Facts on Meniscus Injuries, Tears, Surgery, Massage & Natural Treatments +Patellofemoral Disorder, PES Ansyritis Bursitis, Osteoatthritis

  A friend of mine has a Meniscus Injury / Tear and other injuries so I decided to do some research and this is what I found.  

 

You feel a sudden pop or your knee locks. How do you know if it’s a torn meniscus? This is one of the most common types of knee injuries. Even before you go to the doctor, some signs and symptoms can tell you if there is a meniscus tear. Plus, natural treatments may help you even more than surgery.

 

 

 

 

 

 

 

 

 

 

 

The word meniscus means “crescent” in Greek. This makes sense because the menisci (plural for meniscus) are two C-shaped wedges of cartilage in your knee. They serve as joint cushions and stabilizers, and they facilitate smooth knee joint movement. You have a meniscus located in the middle (medial) and outside (lateral) part of each knee. The image above shows the relationship between the meniscus and the bones around your knee. The femur is your thighbone, and the patella is your kneecap. Your menisci are incredibly tough and resilient.

For instance, when you run, the impact of about five times your body weight compresses your meniscus with each stride. A 6-minute mile takes an average of 1,064 steps to complete. That’s a total of 2,660 times your body weight pounding down on each meniscus after running a mile. Even just the 5,000 to 7,000 steps per day of the average adult takes its toll on your menisci.  

9 Things to AVOID with a Meniscus Tear!

 

What Causes Meniscus Tears?

There are several different ways you can tear your meniscus. For most sports-related injuries, the damage occurs when you squat or twist the knee. Any kind of knee impact may also result in a meniscus tear. A very common situation causing meniscus tears is when you pivot while running. If you get tackled at the same time, the chance of damage is even higher.

Moreover, as you age, your menisci lose their elasticity and thickness. This means they can get torn much easier. Even just a small misstep or rising out of a chair can cause a meniscus tear in older adults.

What Are the Symptoms Of Meniscus Tear?

The symptoms of a Meniscus Tear, Causes, and Natural Treatments depend on the severity of the injury and your age. For example, after a high-velocity sports injury, you might feel a pop and some pain. Still, many athletes keep playing after a meniscus tear if no other damage has been done to the knee.

For older adults, you might not even remember injuring your knee. Plus, a small tear can get gradually worse in time.

In general, there are three different levels of meniscus tear:

1. Mild

Minor pain and/or swelling. Symptoms may disappear after two or three weeks.

2. Moderate

You have pain on one side of the knee. Swelling appears and can worsen over time. Pressure or knee stiffness is common. You might feel sharp pain with certain movements like squatting or twisting. Symptoms may disappear after a few weeks but can linger on and off until you get treatment.

3. Severe

Torn pieces of the meniscus can get stuck in your knee joint. This may cause your knee to lock or pop. You might also feel joint instability or your knee can even collapse without warning.

If you push along the side of your knee where the bones meet (an area called the “joint line”) and it hurts, this could be the sign of a meniscus tear.

How Is A Meniscus Tear Diagnosed?

If you injure your knee and have the symptoms we described, there’s a pretty good chance your meniscus is torn. Still, to be 100 percent sure, you should see a joint specialist. After asking you about your injury, the doctor will examine your knee. Currently, the best way to diagnose a torn meniscus is by having an MRI scan.

Meniscus Tear Treatment

The kind of treatment depends a lot on the location and severity of the tear. The outer edge of each meniscus has a rich blood supply. The chances of healing are better for tears in those areas. The deeper the tear, the less chance there is for spontaneous healing.

Other factors to consider in Meniscus Tear Causes and Natural Treatments are symptom severity, activity level, and age. For instance, if you are a highly competitive athlete, you’ll probably want a faster more aggressive treatment. The average adult, however, may be willing to take their time to avoid risks such as surgery.

Is Surgery The Right Option For Your Torn Meniscus?

In 2006, there were about 1 million arthroscopic knee surgeries performed in the United States, and about 700,000 of those were for meniscus tears. A recent 2017 study noted that surgery for a meniscus tear is “one of the most popular orthopedic procedures, but long-term results are not entirely satisfactory.” In this article, let’s learn about how Is Meniscus Surgery Safe.

Indeed, if you or a loved one has been told that you have a torn meniscus and that you need surgery, you may want to do some more reading before going under the knife. Studies have shown that, in many cases, Meniscus surgery is not safe or produces no better results than time and physical therapy.

What Is A Knee Meniscus?

Everyone has two menisci (plural of meniscus) in each knee — one on the inside of the knee and one on the outside. These C-shaped pieces of cartilage face each other in the center, forming a sort of figure-8 padding that cushions and supports the knee joint. Each one is like a cap on top of the shinbone and both rest underneath the articular cartilage that supports the thighbone.

Throughout your life, the menisci protect the knee joint surfaces and help absorb shock from your activities. In addition to dissipating forces across the knee joint, they also help stabilize it as you move. When you walk, for example, the forces shift from one meniscus to the other, with each absorbing part of the load.

The menisci are hearty pieces of cartilage, but they can be damaged or torn. When that happens, you may experience pain and other symptoms that cause you to seek your doctor’s advice.

What Is A Torn Meniscus?

A torn meniscus is one of the most common knee injuries and occurs when one of the menisci is injured. Although these parts of the knee are made of cartilage, they can still be torn as the fibrous tissues are susceptible to damage.

Moreover, if you were able to look at it, you would see an actual tear injury with potentially ragged edges, much like a torn piece of paper. The tear can also occur along the edges of the meniscus or somewhere in the middle of it.

Doctors usually divide meniscus tears into two types:

1. Traumatic Tear

This type of tear occurs quickly and during activity. It usually is the result of a forceful twisting action while the knee is flexed, such as what may occur during an athletic event or during a slip and fall. It also commonly occurs together with an anterior cruciate ligament (ACL) injury. The ACL is a ligament that connects the thighbone to the shinbone.

2. Degenerative Tear

This type of tear is related to the degeneration of the cartilage that occurs with age or as the result of arthritis. If the articular cartilage breaks down, the bone surface may tear into the meniscus. Repetitive stress on the knee, such as that which may occur with a job that requires a lot of squatting, can also lead to a degenerative meniscus tear.

Doctors also categorize a tear in terms of how it’s shaped. A “bucket-handle” tear, for example, often occurs in the middle of the meniscus and is wide and long. A longitudinal tear is slimmer and often near the edges. A “parrot-beak” tear is more angular in shape and takes a “bite” out of the inside of the meniscus. A “radial” tear occurs on the inside edge and looks like you took the two sides of the C-shaped cartilage and pulled them apart, to create a tear in the middle. A “complete” tear goes all the way through the meniscus, separating a piece of it from the rest.

Doctors may describe the tear as “stable” or “unstable.” A stable tear is on a meniscus that doesn’t move and is, therefore, more likely to heal on its own. An unstable tear is on a meniscus that is likely to move around abnormally and could cause additional complications if not surgically repaired.

How the tear is shaped, where it occurs on the meniscus, and how severe it is all factor into the doctor’s decision for treatment. Minor tears, for example, are often treated conservatively with rest and exercise while more severe, larger tears may require Meniscus surgery.

How Do I Know If I’ve Suffered A Torn Meniscus?

Pain is the most common symptom of a tear, but pain alone could signal other problems too.

Only a doctor can determine if you have a tear, so it’s important that you make an appointment, in the meantime, you can also watch for these other symptoms:

  • Sharp, intense pain in the knee
  • Swelling (may be recurrent in degenerative tears)
  • Difficulty walking and going up and down stairs
  • Difficulty straightening and bending the knee
  • Catching, locking, clicking, and pinching sensations
  • A feeling that the knee is “giving way”
  • A “pop” or tearing sensation at the time of the acute injury (in the case of a traumatic tear)

Symptoms vary depending on the type of tear. An acute tear, for example, is likely to cause symptoms right away, but a degenerative tear may result in a slower onset of symptoms. Pain is usually the first one. It may go away with rest but then will return with activity. Movement can also cause the swelling to return or worsen.

How Is A Torn Meniscus Treated?

Treatments vary depending on how severe a tear is, and whether or not it’s stable. Tears that occur in the outer portion of the meniscus are more likely to heal on their own as that area receives a richer blood supply than the inside area. As blood comes into the area, the tear receives the nutrients it needs to heal. Tears on the inside of the meniscus may need more time, but some of these may heal on their own as well.

Common nonsurgical treatments include the following:

1. RICE

Rest, regular icing, a compression wrap, and elevating the injured knee are sometimes all that’s needed to help it heal; it’s also a good approach for treating the injury even if you go on to use other treatments as well

2. Anti-inflammatory Medications

These anti-inflammatory help to reduce pain and swelling, and also include over-the-counter options like ibuprofen and aspirin.

3. Physical Therapy

Certain exercises and stretches can help reduce swelling and restore a normal range of motion; physical therapy can be used as a treatment on its own or before or after safe Meniscus surgery

4. Injections

Corticosteroid injections can help relieve pain and inflammation, but they can be used for only a limited amount of time.

5. Electrical Stimulation

Stimulation of the muscles around the knee can help improve support for the meniscus while it heals.

No matter which of these treatment methods are used — sometimes, a combination of treatments works best — it’s best to be patient. Healing typically takes six to eight weeks. If none of these options are effective, safe Meniscus surgery may be necessary.

Surgeons typically choose one of two options:

  • Repair

During safe meniscus surgery to repair the meniscus, the surgeon uses sutures to stitch the tear back together.

  • Removal (Meniscectomy)

During a meniscectomy, the surgeon removes part of the meniscus or the entire thing; if he or she removes only part, he or she often repairs what is left; only as a last resort is the whole thing removed as without the meniscus, the knee is left with much less support, which can lead to additional complications down the road, including accelerated arthritis.

The Downsides Of Surgery For A Meniscus Tear

No one wants to go through Meniscus Surgery if not safe, but if your doctor tells you it’s required, then most likely it’s the best option, right?

Not always. In fact, according to several studies, Meniscus surgery often is safe creates no better results than physical therapy, and, sometimes, can result in worse outcomes.

In 2014, scientists reported that there had been an increased number of surgical meniscus repairs performed in the U.S. during a period of seven years, with a doubling of repairs from 2005 to 2011. Similar increases have been reported in other countries, with Denmark reporting a doubling of meniscal procedures between 2000 and 2011, with the largest increases in middle-aged and older patients.

Meanwhile, there have been more studies published questioning the effectiveness of these surgeries. The researchers in the Denmark study also stated, “This increase [in surgeries] contrasts with the mounting evidence showing no added benefit of arthroscopic partial meniscectomy over nonsurgical treatments.”

In 2007, for example, researchers compared two treatments for nontraumatic meniscus tears: surgery with exercise afterward and exercise alone. Results also showed that the surgery provided no additional benefits. Both groups reported decreased pain, improved knee function, and high satisfaction. Researchers therefore concluded that safe Meniscus surgery was not superior to exercise alone in terms of reduced knee pain, improved knee function, and improved quality of life.

Later, in 2013, researchers zeroed in on degenerative meniscal tears and found again that surgery plus physical therapy worked no better than physical therapy alone. Both groups showed clinical improvements at 2-year and 5-year follow-ups with no differences found.

Furthermore, the researchers wrote, “The findings indicate that arthroscopic surgery followed by exercise therapy was not superior to the same exercise therapy alone for this type of patients. Consequently, exercise therapy can be recommended as initial treatment.”

One-third of the patients from the exercise-alone group still had disabling symptoms after exercise therapy but improved after a partial meniscectomy.

In another study of 351 patients, researchers looked at data from those who had surgery and compared it to data from those treated with physical therapy alone and found no significant differences between the two groups in functional improvement after six months. About 30 percent of physical therapy patients undergo surgery within six months.

Several other studies have found similar results — that in the majority of cases, particularly when dealing with degenerative meniscal tears, surgery works no better than physical therapy alone. One study even compared meniscectomy surgery to “sham surgery.” Patients either received a real partial meniscectomy or underwent a procedure in which they received a couple of small incisions so that they thought they went through surgery.

Again, the results were no different between the two groups — both experienced improvements in pain and knee function. Furthermore, there were no significant differences between the groups in the number of patients who required subsequent knee surgery.

There are some cases where surgery may be needed down the road but considering these findings, it seems that most patients could benefit from physical therapy before determining whether surgery is needed.

Can Surgery Create Other Complications?

Surgeons know that if they remove part or all of the meniscus, there is a higher risk for knee arthritis down the road. In a 2017 study, for example, researchers analyzed data from 335 patients who went through a meniscectomy and found that 18.8 percent had to undergo knee replacement surgery in the same knee years later. Researchers then concluded that patients going through meniscectomy had a threefold increased risk of future knee replacement surgery.

When something’s wrong, we often feel compelled to try to “fix” it. Because of that, surgery can be a compelling option. Researchers looked at 53 studies comparing surgery to a placebo and found that in about half the trials, the surgery had no better effect than the placebo.

Meniscal tears are much more common than you may think and can often heal on their own (with a little exercise). In fact, they often exist in older patients without causing any symptoms.

In 2006, researchers reported that meniscal tears were almost equally found in symptomatic (causing pain) and asymptomatic (no-pain) knees and that they were common in older patients. A 2008 study also reported similar findings, stating that meniscal tears are “common in the general population and increase with increasing age.” This finding casts doubt on the idea that most meniscal tears need surgery.

Types Of Exercise That Can Help A Torn Meniscus To Heal

Always check with your doctor before engaging in any exercise or physical therapy program for a torn meniscus.

Below are some commonly recommended exercises that can help:

1. Knee Extension

Lie on your back and place a rolled-up towel under the heel, so it’s about 6 inches off the ground. Relax and allow your knee to straighten gradually. Try to hold for 2 minutes and repeat three times.

2. Heel Slide

Lie on your back, legs out. Keeping the heel down, slide the foot along the ground slowly while bending the knee upward. Slide the heel as far toward the buttocks as you can and hold.

3. Straight-Leg Raise

Lie on your back with your good knee bent and the injured leg straight. While holding that leg straight, lift it gradually, so your heel is about 12 inches off the floor. Hold for 5  seconds and lower slowly.

4. Hamstring Curl

Lie on your stomach with your legs straight. Bend your injured knee, bringing the heel toward your buttocks. Go as far as you can and hold and then lower slowly.

5. Clam Exercise

Lie on your good side with hips and knees bent, feet together. Raise your top leg toward the ceiling while keeping the heels touching. Hold for a couple of seconds and lower slowly. Repeat.

6. Hip Abduction

Stand on the uninjured leg, feet together. Hold onto something nearby for support, if needed. Raise the injured leg straight out to the side as far as you can slowly, then bring it back to center slowly.

7. Heel Dig

Lie on your back, both knees bent, ankles bent so that only your heels are digging into the floor. Pull the belly button toward the spine and lift your hips off the floor gradually until the shoulders, hips, and knees are in a straight line. Hold for about 5 seconds and lower slowly to the floor. Repeat.

The meniscus is a layer of cartilage in the knee with several important functions Source. It helps:

  • distribute loads across the knee joint
  • absorb shock from walking and other activities
  • provide stability to the knee

A tear can occur due to too much strain, sometimes due to exercise. Common symptoms include:

  • pain
  • swelling
  • clicking
  • catching
  • locking
  • weakness

This injury is more common among military personnel on active duty and other very active people. The risk is generally higher among males over 40 years.

Learn more about a torn meniscus.

Recovery times

Less severe meniscus tears can improve in 4–6 weeks with rest and physical therapy. Others may require surgery, and recovery can take up to 6 months.8

For people with less severe tears, doctors may recommend gentle exercises.

It is normal for these exercises to cause a little discomfort. If any exercise causes pain, however, stop doing it.

1. Mini squats

Mini squats can help strengthen the quadriceps, large muscles at the front of the thigh, without putting too much pressure on the knees.

To perform mini squats:

  • Stand with the back, shoulders, and head against a wall.
  • The feet should be shoulder-width apart and about 1 foot from the wall.
  • Slightly bend the knees, bringing the buttocks toward the ground.
  • At around 15 degrees of the bend, stop.
  • Hold the position for 10 seconds, then slowly bring the body back up to the starting position, keeping the back and shoulders against the wall.
  • Perform 2 sets of 8–10 repetitions. Rest for between 30 seconds and 1 minute between the sets.

Keeping the back and shoulders against the wall is key, as it reduces stress on the knees.

2. Quadriceps setting

Quadriceps setting exercise gif

This exercise is isometric, meaning it works the muscles by keeping the body in a static position.

To perform the quadriceps setting:

  • Sit or lie flat on the ground, with the legs extended away from the body.
  • Contract the quadriceps, using them to push the backs of the knees toward the floor.
  • Hold this position for 5 seconds.
  • Perform 2 sets of 10 contractions, resting for 30 seconds to 1 minute between sets.

3. Straight leg raise

This exercise stretches the hamstrings and strengthens the quadriceps.

To perform straight leg raises:

  • Lie on the floor with the left foot flat and the right leg extended.
  • Keeping the back and pelvis in a neutral position, flex the right foot and tighten the right thigh muscles, slowly lifting the right leg off the floor.
  • After lifting the right leg to around 45 degrees, slowly lower it back to the floor.
  • Perform 2 sets of 10 repetitions before switching to the left leg.

4. Hamstring curls

Hamstring curls exercise gif

This exercise strengthens the hamstrings —the muscles at the backs of the thighs.

To perform hamstring curls:

  • Lie on the stomach, keeping the legs straight.
  • Slowly bend the right knee, lifting the right foot toward the buttocks.
  • Slowly lower the right foot.
  • Perform 2 sets of 8–10 repetitions, resting for around 30 seconds.
  • Repeat this with the left leg.

5. Hamstring heel slide

Hamstring heel dig exercise gif

This is another hamstring exercise that also helps build strength in the abdominal muscles.

To perform hamstring heel slides:

  • Lie on the back with both legs out straight.
  • Bend the knee and slide one heel up towards the bottom as far as comfortable.
  • Hold at the end of 5 seconds before returning to the starting position.
  • Perform two sets of 8–10 repetitions, resting for 30 seconds to 1 minute between sets.

6. Standing heel raises

Standing heel raises exercise gif

This exercise is good for building strength in the calf muscles.

To perform standing heel raises:

  • Stand with the feet hip-width apart, with the hands resting on a heavy, solid piece of furniture for support.
  • Slowly lift the heels off the floor as far as is comfortable.
  • Pause in this position, then slowly lower the heels to the floor.
  • Perform 3 sets of 8–10 repetitions, resting for 30 seconds to 1 minute between sets.

7. Clams

clam exercise gif

This exercise works many different muscles, including the hip abductors and the muscles of the buttocks.

To perform clams:

  • Lie on the left side, keeping the hips and feet aligned at all times.
  • Bend the knees 45 degrees, and slowly raise the top knee as high as possible without moving the lower back or pelvis.
  • Slowly lower the top knee to its starting position.
  • Perform 2 sets of 8–10 repetitions, resting for around 1 minute between sets.
  • Repeat on the right side.

8. Leg extensions

leg extension exercise gif

Leg extension exercises build strength in the thighs. A person can safely perform them multiple times a day.

To perform leg extensions:

  • Sit on a chair or bench with your feet flat on the floor.
  • Flex the right foot, then lift it, straightening the right leg.
  • Slowly lower the right foot to the starting position.
  • Repeat this 10 times, then do the same with the left leg.
Exercises to avoid

Some exercises are too strenuous for people with meniscus tears. A person should not:

  • do deep squats
  • do any exercise that involves pivoting or that otherwise twists the knee
  • use free weights to make any of the above exercises harder

Massage for Meniscus Injuries

Discuss in depth the research and science about the Facts on Meniscus Injuries, Tears, Surgery, Massage & Natural Treatments
More Info from ChatGPT
 
Meniscus injuries are common in both athletes and non-athletes alike, and understanding the research and science behind these injuries, as well as their treatments, is crucial for effective management. Here’s an in-depth look at the facts surrounding meniscus injuries, tears, surgery, massage, and natural treatments:
 
  1. Meniscus Anatomy and Function: The meniscus is a C-shaped cartilage structure located in the knee joint between the femur (thigh bone) and the tibia (shin bone). It acts as a shock absorber, helps distribute weight evenly across the joint, and provides stability during movement.
  2. Causes of Meniscus Injuries: Meniscus injuries commonly occur due to twisting motions while the knee is bent, such as during sports activities like soccer, basketball, or skiing. They can also result from degenerative changes associated with aging or wear and tear over time.
  3. Types of Meniscus Tears: Meniscus tears can be classified based on their location, pattern, and severity. Common types include longitudinal tears (vertical tears along the length of the meniscus), radial tears (tears from the inner edge to the outer edge), and bucket-handle tears (where a portion of the meniscus displaces into the joint).
  4. Symptoms: Symptoms of a meniscus tear may include pain, swelling, stiffness, locking or catching sensations in the knee, and difficulty fully straightening or bending the knee.
  5. Diagnosis: Diagnosis of a meniscus tear typically involves a combination of physical examination, imaging tests such as MRI (Magnetic Resonance Imaging), and sometimes diagnostic arthroscopy (a minimally invasive procedure where a tiny camera is inserted into the knee joint).
  6. Treatment Options: a. Conservative Management: Depending on the severity and location of the tear, conservative treatments such as rest, ice, elevation, physical therapy, and nonsteroidal anti-inflammatory drugs (NSAIDs) may be recommended to manage symptoms and promote healing, particularly for minor tears or in cases where surgery is not feasible or warranted. b. Surgery: Surgical intervention, such as arthroscopic meniscus repair or partial meniscectomy (removal of the torn portion of the meniscus), may be necessary for larger or complex tears, or when conservative treatments fail to provide relief. The decision to undergo surgery depends on various factors including the individual’s age, activity level, the extent of the tear, and overall knee health. c. Massage Therapy: Massage therapy may be used as a complementary treatment for meniscus injuries to help alleviate pain, reduce muscle tension, improve circulation, and promote relaxation. However, it should be performed by a qualified therapist and tailored to the individual’s specific condition to avoid exacerbating symptoms or causing further damage. d. Natural Treatments: Certain natural remedies and lifestyle modifications may also be beneficial in managing meniscus injuries. These include maintaining a healthy weight to reduce excess stress on the knee joint, practicing proper body mechanics and technique during physical activities to prevent injury, incorporating strengthening and flexibility exercises into your routine to support knee stability and function, and consuming a balanced diet rich in anti-inflammatory foods such as fruits, vegetables, whole grains, and omega-3 fatty acids.
  7. Recovery and Rehabilitation: Recovery from a meniscus injury, whether managed conservatively or through surgery, typically involves a structured rehabilitation program focused on restoring strength, flexibility, and function to the knee joint. This may include exercises to improve the range of motion, strengthen the surrounding muscles (especially the quadriceps and hamstrings), enhance proprioception (joint position sense), and gradually reintroduce activities to avoid re-injury.
  8. Prognosis: The prognosis for meniscus injuries varies depending on factors such as the type and severity of the tear, the effectiveness of treatment, and individual factors such as age, overall health, and activity level. While many people experience significant improvement with appropriate management, including conservative measures or surgical intervention, some may continue to experience lingering symptoms or develop complications such as osteoarthritis in the affected knee joint over time.

In summary, meniscus injuries are a common orthopedic problem with various causes, symptoms, and treatment options. Understanding the research and science behind these injuries, as well as the effectiveness of different treatment approaches, can help individuals make informed decisions about their care and optimize outcomes. It’s important to consult with a qualified healthcare professional for accurate diagnosis and personalized treatment recommendations based on individual needs and circumstances.

 

Patellofemoral pain syndrome

 

Patellofemoral (puh-tel-o-FEM-uh-rul) pain syndrome is pain at the front of the knee, around the kneecap. The kneecap also is known as the patella. Patellofemoral pain syndrome is sometimes called runner’s knee. It’s more common in people who run and who play sports that involve running and jumping.

 

The knee pain often increases when running, walking up or down stairs, sitting for long periods, or squatting. Simple treatments, such as rest and ice, often help. But sometimes patellofemoral pain needs physical therapy.

Symptoms

Patellofemoral pain syndrome usually causes a dull, aching pain in the front of the knee. The following can increase the pain:

  • Walking up or down stairs.
  • Kneeling or squatting.
  • Sitting with a bent knee for long periods of time.

When to see your doctor

If the knee pain doesn’t improve within a few days or it gets harder to move the knee, call your health care provider.

Causes

Patellofemoral pain syndrome can have several causes. It’s been linked with:

  • Overuse. Running or jumping sports put repeated stress on the knee joint, which can cause irritation under the kneecap.
  • Muscle imbalances or weaknesses. Patellofemoral pain can occur when the muscles around the hip and knee don’t keep the kneecap in line. Moving the knee inward during a squat has been linked to patellofemoral pain.
  • Injury. Trauma to the kneecap, such as when the kneecap gets out of place or breaks, has been linked to patellofemoral pain syndrome.
  • Surgery. Knee surgery can increase the risk of patellofemoral pain. This is especially true of repair to the anterior cruciate ligament using one’s own patellar tendon as a graft.

Risk factors

Factors that can increase your risk include:

  • Age. Patellofemoral pain syndrome typically affects teens and young adults. Arthritis is more often to blame for knee problems in older people.
  • Sex. Women are twice as likely as men to develop patellofemoral pain. This may be because women have wider pelvises. A wider pelvis increases the angle at which the bones in the knee joint meet.
  • Certain sports. Running and jumping sports can put extra stress on the knees. This is especially true when adding more training.

Prevention

Sometimes knee pain just happens. But certain steps may help prevent the pain.

  • Build strength. Strong leg and hip muscles help keep the knee balanced during activity. Avoid deep squatting during weight training.
  • Move safely. Ask a physical therapist about exercises to help you jump, run, and turn correctly. It’s especially important to strengthen outer hip muscles. This will help keep your knee from caving inward when you squat, land from a jump, or step down from a step.
  • Lose excess pounds. If you’re overweight, losing weight relieves stress on the knees.
  • Warm-up. Before running or doing other exercise, warm up with five minutes or so of light activity.
  • Stretch. Promote flexibility with gentle stretching exercises.
  • Build up slowly. Don’t suddenly increase your workouts.
  • Mind your shoes. Wear shoes that fit well and are designed for the activity.

PES Ansyritis Bursitis (Knee Tendon)

Bursae are small, jelly-like sacs that are located throughout the body, including around the shoulder, elbow, hip, knee, and heel. They contain a small amount of fluid and are positioned between bones and soft tissues, acting as cushions to help reduce friction.

Pes anserine bursitis is an inflammation of the bursa located between the shinbone (tibia) and three tendons of the hamstring muscle at the inside of the knee. It occurs when the bursa becomes irritated and produces too much fluid, which causes it to swell and put pressure on the adjacent parts of the knee.

Pain and tenderness on the inside of your knee, approximately 2 to 3 inches below the joint, are common symptoms of pes anserine bursitis of the knee

Cause

Bursitis usually develops as the result of overuse or constant friction and stress on the bursa. Pes anserine bursitis is common in athletes, particularly runners. People with osteoarthritis of the knee are also susceptible.

Several factors can contribute to the development of pes anserine bursitis, including:

  • Incorrect training techniques, such as neglecting to stretch, doing excessive hill running, and sudden increases in mileage
  • Tight hamstring muscles
  • Obesity
  • Being duck-footed or having knock knees
  • Osteoarthritis in the knee

Symptoms

The symptoms of pes anserine bursitis include:

  • Pain slowly develops on the inside of your knee and/or in the center of the shinbone, approximately 2 to 3 inches below the knee joint.
  • Pain increases with exercise or climbing stairs
  • Puffiness or tenderness to the touch in this area

Doctor Examination

Your doctor will examine your knee and talk to you about your symptoms.

Symptoms of pes anserine bursitis may mimic those of a stress fracture, so an X-ray is usually required for diagnosis. Symptoms may also mimic those of a medial meniscus tear.

Treatment

Treatment of pes anserine bursitis is almost entirely non-operative.

Athletes with pes anserine bursitis should take steps to modify their workout program so that the inflammation does not recur.

Other treatments include:

  • Rest. Discontinue the activity or substitute a different activity until the bursitis clears up.
  • Ice. Apply ice at regular intervals three or four times a day for 20 minutes at a time.
  • Anti-inflammatory medication. Non-steroidal anti-inflammatory medication (such as aspirin, ibuprofen, and naproxen) may ease the pain and reduce the inflammation. You can also use topical NSAIDs, like over-the-counter diclofenac gel.
  • Injection. Your doctor may inject a solution of anesthetic and steroid into the bursa, which often provides prompt relief.
  • Physical therapy. Your doctor may recommend physical therapy for specific stretching exercises, and ice and ultrasound treatments.

Osteoarthritis

While age is a major risk factor for osteoarthritis of the knee, young people can get it, too. For some people, it may be hereditary. For others, osteoarthritis of the knee can result from injury or infection or even from being overweight. Here are answers to your questions about knee osteoarthritis, including how it’s treated and what you can do at home to ease the pain.

Osteoarthritis, commonly known as wear-and-tear arthritis, is a condition in which the natural cushioning between joints – cartilage – wears away. When this happens, the bones of the joints rub more closely against one another with less of the shock-absorbing benefits of cartilage. The rubbing results in pain, swelling, stiffness, less ability to move, and, sometimes, the formation of bone spurs.

Osteoarthritis is the most common type of arthritis. While it can occur even in young people, the chance of getting osteoarthritis rises after age 45. More than 32 million people in the U.S. have osteoarthritis, with the knee being one of the most commonly affected areas. Women are more likely to have osteoarthritis than men.

The most common cause of osteoarthritis of the knee is age. Almost everyone will eventually have some degree of osteoarthritis. However several things increase the risk of having significant arthritis at an earlier age.

  • Age. The ability of cartilage to heal decreases as a person gets older.
  • Weight. Weight increases pressure on all the joints, especially the knees. Every pound of weight you gain adds 3 to 4 pounds of extra weight to your knees.
  • Heredity. This includes genetic mutations that might make a person more likely to have osteoarthritis of the knee. It may also be due to inherited abnormalities in the shape of the bones that surround the knee joint.
  • Gender. Women age 55 and older are more likely than men to get osteoarthritis of the knee.
  • Repetitive stress injuries. These are usually a result of the type of job a person has. People with certain occupations that include a lot of activity that can stress the joint, such as kneeling, squatting, or lifting heavy weights (55 pounds or more), are more likely to get osteoarthritis of the knee because of the constant pressure on the joint.
  • Athletics. Athletes involved in soccer, tennis, or long-distance running may be at higher risk for osteoarthritis of the knee. That means athletes should take care to avoid injury. However, it’s important to note that regular moderate exercise strengthens joints and can decrease the risk of osteoarthritis. Weak muscles around the knee can lead to osteoarthritis.
  • Other illnesses. People with rheumatoid arthritis, the second most common type of arthritis, are also more likely to get osteoarthritis. People with certain metabolic disorders, such as iron overload or excess growth hormone, also run a higher risk of osteoarthritis. 

Symptoms of osteoarthritis of the knee may include:

  • Pain that increases when you are active, but gets a little better with rest
  • Swelling
  • Stiffness in the knee, especially in the morning or when you have been sitting for a while
  • Less mobility of the knee, making it hard to get in and out of chairs or cars, use the stairs, or walk
  • A creaking, crackly sound that is heard when the knee moves

The diagnosis of knee osteoarthritis will begin with a physical exam by your doctor. Your doctor will also take your medical history and note any symptoms. Make sure to note what makes the pain worse or better to help your doctor determine if osteoarthritis, or something else, may be causing your pain. Also, find out if anyone else in your family has arthritis. Your doctor may order more tests, including:

  • X-rays, which can show bone and cartilage damage as well as the presence of bone spurs
  • Magnetic resonance imaging (MRI) scans

MRI scans may be ordered when X-rays do not give a clear reason for joint pain or when the X-rays suggest that other types of joint tissue could be damaged. Doctors may use blood tests to rule out other conditions that could be causing the pain, such as rheumatoid arthritis, a different type of arthritis caused by a disorder in the immune system.

The primary goals of treating osteoarthritis of the knee are to relieve the pain and make you more mobile. The treatment plan will typically include a combination of the following:

  • Weight loss. Losing even a small amount of weight, if needed, can significantly decrease knee pain from osteoarthritis.
  • Exercise. Strengthening the muscles around the knee makes the joint more stable and decreases pain. Stretching exercises help keep the knee joint mobile and flexible.
  • Pain relievers and anti-inflammatory drugs. This includes over-the-counter choices such as acetaminophen, ibuprofen, or naproxen sodium. Don’t take over-the-counter medications for more than 10 days without checking with your doctor. Taking them for longer increases the chance of side effects. If over-the-counter medications don’t provide relief, your doctor may give you a prescription anti-inflammatory drug or other medication to help ease the pain.
  • Injections of corticosteroids or hyaluronic acid into the knee. Steroids are powerful anti-inflammatory drugs. Hyaluronic acid is normally present in joints as a type of lubricating fluid.
  • Alternative therapies. Some alternative therapies that may be effective include topical creams with capsaicin; acupuncture; or supplements, including glucosamine and chondroitin or SAMe.
  • Using devices such as braces. There are two types of braces: “unloader” braces, which take the weight away from the side of the knee affected by arthritis; and “support” braces, which provide support for the entire knee.
  • Physical and occupational therapy. If you are having trouble with daily activities, physical or occupational therapy can help. Physical therapists teach you ways to strengthen muscles and make your joints more flexible. Occupational therapists teach you ways to do regular, daily activities, such as housework, with less pain.
  • Surgery. When other treatments don’t work, surgery is a good option.

If your doctor wants to treat the osteoarthritis in the knee with surgery, the options are arthroscopy, osteotomy, and arthroplasty.

  • Arthroscopy uses a small telescope (arthroscope) and other small instruments. The surgery is done through small cuts. The surgeon uses the arthroscope to see into the joint space. Once there, the surgeon can remove damaged cartilage or loose particles, clean the bone surface, and repair other types of tissue if damage is found. The procedure is often used on younger patients (ages 55 and younger) to delay more serious surgery.
  • An osteotomy is a procedure that aims to make the knee alignment better by changing the shape of the bones. This type of surgery may be recommended if you have damage mostly in one area of the knee. It might also be recommended if you have broken your knee and it has not healed well. An osteotomy is not permanent, and further surgery may be necessary later on.
  • Joint replacement surgery, or arthroplasty, is a surgical procedure in which joints are replaced with artificial parts made from metals or plastic. The replacement could involve one side of the knee or the entire knee. Joint replacement surgery is usually reserved for people over age 50 with severe osteoarthritis. The surgery may need to be repeated later if the prosthetic joint wears out after several years. But with today’s modern advancements, most new joints will last over 20 years. The surgery has risks, but the results are generally very good.

Latest treatments:

Platelet-rich plasma (PRP) injections. In this treatment, your doctor takes a sample of your blood and spins it in a machine called a centrifuge to pull out your blood’s platelets and plasma. When injected back into the joint, this super-concentrated mixture contains substances that could promote healing

Even though they’re popular with some high-profile athletes, PRP injections still aren’t proven, and the treatment formulations can vary a lot.

It is a treatment that is not recommended because of the lack of standard dosages and preparation.

Mesenchymal stem cells, or MSCs. Your bone marrow makes these types of cells. They can grow into new tissues, including cartilage. By gathering these cells and injecting them into the knee joint, the hope is that they will give rise to new cartilage and reduce inflammation.

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Therapeutic Deep Tissue, Swedish Massage, Sports Injury Massage Therapy in Santa Barbara, Goleta, Ca.

*Disclaimer: This information is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition. The information provided is for educational purposes only and is not intended as a diagnosis, treatment, or prescription of any kind. The decision to use, or not to use, any information is the reader’s sole responsibility. These statements are not expressions of legal opinion relative to the scope of practice, medical diagnosis, or medical advice, nor do they represent an endorsement of any product, company, or specific massage therapy technique, modality, or approach. All trademarks, registered trademarks, brand names, registered brand names, logos, and company logos referenced in this post are the property of their owners.