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Knowing Your Knees
The
knee is a hinge joint that bends and straightens the lower leg,
permitting a person to sit, stand, and pivot. The knee joint is
almost entirely dependent on tendons, ligaments and cartilage for
strength and stability, thus making it extremely vulnerable to injury.
The most important part of the knee is the anterior cruciate ligament
( ACL), the main stabilizer of the knee.
The
ACL is located in the middle of the knee, it stretches from the
thighbone (femur) to the shinbone (tibia) and limits rotation and
forward movement of the tibia, keeping the knee in proper alignment.
Women are two to eight times more likely than men to suffer ACL
tears.
Sports that involve cutting, stopping, sharp turns, jumping or twisting,
like skiing, tennis, basketball and soccer put women athletes at
a higher risk for knee injuries. In most cases, a ligament (attach
bone to bone) or tendon (attach muscle to bone) in the knee becomes
stretched or torn.
The
XX Factor
The
increased susceptibility of women may be due to anatomical and physiological
differences. The broader hips of women, make them more knocked kneed,
causing the knees to land at more of an angle after a jump, which
may put greater stress on the ACL. Also women tend to have less
muscle mass and are relatively weaker in the quadriceps and the
hamstrings, which provide support to the ACL.
The
"femoral notch" is a space at the bottom of the thighbone and because
it is narrower or tighter in women than in men and it puts the ACL
at greater risk of tearing. Lastly Studies suggest that when estrogen
levels are highest there is increased laxity of muscular tissue,
and at this time women may be more at risk for a knee injury.
Putting
It Back Together
The
anterior cruciate ligament is most often injured by a sudden pivoting
motion. Experiencing pain, swelling and limited motion let you know
there is a problem. An ACL injury may also be painless, instead
the person may hear a popping sound. The knee may feel as if it
is giving away and buckle when weight is placed on it. To diagnose
an injury, an examination is preformed to see the amount of movement
of the joint when pressure is applied in different directions.
An
MRI is very accurate in detecting a complete tear, but arthroscopy
may be the only reliable means of detecting a partial tear. Treatment
for knee injuries will depend on the age of the patient and level
of activity desired. For an incomplete tear, the doctor may recommend
that the patient begin physical therapy to strengthen surrounding
muscles, and prescribe a brace for the patient to wear during activity.
Many patients not involved in sports can function without a completely
stable ACL if they avoid twisting or pivoting movements.
For
a completely torn ACL in an active person, the doctor is likely
to recommend surgery. The surgeon may reattach the torn ends of
the ligament or reconstruct the torn ligament by using a piece of
healthy ligament from the patient. After surgery, the patient will
use crutches for at about two weeks and wear a brace for four weeks.
The patient must follow an exercise and rehabilitation program for
4 to 6 months, hopefully this will improve stability and strength
enough for the athlete to return to an active lifestyle.
Staying
In The Game
Women
can reduce their risk of ACL injuries by making sure they are in
good shape and properly conditioned before participating in sports.
Stretching the muscles in the front of the thigh (quadriceps) and
back of the thigh (hamstrings) reduces tension on the tendons and
relieves pressure on the knee during activity.
Conditioning
with weights to build knee muscle strength helps may reduce the
risk of ACL injury. Wearing shoes that both fit properly and are
in good condition to help maintain balance and leg alignment when
walking or running. Maintaining appropriate weight to reduce stress
on the knee.
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