to Ruin Your Knees

Article featured on WebMD

Whether you’re a seasoned athlete, a weekend warrior, or totally laid-back when it comes to exercise, knowing how to protect your knees from damage can mean the difference between a fulfilling lifestyle and longterm, strained mobility.Cruising on the track in the heat of a roller derby match, 27-year-old Rachel Piplica was not at all prepared for the realization that her knee could sideline her from competitive skating for months, possibly years.”Suddenly, I heard a pop and it felt like my knee bent sideways. The pain was so bad I just fell and crawled away,” Piplica tells WebMD.The Los Angeles fashion designer who skates under the name Iron Maiven tried to keep going. “I took one more stride and my knee just let go again. The doctor immediately said, ‘I think you tore your ACL.'”

Piplica had experienced some warning signs during her previous season of skating as captain of her team, but she ignored them for the most part. “I had tremendous pain in my leg anytime I’d squat down so I just kept my right leg straight. But I never saw a doctor for it. I just assumed, ‘I’m in a contact sport and this is what happens,’” she tells WebMD.

Knee deep: A complex and vulnerable joint

Her torn ACL diagnosis confirmed, Piplica quickly learned how susceptible the knees can be to injury. According to the American Academy of Orthopaedic Surgeons, these joints are responsible for sending nearly 15 million Americans to the doctor every year.

And it’s not just athletes who suffer. Knee problems can happen to anyone.

“Because they’re the main hinge between the ground and the rest of your body, the knees serve as your ‘wheels’ that get you around and allow you to be active,” says University of Pennsylvania orthopedic surgeon and sports medicine specialist Nicholas DiNubile, MD. “Life can really go downhill when you damage your knees,” says DiNubile, who is a spokesman for the American Academy of Orthopaedic Surgeons and author of FrameWork – Your 7-Step Program for Healthy Muscles, Bones and Joints.

Bound by an intricate system of ligaments, tendons, cartilage, and muscle, the knee is highly prone to injury. It’s a complex hinge where the femur (thigh bone), tibia (shin bone), fibula (next to tibia) and kneecap all come together.

“It’s hard to find the right balance between mobility and stability; the knee needs to move back and forth, twist a little, and pivot too,” DiNubile says. The knee’s ligaments can tear, its tendons can swell up, osteoarthritis can take hold, and even everyday wear and tear can ruin a perfectly good set of knees.Here are six pitfalls you can avoid to save your knees.

1. Ignoring knee pain.

An occasional ache here and there is common. “But knowing when you can and can’t ignore pain is key,” says sports medicine specialist Jordan Metzl, MD, from the Hospital for Special Surgery in New York City.

Metzl’s rule of thumb: When the pain limits your ability to do what you normally do, you need to have it checked out.

“If your body is sending you signals, you need to listen to them. If they persist, you need to have it checked out,” he tells WebMD.

For Piplica, exploratory surgery revealed a torn meniscus she had endured in the past — unbeknownst to her — followed by the more recent ACL tear.

“In hindsight, maybe that first injury could have been repaired earlier, although I don’t know if I could have avoided this one altogether,” she says. “At least I would have been more careful.”

2. Being overweight.

Every pound of body weight yields five pounds of force on the knee, so even 10 extra pounds can put a considerable load on those joints.

Being overweight also increases your chances of osteoarthritis in the knee, a common and often disabling form of arthritis that wears away the knee’s cushiony cartilage. Excess pounds also cause existing arthritis to worsen more rapidly. According to the CDC, two out of three obese adults suffer from knee osteoarthritis at some time in their life.

Although diet and exercise are critical for weight loss, it’s a double-edged sword.

“If your knees hurt, it’s harder to lose weight through exercise,” says Metzl. So he recommends activities that go easy on the knee.

For example, opt for a stationary bike over running on the treadmill, and walk on a flat surface instead of hilly turf. If you’re a die-hard treadmill fan, then go for longer sessions of walking punched with brief intervals of brisk walking or running every three to five minutes, DiNubile says.

3. Not following through with rehab and rest.

The rest and rehabilitation period after a knee injury is critical to avoiding future pain or reinjury. Depending on the type of damage and treatment, recovery could last anywhere from a couple of weeks to several months.

“During the rehab period, you need someone to help you tell the difference between something that just hurts, and something that’s going to do you harm,” says DiNubile.He tells WebMD that many of his young athlete patients are too eager to return to regular play as soon as they stop limping. He advises patients to work with an orthopedic surgeon, a sports medicine physician, a physical therapist, an athletic trainer, or some combination of these pros, in order to ensure proper focus is placed on gradually strengthening the knees.

4. Neglecting your ACL.

One of the most commonly injured ligaments in the knee, the anterior cruciate ligament (ACL) is responsible for about 150,000 injuries in the U.S. every year.

As Piplica learned firsthand, sports like roller derby that involve quick cuts, twists, and jumping, put the ACL at higher risk for rupturing. More traditional high-risk sports include soccer, basketball, football, and volleyball.Women in particular have a two- to eight-times higher risk for ACL tears compared to men, mainly because the way women naturally jump, land, and turn puts greater strain on the ACL.However, male and female athletes alike can be trained to “rewire” themselves and thus lower risks of knee injury. That’s done through neuromuscular training, which involves supervised practice in improving agility, leg strength, and jump-landing techniques for better knee joint stability.These specialized techniques are effective in reducing risks of knee injury by almost one-half, according to a 2010 review of seven neuromuscular training studies.

“Given what we know in how useful it can be in reducing ACL tears, it’s irresponsible of coaches and parents to not require athletes to undergo neuromuscular training,” says DiNubile.

He recommends that athletes of any age who play ACL risk-prone sports should seek help from an athletic trainer or other trained professional to help avoid this debilitating injury.

5. Overdoing it.

“You make gains in fitness when you work hard and then allow your body to recover. You can’t do a hard workout every day,” Metzl says.

A sudden increase in intensity or duration of exercise can cause overuse injuries from repetitive strain. Tendonitis and kneecap pain are common symptoms in the knee.Pushing too hard is also related to overtraining syndrome, a physiological and psychological condition among athletes in which they exceed their ability to perform and recover from physical exertion, often leading to injury or lowered performance.Be sure to include stretching exercises before and after working out. And follow hard training days with easy ones so your body can recover.6. Overlooking other muscles around the knees.

Weak muscles and lack of flexibility are primary causes of knee injuries. When the muscles around the kneecap, hip, and pelvis are strong, it keeps the knee stable and balanced, providing support by absorbing some of the stress exerted on the joint.DiNubile stresses the importance of building the quadriceps and hamstring muscles, as well as proper strengthening of the body’s core muscles, including the obliques, lower back muscles, and upper thigh.
His favorite tool to help accomplish this strengthening is a Swiss medicine ball. Other exercises to try are knee extensions, hamstring curls, leg presses, and flexibility exercises.Piplica recalls realizing just how weak some of her leg muscles were.”Roller girls are striding out so much with their outer leg muscles, but we aren’t necessarily working our inner knees,” she says. “I remember when I would run for exercise, my calves and shins would hurt so bad. That surprised me, because I thought if anything was strong, it was my legs.”Piplica says she wishes she had been better educated about crosstraining activities for roller skaters, and what muscle groups they need to focus on to keep their knees healthy.

As she awaits surgery to repair her torn ACL, Piplica tells WebMD that her perspective on long-term care for her knees has definitely changed.

“Half of me is frustrated about not being able to skate sooner, but the other half knows how important it is to get better so I don’t do this again. I’m 27 years old with a serious knee injury preventing me from moving around. So I need to look beyond just skating, skating, skating. I don’t want to have knee problems when I’m 40 or 50 because I’m not giving my body the kind of attention it needs right now.”


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

How to Walk Towards Healthier Knees

Article featured on ScienceDaily

A new study published today in Arthritis & Rheumatology led by researchers at Baylor College of Medicine reveals that walking for exercise can reduce new frequent knee pain among people age 50 and older diagnosed with knee osteoarthritis, the most common form of arthritis. Additionally, findings from the study indicate that walking for exercise may be an effective treatment to slow the damage that occurs within the joint.

“Until this finding, there has been a lack of credible treatments that provide benefit for both limiting damage and pain in osteoarthritis,” said Dr. Grace Hsiao-Wei Lo, assistant professor of immunology, allergy and rheumatology at Baylor, chief of rheumatology at the Michael E. DeBakey VA Medical Center and first author of the paper.

The researchers examined the results of the Osteoarthritis Initiative, a multiyear observational study where participants self-reported the amount of time and frequency they walked for exercise. Participants who reported 10 or more instances of exercise from the age of 50 years or later were classified as “walkers” and those who reported less were classified as “non-walkers.”

Those who reported walking for exercise had 40% decreased odds of new frequent knee pain compared to non-walkers.

“These findings are particularly useful for people who have radiographic evidence of osteoarthritis but don’t have pain every day in their knees,” said Lo, who also is an investigator at the Center for Innovations in Quality, Effectiveness, and Safety at Baylor and the VA. “This study supports the possibility that walking for exercise can help to prevent the onset of daily knee pain. It might also slow down the worsening of damage inside the joint from osteoarthritis.”

Lo said that walking for exercise has added health benefits such as improved cardiovascular health and decreased risk of obesity, diabetes and some cancers, the driving reasons for the Center for Disease Control recommendations on physical activity, first published in 2008 and updated in 2018. Walking for exercise is a free activity with minimal side effects, unlike medications, which often come with a substantial price tag and possibility of side effects.

“People diagnosed with knee osteoarthritis should walk for exercise, particularly if they do not have daily knee pain,” advises Lo. “If you already have daily knee pain, there still might be a benefit, especially if you have the kind of arthritis where your knees are bow-legged.”


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm