What Are the Alternatives to Knee Surgery?

Knee injuries are very common in the United States and result in over 1 million surgeries per year. Out of those surgeries, there are an estimated 650,000 arthroscopic meniscal procedures performed every year.

That's a lot of cutting!

The problem with knee surgery, especially on the meniscus, is that it can leave the knee incredibly unstable. In fact, re-operation rates for post-meniscectomy can be as high as 29%. This may lead you to question the validity behind this type of knee surgery in the first place.

At The Darrow Sports and Wellness Institute we feel the same way. We try other procedures long before we send a patient to surgery. We believe in more natural modes of healing and therefore make sure we have exhausted all other avenues first. Before we get into that, though, it's valuable, if not essential, to understand what causes knee pain and failure in the first place. To do that, you must understand the anatomy of the knee, specifically that of the meniscus.

What is the Meniscus?

The meniscus is a crescent-shaped fibrocartilaginous structure that usually refers to either of two specific parts of cartilage of the knee: The lateral and medial menisci. Together the menisci provide structural integrity to the knee when it's under pressure, nutrition and lubrication to articular cartilage, and shock absorption during movement. Several ligaments also work in tandem with the menisci to prevent overextension of motion.

Meniscal damage can be caused by acute injury or gradual overuse. Tears are the most common injury. The problem with the meniscus is that it's a poorly vascularized tissue, meaning blood flow to the area is very limited. In fact, only a small percentage (10 to 25%) of the meniscus receives a direct blood supply. If the injury is to this area, there is a moderate chance of natural, internal repair, whereas the other areas of the meniscus, if injured, cannot heal from injury whatsoever.

How Do You Know You Have Suffered a Meniscus Tear?

If the tear is caused by sudden injury or trauma, often the pain is immediate and accompanied by a pop. If it's from ongoing stress and overuse, the pain is less obtrusive and simply increases over time. In both instances, there is usually a bit of swelling and a decrease in mobility and mechanical function. Also, a common characteristic of a meniscal tear is a constant clicking, popping, or locking of the knee joint.

Although these overt symptoms lead many patients to seek help, surprisingly many patients have tears and have no idea. A study in the New England Journal of Medicine showed that out of 991 knees scanned with an MRI, 60% of the patients had a meniscal tear without the hallmark symptoms associated with it. This study illustrates a two-fold importance. One: Meniscal injuries are more common than once thought. Two: If your doctor gets an MRI when you have pain, and finds a meniscus tear, his answer is most likely surgery. However, no one knows if that tear had been there silently for 20 years. According to the study, there is a 60% chance that the meniscus tear is not causing the pain. So why have surgery in the first place.

Thus Surgical Intervention

Surgery for the meniscus consists of several different methods of attack: meniscectomy, meniscal repair, and meniscal allograft transplantation. Although they may offer short-term relief for pain, more often than not, these surgeries result in further degeneration and future pain and instability in the knee. Why? Because no surgery is going to change the inherent lackluster blood supply to the meniscus! Therefore a new method needs to be employed.

A New Mode of Attack

Since it's more a matter of healing, Platelet-Rich Plasma (PRP) therapy seems like the most common sense and obvious mode of attack. PRP works on the meniscus in an entirely different way than surgery. This non-invasive procedure essentially allows your body to heal itself, by using your own platelets re-injected back into the area of injury.

By delivering to the damaged meniscus an extra dose of what it needs the most: your platelets, the meniscus is able to begin healing on its own. How it does this is nothing short of amazing. Platelets stimulate growth factors, which are a necessary part in the healing and regeneration process. By inciting an inflammatory response, PRP boosts an immediate immune response-the growth factors. After this stage, fibroblasts enter the picture and begin depositing collagen, the framework of regeneration. The collagen cells than mature into healthy, robust tissue. So instead of removing the injured meniscus, like in surgery, PRP heals the injured tissue, while also creating new, structurally sound tissue.

Since the meniscus is biologically unable to do it itself, PRP Prolotherapy is imperative!

Why Take Motorcycle Riding Gear Serious?

So you've finally dived straight into the scary world of motorcycling and bought your first bike but low and behold you've just found out you need to get more accessories to avoid any serious injury and to ensure you operate at your best while on the ride with your bike. Quality motorcycle riding gear is no joke and should be taken serious. It doesn't take a genius to realize that decent riding gear will improve your overall ability to also improve your enjoyment. The ultimate purpose of motorcycle riding gear is to protect you in the unlikely event of ending up in an accident or collision. Let's break it down into what accessories you'll need and what you can expect to pay on average.

• Motorcycle Helmets - The most important of the bunch. Look for helmets that have been certified by the DOT or by the Snell Foundation. This matter is not to be taken lightly as studies show that rider's are more likely to survive an accident when using certified helmets. Types available include; Full face, Open face, Hal face or Skid Lid, Modular or Flip-up, Off Road/Motocross, and lastly Novelty Helmets (most of these are not certified by the DOT).

• Motorcycle Leather Jacket - The basic idea here is to offer you protection on your elbows, chest and back. Be careful of knock-off or Cheap leather jackets made from pig or goat's leather. You want leather jackets made from Cow hide or Buffalo. Yamaha has an extensive range of leather jackets with a strong focus on protection and performance. Another recommended brand is Olympia that specializes in Viper Mesh textile jackets that are multi-functional offering super ventilation and can transform to short sleeved garments with the clever use of zips.

• Motorcycle Boots - Your main aim here is to get boots that are breathable and comfortable. It's very important that the boot provides support for your ankles and heels. Two different types of motorcycle boots are available namely Tall and Short Biker boots. Short boots are popular due to the fact that they offer more free movement but don't protect your shins and upper leg. Tall boots are the most popular and offer maximum protection from the elements (like riding in winter) and your body in the event of a collision.

• Motorcycle Gloves - Crucial in keeping your hands safe and warm. It's important to have good circulation while maintaining a decent grip while riding and shifting gears. Consider investing in a quality pair of Motorcycle Heated Gloves that serve to protect your hands while providing warmth when you most need it in winter months.

• Motorcycle Pants - These need to be comfortable and durable at the same time. Olympia offer great quality pants that keep you well ventilated without feeling the chill of winter. Alternative leather brands keep your knees well protected.

Companies like Yamaha and Olympia have invested millions into the research and development of highly functional motorcycle riding gear so all you have to do is consult your local dealer or look online.

How Much Compensation for a Knee Injury?

How much compensation for a Knee Injury?

Have you had an accident playing football damaged your knee? Maybe you were in a car accident and your knee was damages? Would you like to know what compensation you might be entitled too?

Well for a start damage to the knee can be quite serious, we all need our knees functioning properly to be able to walk and go about our daily routine. Depending on the extent of your injury will depend on how much compensation you will get. The amount of compensation for any knee injuries falls between a few hundred pounds for a simple twist to up to £50,000 for more serious injuries.

The amount of compensation you could receive from a serious knee injury where the injured had lengthy treatment, a considerable amount of pain and loss of function, arthrodesis or arthroplasty has taken place or is inevitable the amount would be in the region of £40,750 to £56,000.

For a less fracture extending into the knee joint causing constant pain, limiting movement, loss of agility with the possibility of osteoarthritis the amount of compensation you might receive would be in the region of £30,500 to £40,750.

A less severe knee injury resulting in less severe disability where there is still continuing symptoms of pain and limitation of movement could result in a award of £15,500 to £25,000.
Moderate knee injuries involving dislocation, torn cartilage or meniscus which might accelerate symptoms from a pre-existing condition which result in minor instability, weakness or other mild future disability the amount you could receive in compensation would be in the region of £8,400 to £15,500.

Less serious moderate knee injuries where there maybe some pain and discomfort, the amount of compensation would be in the region of £8,150. Where there has been complete recovery the award is unlikely to exceed £3,500.

These amounts are from the judicial studies board as of 2006. For more accurate information about your injury and how to go about making a claim you will need to find a competent accident solicitor. Companies that specialises in offering free impartial advice that can explain the no win no fee agreement in simple terms are the ones to go for. There are so many no win no fee accident solicitors in the UK and they are all competing for your cases. Unfortunately it can be big business for solicitors as they demand huge fees. The best solicitors are the ones that put you and your needs first.

You may have heard of the term 'no win no fee'. It is often used and rarely understood. It basically means that the solicitor is working for free until the case is won. When the case is one your solicitor will claim its own expenses back from the person who was responsible. If the negligence was on the part of your employer then your employer should have insurance to cover this. There maybe a chance that you may loose you case in which case you will be offered insurance to protect you from the costs also. Generally a good solicitor will only take on a case they believe they can win.

Remember claiming compensation for accidents is your legal and civil right. If the accident was not your fault and you have suffered because of the injury then you have every right to pursue a claim and you should.

Physical Therapy Exercises for the Knee After Surgery

Physical therapy exercises are an important and imperative aspect of rehabilitation for the knee after surgery. In the period after the surgical procedure, the recuperating patient would have to start such exercises under the guidance of a professional. Whenever muscles are unused, they tend to become weak and do not properly perform their function of moving and supporting the body. The patient may have not used his leg muscles much because of the knee problem, thereby causing the weakness. By performing the recommended exercises, strength can be restored.

Objectives of Post-surgical Rehabilitation

The muscles most affected by the surgical procedure are the quadriceps muscles (vastus intermedius, vastus lateralis, rectus femoris, and vastus medialis). Physical therapy rehabilitation following surgery of the knee is carried out to achieve certain objectives:

• Independence in walking and getting up and down the stairs

• Getting the knee back to the suitable range of motion because the muscles and tendons might have become stiff due to limited movement during and after the procedure

• Protecting against further injury

• Re-establishing strength in the joints so that the patient would be able to support his weight for the customary everyday tasks

A supervised and regular exercise program would help to achieve these objectives. People of different age groups can benefit from such a program.

Physical Therapy Exercises Adopted after Knee Surgery

Stretching - Fundamental stretching movements would help to relax the front portion of the leg and also to enhance general lower extremity flexibility.

Isometric Strengthening - This helps to develop strength by the contracting of muscles in such a way that there is no flexing of the knee. The patient may be able to improve and feel the force of the contractions for a deconditioned or weak muscle.

Quadriceps Strengthening - The quadriceps are a group of four muscles in front of the thigh. These muscles should be in a good condition to effectively perform their function of moving and strengthening the knee.

Isotonic Exercises - These movements effect alterations in muscle length and are normally done to achieve stability and strength. Effective movements of this kind would be targeted at building the hamstrings and the quadriceps. These are the muscles that enable extension and flexion of the knee.

There are limitations in trying to perform physical therapy exercises for the knee following surgery at home. So, it is better to go to a center specializing in this area and get help from the specialists. Ask about the various medical insurance plans that the center supports.

Inflammation Pain - Make the Pain in Your Neck, Knee Or Shoulder Go Away

Most pain is due to inflammation and Millions of Americans suffer from chronic pain as a result. Some times anti-inflammatory medications work, but when they don't, many are forced to see a doctor and take medications that can be harmful to your body. Even over the counter medications such as ibuprofen and aspirin can be harmful if you take the over an extended period of time.

Generally when you go to your doctor, they will rest, light exercise, weight loss, stretching and anti-inflammatory medication that can also control the pain. In many cases, steroid medications are used and the patient may eventually require joint replacement.

Whether you have shoulder, neck, knee joint pain or even chronic arthritis, there are natural alternatives. There are certain food that are anti-inflammatory foods, but there are also foods that can cause inflammation. Most likely foods you are eating every day. What you eat can affect your body. Eating foods that are high in saturated and trans fat and sugar are definitely foods that cause inflammation.

Foods That Cause Inflammation
Processed meats such as lunch meats, hot dogs and sausages contain chemicals such as nitrites that are associated with increased inflammation and can cause chronic diseases. Saturated fats are particularly found in meats, dairy products and eggs. Although I don't recommend that you cut these out completely, it is just something to keep in mind. Low fat milk and cheese would be a better choice. A diet high in sugar has also been linked to inflammation, obesity, and chronic diseases such as diabetes. So cut way back on the cookies, sodas and candy. Eating vegetables and fruit are important, but there are even some of those that are not good for people to eat if they have joint pain or other inflammation. People with arthritis or any kind of joint pain, should stay away from potatoes, tomatoes, and eggplant. These foods can actually make inflammation worse. These vegetables are part of the nightshade family of plants and contain a chemical alkaloid called solanine. Solanine can trigger pain in some people. Try it for a couple weeks to see if it makes a difference.

Anti-inflammatory Foods
Oils are good in your diet if you use the right kind. Use olive oil and canola oils when cooking. Walnuts and pumpkin seeds are also anti-inflammatory foods. Good protein sources are lean poultry, fish and seafood, nuts, beans and seeds. Avoid red meats, as they may cause inflammation. Eating soybeans, tofu, and soy milk are a great way to get your protein and also help reduce pain and inflammation. A diet high in fiber is also a terrific way to reduce your inflammation. Eating lots of whole grains, vegetables and fruit will increase your fiber intake. Berries are also a great food choice, especially blueberries and strawberries which are packed with anti-inflammatory phytochemicals and anti-oxidants. The color in brightly colored fruits, vegetables and berries contain many phytochemicals that have anti-inflammatory properties. One example is quercetin, which is found in apple and red onion skins.

Diet Tips
Over all, when you are choosing anti-inflammatory foods to help reduce your inflammation and pain, choose fresh foods instead of heavily processed foods. Here are some tips:

• Breakfast could be oatmeal served with fresh berries and walnuts, with a cup of soy milk.


• Snack on whole fruits, nuts, seeds, and fresh vegetables throughout the day instead of cookies and candy.


• Eat more fish and less fatty red meat.


• Stay away from deep fried foods and bake or stir fry your meals instead.


• Choose green, orange, and yellow vegetables for your side dishes.


• Drink plenty of water, fresh 100% fruit and vegetable juices.

Knee Reconstruction Surgery - Key Questions to Ask Your Surgeon

Not so long ago twin sisters aged fifteen years of age in the same sport at the same game injured their ACL (Anterior Cruciate Ligament) in their knee. One did the left knee the other her right. An ACL injury causes the recipient to be restrictive when it comes to any side way movement, in others words you cannot side shuffle, change direction quickly, step to either side and also you cannot weight bare. ACL damage is one of the most common knee injuries equated to running, jumping and contact sports for males or females. These particular twins were playing the sport of choice netball, which has a lot of stop start movements as well as plenty of jumping and running and the occasional contact.

So with this journey into the unknown of a ACL injury we had plenty of questions that needed answers, so we could get to the end with the correct results.

What can cause this injury?

The surgeon explained that an ACL knee injury happens due to incorrect weight allocation to the knee area from down would force of your bodies movements. For example being tackled in a rugby game and being pushed back in a kneeling position backwards with your thigh area going the wrong direction to your knee and lower leg. Side stepping with the wrong weight distribution. Also playing netball and when landing after jumping having your weight go the wrong way you want causing you to twist your knee. Being over weight and trying to train again with not enough support from your thigh, calf and hamstrings to your knee.

How could this been prevented?

Preventative measures for this injury means having to build up and strengthen the muscles in your quad (thigh), calf and hamstrings. By incorporating exercises to suit these muscle parts you will have an excellent chance of non-injury in that area. Also technique is a vital ingredient to support this, executing the correct movements with the right about of force will lessen the risk of injury.

Take a look at the top sprinters in the world, look at the development of their quads, calves and hamstring areas, they are unbelievable, but this is why they can run at super human speeds. They have bi-o-mechanically changed their body shape to cope with the G-forces they put out when they run.

How do you treat this injury?

According to the surgeon the treatment depends a lot on the severity of the injury. An x-ray followed by a MRI may be required to fully assess the damage and give the best course of what is needed to sort out the injury surgically. This operation consists of cartilage (ligament) replacement; grafting mainly from your hamstrings does this and the new ACL (Anterior Cruciate Ligament) is fastening to the femur (thigh bone) and the fibula (lower leg) by staples or screws.

What is the next step after surgery?

Rest period of around two weeks keeping leg elevated, also at the same time try to slowly weight bare with the use of crutches when going to the bath or moving around, remembering to only do what you can depending on how much pain you can tolerate. The main reason for this is to get the walking movements back, because the surgery would have caused your knee to cease up. Once you and your physio are confident in your progress rehab in the gym can start.

What does the physio offer?

Firstly you get an expert in the field of Anatomy and physiology that means they have the best knowledge of what the human body can and cannot do. They will put you through the right program for your knee recovery, explaining why you must do certain exercises for your rehab. They also have the ability to tell if you are not doing your program to the best of your capability. The physio is your ticket to a speedy recovery, but only if you have the commitment and determination to do the work.

When can one go back to physical activities?

Once you have done all the work required and the physio is happy with the progress, only then can he determine whether or not you are ready for that big step back into physical activity. Some of the factors may be that your muscle development from surgery has finally improved to a state where you can now begin to train and exercise more frequently. Also that you are able to increase your work load in your sessions, like weight training-lifting more, running longer and more importantly have less uncomfortable pain from you injury. Lastly the fact that your visits with your physio have gone from everyday to one visit a week shows him you are do the work not just with him, but also at home.

So these are just some of the questions you may want to ask your surgeon and physiotherapist if you are ever in this situation requiring an ACL knee injury.

Valgus - What Does This Mean in Osteoarthritis of the Knee?

'Valgus' is a term used by the medical profession to describe joints that form an angle different from the usual. It does not apply only to the knee. Valgus means that the part of the body furthest away from the torso is angled away from the midline position. In simple terms, if the knees are described as valgus, they are 'Knock-kneed.'

Valgus knees indicate that the arthritis is mainly on the outside of the knee. The wearing down of the cartilage lining on the outside of the knee has led to a change in the angle through the joint. The terminology a doctor would use would be to describe being knock-kneed as having a valgus deformity, or the latin phrase 'genu valgum.'

Doctors approximate the angle of deformity to assess the progression of the degenerative joint disease. Please note: there is natural variation between individuals, with some having a larger angle through the knee than others. The change in angle is the important factor.

When a knee becomes so painful that surgery is the only option, the good news is that in most cases the surgeon can correct any angulation. It is not uncommon for patients to have a straighter knee after their operation than they have had for years.

As is common in osteoarthritis, it is important not to focus too much on factors such as joint angle - after all it is just a measurement. Symptoms, particularly pain, generally take priority in the decision making process. It is wise to seek an expert opinion however, as on some occasions, large deformities make surgical intervention more difficult than usual.