How to Walk Towards Healthier Knees

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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

Osteoarthritis and Runner’s Knee Can Both “Bring You to Your Knees”

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Article featured on Noyes Knee Institute

Pain in the knee area is a common issue among athletes. However, anyone can experience knee pain. It is vital to get proper treatment to get rid of the pain. More importantly, you should seek to understand the issue before considering treatment or scheduling a knee surgeon.

Will I Need a Knee Surgeon for Runner’s Knee?

A proper diagnosis from an orthopedic doctor is essential if your knee aches whenever you get from a chair or while walking, jogging, and running. You may also or experience a  constant dull ache around the knee area. Osteoarthritis (OA) and runner’s knee and are common causes of knee aches.

Injury, disease, and extra strain on the knees may also result in more sharp pain. You won’t necessarily need surgery to relieve knee pain or correct the underlying issue. The doctor will perform various tests and scans to determine what’s causing the pain.

How’s Runner’s Knee Different from Osteoarthritis?

Runner’s knee is medically referred to as patellofemoral syndrome and is basically pain experienced around your kneecap area. It occurs when you overuse your knees. Running, training, jogging, squatting, and climbing may exert excess stress on your kneecap.

If the kneecap isn’t moving properly in its groove, it may wear out the protective cartilage that prevents bones from rubbing on each other. Runner’s knee symptoms include a dull pain/ache in the kneecap area, especially after sitting for extended periods or when walking, running, and jumping.

Osteoarthritis is another form of knee pain among adults 50 years and older. It simply refers to knee joint arthritis. OA pain results from bones rubbing against each other when the cartilage begins to wear out, which is similar to what happens with runner’s knee.

Common symptoms of osteoarthritis include pain that gets worse over time, stiffness, warmth, swelling, redness, and difficulty maneuvering (bending/straightening) the knee. Arthritis pain may feel worse when you wake up or during bad weather. OA and the runner’s knee have many overlapping symptoms.

How Can I Relieve Runner’s Knee and Osteoarthritis?

It is essential to seek medical advice if you experience any pain around your knee area. Runner’s knee is common among track athletes, while osteoarthritis is widespread among older people of all levels of physical activity. However, both conditions can certainly happen to people of all ages.

Your orthopedic doctor will assess the pain and determine the right treatment option. Each case is unique, so pain stemming from injuries, such as falls, will require different treatment from cases of knee overuse. Below are the vital steps in relieving all types of knee pain:

  • Get Diagnosis – You should consult an orthopedic doctor for a comprehensive diagnosis of the issue to determine the underlying cause and scale of damage.
  • Discuss Treatment – The doctor will discuss different remedies available for your case. Common options include therapy, medication, injections. Surgery may be required in severe cases.
  • Ongoing Recovery – Your doctor will recommend various practices, including physical therapy, pain relievers, lifestyle changes, etc.

Advanced Knee Treatment

Both runner’s knee and osteoarthritis can cause severe pain and require prompt addressing. Without proper treatment, the condition may get worse, calling for advanced procedures and longer recoveries. As such, you should seek professional advice as soon as you notice the pain.

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

What Kind of Injuries Cause Knee Pain?

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Article featured on Noyes Knee Institute 

Are you someone that has been dealing with knee pain that affects you daily? Conditions like these can affect people at any time and age. Thankfully, you can benefit from the expertise of an orthopedic knee surgeon, no matter what your situation is.

Today, we’ll discuss some common injuries that can cause knee pain. We’ll also talk about when you should see a doctor to address this.

Meniscus Tears

When people talk about torn knee cartilages, they’re likely talking about a meniscal tear. The menisci are two pieces of cartilage that cover the end of your bones. They can either tear suddenly during sports events or slowly due to aging.

When the meniscus tears due to aging, medical experts refer to it as a degenerative tear. As for sudden tears, you may experience or hear a pop in the knee. Once the injury occurs, you may witness higher levels of pain over the next few days.

Anterior Cruciate Ligament (ACL) Injuries

The ACL ligament runs diagonally down the front of the knee and provides stability to your joints. Injuries that occur in the ACL can be serious and even require surgery. ACL injuries can range from a Grade 1 mild sprain to a Grade 3 total tear.

ACL tears can occur as a result of these movements that occur in sports or non-sport events.

  • Awkward jumps and landing
  • Colliding with others
  • Quick direction shifts
  • Sudden starts and stops

Any ACL or other ligament injury can result in serious knee pain that may indicate the need for surgery.

Post Traumatic Arthritis (PTA) In The Knee

PTA is a form of arthritis that occurs as a result of serious knee injuries. Injuries such as broken bones or ligament tears can wear down your joint surface. That, in return, can also lead to arthritis as time goes by.

These injuries can lead to damage to your knee cartilages as you age and lead to pain, stiffness, and swelling. If you experience these symptoms, contact your orthopedic knee surgeon to discuss the right pain relief options for you.

Tendon Issues

Tendon injuries, such as tendonitis or tendon tears, commonly occur in athletes or mid-age people that participate in physical activities. Tendons are soft tissues that connect the knee cap to the shinbones. The most common tendon that receives injury is the patellar tendon. This tendon works with the front of the thigh so that a person can run and jump.

Tendonitis is also known as jumper’s knee since this condition is common amongst athletes who jump often. Other types of physically active people can develop this as well.

As for more serious tendon injuries, direct impact from hits or falls can cause a tendon tear. This can lead to severe knee pain, which can require treatment or even surgery.

When Should I See An Orthopedic Knee Surgeon?

It may be time to see an ortho doctor if you’re dealing with these conditions resulting from knee area injuries.

  • Bone injury
  • Chronic pain
  • Muscle injury

Not only do they provide you with unique solutions to treat your condition, but they’ll also give you preventative advice.

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

Options for Treating Arthritis in the Knee

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Article featured on The Noyes Knee Institute

Knee osteoarthritis can occur when the cartilage around the knee wears down. Without the protection of cartilage, bones in the joint grind together, causing inflammation and pain. In severe cases, a knee surgeon might recommend knee replacement or arthroscopic surgery. Fortunately, many non-invasive options help relieve the pain of arthritis in the knee.

Osteoarthritis and Rheumatoid Arthritis: What’s the Difference?

Knee osteoarthritis is a progressive condition in which the subchondral bone suffers damage as the cartilage slowly wears away. This type of arthritis is common in middle-aged and elderly patients and happens more frequently in females than males.

Rheumatoid arthritis (RA) is a disorder of the autoimmune system which leads to chronic inflammation. RA usually presents in both knees at the same time. Other joints, including fingers, toes, ankles, and wrists may also be affected.

Both types of arthritis respond to the conservative treatments listed below. However, as an auto-immune disorder, RA also requires specific medical care.

Treatments for Arthritis in the Knees

Weight Loss

For every pound of weight lost, you relieve four to six pounds of pressure from the knee. Carrying a significant amount of extra weight puts extra strain on knee joints which aggravates arthritis symptoms. However, even if you are not obese, losing just five to ten pounds could significantly relieve arthritis pain.

Avoid Aggravating Activities

While it’s important to continue exercising and moving your knees, overdoing it can make problems worse. Avoid the following activities if you notice pain or swelling up to 24 hours after participation:

  • High-impact exercise/sports
  • Kneeling/squatting
  • Walking for periods longer than 60-90 minutes without a rest break
  • Using stairs (inclining or declining)
  • Sitting in one position for more than 30 minutes without a break (such as during a long drive)
  • Standing for periods longer than 30-60 minutes

It may not be practical to avoid all of these activities every day, but reducing them as much as possible should help alleviate arthritis knee pain.

Anti-Inflammatory Medications

NSAIDs can be extremely helpful in easing arthritis pain. However, it’s important to use prescription or over-the-counter anti-inflammatory medications only as recommended by your physician. Overuse can cause serious side effects.

Knee Injections

Steroid or synthetic lubricant injections such as Synvisc may be recommended when diet and other lifestyle changes are ineffective.

Physical Therapy

Physical therapy and “knee-friendly” exercises are often recommended to help regain strength and flexibility in the knee joint.

Knee Surgery

When conservative methods fail, it may be time to consider knee surgery. Many people automatically think of total knee replacement when they think of surgery for treating knee arthritis, but there are several other surgical options to consider:

  • Arthroscopic debridement, abrasion arthroplasty
  • Autologous chondrocyte implantation
  • Femoral osteotomy
  • High tibial osteotomy
  • Meniscus transplantation
  • Osteochondral autograft transfer
  • Partial knee replacement

You and your knee surgeon will determine the surgical option that’s best for your situation. If you have sustained additional knee injuries, other procedures may be performed simultaneously as surgery to correct arthritis.

Should I see a Knee Surgeon?

If you have tried conservative therapies, but your arthritis pain continues to get worse, it may be time to consider 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, 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 Tips for Parents With Kids Who Have Osgood-Schlatters Disease

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Article featured on Orthogate

Anterior knee pain is a common complaint of young athletes participating in sports. As a teenager, most of the aches and pains disappear as fast as they show up. However, when the pain doesn’t go away it can be frustrating and scary to deal with as a parent. Osgood-Schlatters Disease (OSD) is one of the common ailments that cause pain in the front of knee particularly in teenage athletes ranging from 12-15 years old. Injuries at this age can be a challenge, as kids of that age have difficulty communicating their pain, understand their diagnoses, and can get frustrated with the missed time on the playing field.

Osgood-Schlatters also tends to linger and stay longer than any teenager would like. That’s when you decide to see a doctor. However, OSD is just common enough and not serious enough that some doctors might brush it off as unimportant. What’s a parent to do? Here’s a guide to help you and your growing teenager get through it and maintain the sanity of your household through the process.

What is Osgood-Schlatters Disease?

First, the word disease can be a little misleading. Osgood-Schlatters Disease is less of a disease and more of an overuse injury involving the patella tendon. OSD is most common during the adolescent growth spurt as the bones are maturing. The pull from repetitive movement such as jumping causes tension through the patella tendon on Tibial Tuberosity. This traction injury can cause inflammation, tenderness to the touch, and formation of a painful bony bump to form on the front of the shin.

Risk Factors for Osgood-Schlatters Disease?

The primary risk factors for Osgood-Schlatter disease are repetitive movements during a certain age range. Other risk factors include:

  • Age – OSD is most common during puberty and large growth spurts. The typical range for boys is 12-15 and girls from age 10-13
  • Gender – OSD occurs more frequently boys but the incidence is increasing in young girls as more young ladies are participating in sports
  • Sports – Most commonly found in sports with high force production in the legs such as running, jumping, and cutting. Basketball, hockey, and soccer are the most common sports associated with OSD.

Top Tips for Patients To Help Recover from Osgood-Schlatter Disease

Create a Schedule

This might be the most important tip to consider. Recovering from OSD requires consistency and a schedule can help. Create a daily schedule to ice the tendon, to stretch the quadriceps, and to even perform self-massage can speed up recovery. Also, schedule some downtime to allow the knee adequate rest. Kids tend to have a really hard time understanding the importance of treating their injuries seriously. For good time management skills try writing out daily, weekly, and monthly recovery goals.

Take Active Time Off

OSD is an overuse injury from repetitive patellar tendon tension. If the young athlete continues to play and practice without adequate tendon rest it could re-injure the tendon. This can prolong the recovery timeline and cause more frustration. The tendon needs proper time to heal and this can be difficult during the middle of the season, especially for a teenager. Try to help them understand that active movement and activities such as walking and biking are good but they need to take a break from jumping, running, and sports. Figure out other ways they can be involved with the team while they heal as OSD can take up to 6-8 weeks to heal in severe cases.

Brace it

For mild cases and athletes returning to their sport, a brace may help with pain and prevent a recurrence. A brace for Osgood-Schlatters changes the location of tension from the Tibial Tubercle to the brace. The tendon is allowed to heal with less tension but yet your athlete is still able to participate. This may also stop the progression of new cases of OSD before they become severe and help them get back to sports sooner.

Emphasize Proximal Hip Strengthening

The knee is a slave to the hip and ankle. The knee joint bends forwards and backward but the rotation of the knee is controlled from the joints above and below it. One of the best ways to stabilize the knee focuses on the lateral hip muscles through exercises such as the side-lying clamshell and the single-leg deadlift. The stronger the hip gets, the more stable the knee will become and it will be able to handle more stress. These exercises also won’t aggravate OSD, so they are safe to start at any time.

Talk about Expectations

Taking 4-6 weeks off during the middle of the season may seem like an eternity for a 13-year-old but it’s important to talk about expectations and timelines. The younger teens may not understand the importance of healing now to prevent future complications. They shouldn’t be running or jumping while at school. Take time to talk to them about how they feel about missing playing time. The young athlete may be seen apprehensive about losing their starting spot in the lineup or worry that they will be forgotten by their teammates. Feeling depressed about their injury is fairly common.

Prevent it with Cross-Training

One of the best ways to prevent OSD from returning or starting in the first place is through cross-training. Specializing in one sport has been shown to increase the injury rate in young athletes. The demands of participating in different sports change the repetitive trauma to the muscle, tendons, and ligaments. By playing multiple sports over the year it promotes well-rounded muscle development, better movement quality, and needed rest between seasons. Kids need to be well-rounded athletes before they can specialize.

Conclusion:

Osgood-Schlatters can be a frustrating and scary injury to deal with as a parent. However, with a solid game plan, proper communication, and maintaining active rest,  your young athlete will be back on the field in no time.

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

7 Rare Causes of Knee Pain

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Article featured on Healthgrades

Knee Pain Without Injury

Injury, ongoing stress, and aging are the most common causes of knee pain. But what if none apply? One of several rare causes of knee pain may be at work, including benign tumors, fluid buildup, infection, certain types of arthritis and even genetic mutations. Many of these causes have the exact same symptoms but require very different treatments. It’s important to work with your doctor to arrive at an accurate diagnosis so you can not only start easing symptoms, but also prevent long-term damage to your knee joint.

1. Tenosynovial Giant Cell Tumor (TGCT)

TGCTs are non-cancerous tumors that grow around the knee joint. They can cause pain, swelling, and stiffness that affects your mobility and stability. Your knee may lock up at times, accompanied by a popping or creaking sound (crepitus). If you have symptoms of TGCT, talk with your doctor. Left untreated, TGCT can lead to osteoarthritis that may damage your knee joint and the surrounding cartilage and bones permanently. Treatment options can include surgery, radiotherapy, or targeted medication that works in the body on a cellular level to improve symptoms.

2. Synovial Chondromatosis

Like TGCT, synovial chondromatosis is non-cancerous and can also lead to osteoarthritis that causes damage if not treated. Symptoms are similar, too: knee pain, swelling, and difficulty with movement, sometimes with a popping sound. Unlike TGCT, synovial chondromatosis doesn’t involve tumors. It’s a condition that occurs when a membrane of the knee that lubricates the joint–the synovium–produces cartilage nodules that bump into and damage healthy, protective cartilage in the joint space. Depending on the size and volume of the nodules, either non-invasive or traditional surgery may be recommended.

3. Chondrocalcinosis 2 (CCAL2)

CCAL2 is a genetic disorder caused by a mutation in the ANKH gene. The mutated gene carries calcium crystals to the cartilage around the knee joint, which damages it. Symptoms can vary significantly. They may include knee pain, swelling, and impaired mobility like other knee conditions or they may feel more like sudden attacks of pain with redness and a warm feeling. CCAL2 can’t be cured, but many effective treatments are available to ease symptoms. They include procedures to drain fluid from the knee and medicines such as corticosteroids and nonsteroidal anti-inflammatory drugs (NSAIDs).

4. Pigmented Villonodular Synovitis

It’s not yet known what causes pigmented villonodular synovitis (PVNS), and the symptoms are similar to other knee conditions. When you have PVNS, the lining of your knee joint swells and grows, and fluid builds up. Your doctor may test fluid from your knee to diagnose the condition. Symptoms can come and go, so the first step may be resting your knee and taking nonprescription pain relievers. If symptoms are severe and persist over time, your doctor may recommend surgery to remove your knee joint lining. A non-invasive procedure may be an option.

5. Adult Still’s Disease

Adult Still’s disease is a type of inflammatory arthritis that can come with distinct symptoms in addition to knee pain: rash, fever, and sore throat. Your knee joint may also feel achy, and nearby muscles may hurt. It’s not known what causes Adult Still’s disease, but some research points to infection. The condition is usually treated with one or more of these medicines: NSAIDs; steroids; methotrexate; and biologic drugs that target your body’s inflammatory response at the cellular level.

6. Septic Arthritis

Septic arthritis is a joint infection, and the most common type is Staphylococcus aureus (staph). The infection can be caused by an injury such as a cut or animal bite or it can be introduced during surgery–but it’s usually caused by an infection that has traveled from another part of your body like your urinary tract or skin. Septic arthritis is painful, and it may come with swelling, redness, warmth, or fever. Treatment usually includes draining the fluid around the knee joint and taking antibiotics.

7. Reactive Arthritis

Like septic arthritis, reactive arthritis in the knee can also be caused by an infection that has travelled from another part of your body. The most common types are sexually transmitted infections (STIs) and food poisoning. Antibiotics are usually prescribed to cure the infection. Symptoms include pain and swelling, as well as irritation of the genitals or eyes. If you have any symptoms of a rare knee condition, try to write them down and note how long they last. Bring this information to your doctor’s appointment to inform the diagnosis and help speed your time to treatment.

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

Patellar Tendinitis: Causes and Symptoms

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Article featured on Mayo Clinic

Overview

Patellar tendinitis is an injury to the tendon connecting your kneecap (patella) to your shinbone. The patellar tendon works with the muscles at the front of your thigh to extend your knee so that you can kick, run and jump.

Patellar tendinitis, also known as jumper’s knee, is most common in athletes whose sports involve frequent jumping — such as basketball and volleyball. However, even people who don’t participate in jumping sports can get patellar tendinitis.

For most people, treatment of patellar tendinitis begins with physical therapy to stretch and strengthen the muscles around the knee.

Symptoms

Pain is the first symptom of patellar tendinitis, usually between your kneecap and where the tendon attaches to your shinbone (tibia).

Initially, you may only feel pain in your knee as you begin physical activity or just after an intense workout. Over time, the pain worsens and starts to interfere with playing your sport. Eventually, the pain interferes with daily movements such as climbing stairs or rising from a chair.

When to see a doctor

For knee pain, try self-care measures first, such as icing the area and temporarily reducing or avoiding activities that trigger your symptoms.

Call your doctor if your pain:

  • Continues or worsens
  • Interferes with your ability to perform routine daily activities
  • Is associated with swelling or redness about the joint

Causes

Patellar tendinitis is a common overuse injury, caused by repeated stress on your patellar tendon. The stress results in tiny tears in the tendon, which your body attempts to repair.

But as the tears in the tendon multiply, they cause pain from inflammation and weakening of the tendon. When this tendon damage persists for more than a few weeks, it’s called tendinopathy.

Risk factors

A combination of factors may contribute to the development of patellar tendinitis, including:

  • Physical activity. Running and jumping are most commonly associated with patellar tendinitis. Sudden increases in how hard or how often you engage in the activity also add stress to the tendon, as can changing your running shoes.
  • Tight leg muscles. Tight thigh muscles (quadriceps) and hamstrings, which run up the back of your thighs, can increase strain on your patellar tendon.
  • Muscular imbalance. If some muscles in your legs are much stronger than others, the stronger muscles could pull harder on your patellar tendon. This uneven pull could cause tendinitis.
  • Chronic illness. Some illnesses disrupt blood flow to the knee, which weakens the tendon. Examples include kidney failure, autoimmune diseases such as lupus or rheumatoid arthritis and metabolic diseases such as diabetes.

Complications

If you try to work through your pain, ignoring your body’s warning signs, you could cause increasingly larger tears in the patellar tendon. Knee pain and reduced function can persist if you don’t tend to the problem, and you may progress to the more serious patellar tendinopathy.

Prevention

To reduce your risk of developing patellar tendinitis, take these steps:

  • Don’t play through pain. As soon as you notice exercise-related knee pain, ice the area and rest. Until your knee is pain-free, avoid activities that put stress on your patellar tendon.
  • Strengthen your muscles. Strong thigh muscles are better able to handle the stresses that can cause patellar tendinitis. Eccentric exercises, which involve lowering your leg very slowly after extending your knee, are particularly helpful.
  • Improve your technique. To be sure you’re using your body correctly, consider taking lessons or getting professional instructions when starting a new sport or using exercise equipment.

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

Knee Hyperextension: What is it?

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Article featured on News Medical Life Sciences

Knee hyperextension is a condition caused when the knee straightens too far, beyond the normal maximum limit of 00 and often with the joint in varus malalignment. In the properly aligned knee, the load is borne on a line running down the center of the hip, knee and ankle, but in a varus deformity (bowleg form), the line is shifted outwards and back.

The most common injuries are posterolateral joint injury and avulsion of the bone attached to the anterior cruciate ligament, and they are especially common in young children due to their softer bones. Posterior cruciate ligament, however, is rare.

Causes

Knee hyperextension may occur because of:

  • Trauma caused by impact to the front of the knee, which makes the joint move backward, putting high strain on the anterior cruciate ligament – such as when a football player faces a leg tackle.
  • Pushing the femur or patella over the tibia, the lower leg bone, for example when one slides to a sudden stop using one leg, which stresses the major ligaments within the knee.
  • Genu recurvatum: this is a deformity characterized by knee hyperextension over 5 degrees.
  • Nerve damage, such as Brain injury (congenital, stroke-induced or traumatic), or poliomyelitis, may cause hyperextended gait because of muscle (quadriceps or calf muscle) atrophy, spastic plantar flexion of the ankle, or contractures of the heel tendons.

Symptoms

The cause of hyperextension predicts the symptoms, which may be minor pain and swelling when it occurs to a trivial degree, but may consist of sharp pain, strained or torn cruciate ligaments, avulsion of bone chips accompanying such tears, and bone bruising may occur on the anterior part of the knee joint. When the injury is at the posterolateral aspect, the ACL and the PCL typically tears. The rate of strain doesn’t seem to be the major factor as anterior cruciate ligaments tears vary at all rates of strain. Genu recurvatum may present with knee pain, abnormal gait, and a lack of proprioceptive perception, which makes it difficult to tell when the terminal extension of the knee is attained.

The hyperextended knee gait is marked by various degrees of abnormality. In some, the patient can walk only with the aid of a cane or a crutch. In others with minimal weakness, the knee becomes hyperextended only when the patient walks too much or indulges in other heavy work or exercise, leading to muscle fatigue and loss of joint support. The associated ligamentary and muscle weakness and joint integrity also contribute to the final abnormality of gait, as does the presence of arthritis in the knee joint.

Another symptom is knee instability, or a feeling of giving way at the knee, in part or full, during normal activities.

Pain may be felt over the knee or to the medial side, and is caused by compression of the soft tissues by the malaligned knee, as well as on the posterolateral aspect, due to stretching of the soft tissue. In acute hyperextension injury the knee may pop and acute swelling often occurs within a few hours of the injury. The pain can become too severe for normal support of weight during walking or running.

Anatomy

The knee joint is supported on the lateral and posterior aspects by the fibular collateral ligament, and the popliteus muscle with its tendon and ligament. This complex of structures keeps the knee compartment from widening laterally, prevents dislocation of the lateral surface of the tibial component of the knee to the back, keeps the tibia from rotating, and thus prevents both knee hyperextension and genu recurvatum. The bones may show varus alignment, in some cases. A triple varus knee is caused by three factors:

  • Tibiofemoral alignment is disturbed.
  • The lateral tibiofemoral compartment separation is increased because of weak supporting structures on the posterolateral aspect of the knee.
  • The knee appears bowlegged in skeletal outline when fully extended.

In most cases both the posterolateral structures and the anterior cruciate ligament is damaged or at least weak, as following a knee injury or any other cause of muscle atrophy. Patellofemoral arthritis is another cause, but in this case the hyperextended knee gait is due to pain as well as muscle weakness.

Diagnosis

The history will offer clues to the diagnosis, such as prior knee injury. A physical examination will help confirm and grade the injury, including joint mobility, visible injury, bruising or swelling, and locking of the joint. Imaging is needed in severe injury and especially if surgery is contemplated. MRI and X-ray imaging are typically performed.

Treatment

Minor hyperextension of the knee may require only the R.I.C.E approach:

  • Rest and avoidance of physical activities that strain the knee in any way for a few weeks.
  • Ice application several times a day.
  • Compression using a knee brace and crutches for support are helpful in protecting the ligaments of the knee against any further damage.
  • Elevation to reduce edema.

Severe cases will require physical therapy, with graded exercises of the quadriceps and other hip and knee muscles. This should be done under supervision so that further injury does not occur, and full joint mobility is attained. Surgery is required to reattach torn ligaments and will again be followed by physical therapy.

Correction of the hyperextended knee gait is crucial if the deformity is to be corrected permanently, otherwise the excessive tensile force on the ligaments inside the joint and increased muscle force could increase the load on the joint capsules, especially the medial and lateral compartments. This can be harmful to joint integrity in varus malalignment.

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

Swollen Knee Causes and Treatments

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Article featured on the Mayo Clinic

Overview

A swollen knee occurs when excess fluid accumulates in or around your knee joint. Your doctor might refer to this condition as an effusion (ih-FYU-zhen) in your knee joint. Some people call this condition “water on the knee.”

A swollen knee may be the result of trauma, overuse injuries, or an underlying disease or condition. To determine the cause of the swelling, your doctor might need to obtain a sample of the fluid to test for infection, disease or injury.

Removing some of the fluid also helps reduce the pain and stiffness associated with the swelling. Once your doctor determines the underlying cause of your swollen knee, appropriate treatment can begin.

Symptoms

Signs and symptoms typically include:

  • Swelling. The skin around your kneecap can puff up noticeably, especially when you compare the affected knee to the normal one.
  • Stiffness. When your knee joint contains excess fluid, you might not be able to bend or straighten your leg completely.
  • Pain. Depending on the cause of the fluid buildup, the knee might be very painful — to the point that it’s difficult or impossible to bear weight on it.

When to see a doctor

See your doctor if:

  • Self-care measures or prescribed medications don’t relieve the pain and swelling
  • One knee becomes red and feels warm to the touch compared to your other knee

Causes

Many types of problems, ranging from traumatic injuries to diseases and other conditions, can cause a swollen knee.

Injuries

Damage to any part of your knee can cause excess joint fluid to accumulate. Injuries that can cause fluid buildup in and around the knee joint include:

  • Torn ligament, particularly the anterior cruciate ligament (ACL)
  • Cartilage (meniscus) tear
  • Irritation from overuse
  • Broken bones

Diseases and conditions

Underlying diseases and conditions that can produce fluid buildup in and around the knee joint include:

  • Osteoarthritis
  • Rheumatoid arthritis
  • Infection
  • Gout
  • Pseudogout
  • Bursitis
  • Cysts
  • Tumors

Risk factors

  • Age. Your likelihood of developing a swollen knee related to arthritis increases as you age.
  • Sports. People who participate in sports that involve twisting the knee, such as basketball, are more likely to experience the types of knee injuries that cause swelling.
  • Obesity. Excess weight puts added stress on the knee joint, contributing to the tissue and joint overload and knee degeneration that can lead to a swollen knee. Obesity increases your risk of osteoarthritis, one of the more frequent causes of knee swelling.

Complications

Complications of a swollen knee can include:

  • Muscle loss. Fluid in the knee can harm the working of your muscles and cause thigh muscles to weaken and atrophy.
  • Fluid-filled sac (Baker’s cyst). The buildup of fluid in your knee can lead to the formation of a Baker’s cyst in the back of your knee. A swollen Baker’s cyst can be painful, but usually improves with icing and compression. If the swelling is severe, you might need to have fluid removed (cyst aspiration).

Prevention

A swollen knee is typically the result of an injury or chronic health condition. To manage your overall health and prevent injuries:

  • Strengthen the muscles around your knee. Strong muscles around a joint can help ease pressure on the joint itself.
  • Choose low-impact exercise. Certain activities, such as water aerobics and swimming, don’t place continuous weight-bearing stress on your knee joints.
  • Maintain a healthy weight. Excess weight contributes to the wear-and-tear damage that can lead to a swollen knee.

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

Why Do My Knees Pop?

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Article featured on Cone Health Medical Group

Have you ever bent down to pick up something and heard a loud pop or crack coming from your knees? This sound is called “crepitus,” which is defined as “joint noise.” Popping knees are not unusual. It happens when carbon dioxide builds up in the joint’s synovial fluid and is released as a gas bubble that bursts when the joint adjusts rapidly. It is the same process that causes knuckles to crack.

Most of the time, this noise should cause no concern. There has been a rumor circulating for years that popping joints are a sign of impending arthritis, but there has been no research that supports this.

Some folks may hear a grinding noise in the knee when they squat. This is another form of crepitus and is typically nothing to be concerned about. The sound is caused by the cartilage rubbing on the joint surface and other soft tissue when the knee moves.

Most people experience crepitus their entire lives with no problems.

What if it hurts when my joints pop or grind?

You should be concerned if you have joint noise that is accompanied by pain, discomfort or swelling. This could be a sign that medical attention is required. Two of the most common cause for knee pain are:

  1. Cartilage injury or wear. The underside of your kneecap can unevenly rub on the front of your femur (thigh bone) and cause the cartilage under your kneecap to soften and wear off. Once the cartilage wears off, it hangs around the joint and can irritate the surrounding area. This irritation can result in pain when squatting, climbing stairs or even sitting for an extended period.
  2. Meniscus tear. The rubbery disc that cushions your knee and absorbs shock is called the meniscus. It can tear when there is an unexpected twist or turn in the joint, usually when the knee moves and the foot stays stationary. With aging comes greater risk of a meniscus tear, even through everyday activities.

What are the treatment options for knee injuries?

  • Rest – Stay off your knee as much as possible.
  • R.I.C.E. – Rest, ice, compression and elevation will promote healing and reduce swelling.
  • Knee Brace – There are many kinds, so it is best to consult your care provider for advice.
  • Physical therapy – A physical therapist can help you learn techniques and exercises to strengthen your knee and allow it time to heal.
  • Surgery – Minimally invasive surgery, especially for meniscus tears, can repair the tear and clear out any tissue causing pain, swelling and irritation.  

To help protect the knees, try exercises that develop the quadriceps, which are the muscles in the front of the thigh. Exercises that benefit this muscle group are walking, cycling and swimming. Other effective ways of protecting the knees are wearing supportive shoes, warming up before and stretching after exercise, and maintaining a healthy body weight.

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