The Healthy Knee – An Imperfect Miracle

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As sports become more demanding, knees are taking more punishment. Knee injuries are easier to prevent than they are to repair, says one doctor in Ontario.

With the glow of warm weather comes a surge in outdoor sports. Parks and fields swarm with activity. Sports such as soccer, baseball, football and rugby are ignited by the arrival of spring. Tennis players and golfers grab their gear and race outdoors to chase their passion. Year round sports like basketball and hockey carry on with camps and summer leagues. Hikers and bikers take to the paths and trails. Strong, healthy knees make all these activities more enjoyable, but there may be a price. All sports pose a risk of injury, but no single body part takes as much punishment as the knee. Complete rehabilitation packs can help, and you can use them at home. Prevention, diagnosis and treatment of knee injuries are in the spotlight as sport grows and becomes more competitive.

The Miracle of the Knee

The human knee joint is a marvel of engineering and durability. It bends and straightens and supports the body while standing and walking. It flexes and twists and kicks, and always comes back into place. Part of its repertoire includes dancing, jumping, changing direction, and running. Healthy knees are a central transmitter of energy between the upper and lower body, and make it possible to truly excel in the complex movements of athletics. The knee is a modern miracle, but it is not perfect. The evolution of sports has raised the bar of competition to unforseen levels. Increased demands to perform have placed heavy stress on the knee, with injuries appearing in younger athletes, some of whom who are still growing.

Dr. Brett Dunlop is an orthopedic surgeon in Hamilton, Ontario. He sees and treats knee injuries on a regular basis, and makes it clear that once the soft tissue in the knee is damaged even slightly, the process of arthritis begins, and will continue.

“Any trauma in the medial catrilage will start to wear on the shiny articular surface of the tibia and fibula, and at this point deterioration begins.”

Injuries to the soft inner tissue, or meniscus, can often go unnoticed, or felt as mild pain. In young teens, the pain goes away quickly and is forgotten by the next game or practice.

“Kids are tough, and the high level of competition leads to the trivializing of knee injuries. They won’t notice the more dramatic symptoms for years, but regardless of age, the process won’t reverse itself.”

Later in life, painful and limiting knee injuries can be treated with arthroscopic surgery, and short term results are often sufficient to allow athletes to resume their activity at a high level. The joint itself however, has a reduced performance life from the moment of that first twist or tweak, and the removal of material from the joint sometimes takes the good with the bad.

“A lot of patients have injured cartilage removed from the knee, but the structural damage continues to occur. As a result, you have alot of great athletes with bad knees. Bobby Orr had all the cartilage removed from his knees by age 16.” says Dr. Dunlop.

The effects of knee injuries can be minimized with strengthening exercises in the quadriceps and hamstrings. Physiotherapy programs and anti-inflammatory medications also help, but the only real prevention of knee injuries may be to avoid the high impact sports altogether. However, the glamour and appeal of professional sports combined with the pure thrill and invincibility felt by all athletes will likely make knee problems a first-hand experience for many.

Doctor Dunlop has noticed that, with wear on the joint beginning earlier in life for all active people, the average age of candidates for major surgery has dropped. He sees patients as young as 40 with advanced knee deterioration that used to appear in 70-year olds.

“They’re jumping on the wear curve a lot sooner,” He says.

Is Replacement an Option?

This query is heard more often lately in the presence of an orthopedic surgeon. Joint replacement has reached staggering levels of sophistication and accessibility. Some patients reach a point where the pain and damage in the knee is beyond rehabilitation, making them eligible for the ultimate fix; one or two new knees. Success stories abound, not just in seniors’ circles, but in healthy active younger patients as well. New hips and knees are a growing and popular procedure, as lower body stresses mount over a lifetime. Total Knee Arthroplasty (TKA) has been in experimental stages for decades now, and has reached a truly “bionic” level. However, waiting lists are long and candidate selection is rigorous for this costly procedure.

The knees are a priceless tool in everyday life. They move and support in incredible ways, but there is a limit to what and how much they can do. Wear and tear can go undetected for years, and it can be a challenge to accept that a sport or activity of choice may reduce the life of one of the most vital joints in the body. The best prevention of any sports injury is a combination of strength and flexibility in and around the joint. Weight control is also a key consideration when protecting the knee. Keeping off the pounds keeps off the pressure. Listening to the knees early in life might prevent feeling them later.

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