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Straight Talk About Injuries


It seems that everybody has a knee problem, and it's small wonder. The knee must remain stable through a continuously changing range of situations. The knee must support the weight of the body and accept the forces produced by walking, running and jumping while at the same time acting as a lever to propel the body through space. Bones, cartilage, ligaments, muscles and fluids are constantly working in a dynamic ballet in an attempt to balance the need for stability and mobility. When one part of this complex orchestra falls out of step, we have a knee problem. The problems associated with the knee are so varied that we will not attempt to cover them all here. If you are having problems and feel that they are getting worse with time, get in to see a good sports medicine physician. We will discuss some common problems with the knee, so read on and you may find some valuable information.

General Supports

We often get asked for a good general knee support. Quite often people experience knee pain and want a simple brace to make it better. Well, knowing what we do about how many problems there can be with the knee, these people are the most difficult to serve. We have developed a list of good general knee braces that are inexpensive, provide good compression and seem to help provide some general pain relief. Look in the knee section of The Sports Medicine Shop's web site for descriptions, prices and comparisons.

Patella Femoral Tracking Problems

Patella femoral tracking problems are a common source of knee pain, and while this problem is more predominant in women, men are also frequently afflicted. Patella femoral tracking problems can be complex in their cause, but are most frequently caused by a muscular imbalance in the knee. The patella (kneecap) is supposed to move up and down on the femur (thighbone) when the knee flexes (bends) and extends (straightens). There is a groove in the femur, which the patella normally runs through. The patella moves in response to the quadriceps muscle group (the muscles comprising the front of the thigh). The quadriceps muscle group is made up of four muscles, which pull on the patella in three directions. Two muscles pull straight up, one muscle pulls laterally (out) and the other muscle pulls medially (in). The problem usually arises because the muscle pulling laterally on the patella (the vastus lateralis) becomes stronger than the muscle pulling medially (the VMO). The result of this imbalance is that the patella starts to move laterally in the groove on the femur, rather than straight up and down. This causes the patella to rub painfully on the edge of the groove on the femur and results in the characteristic pain around the patella, normally seen with patella femoral tracking problems.

Correcting the problem is quite possible and a good physical therapist should be able to produce some excellent results. The VMO needs to be strengthened while preventing the vastus lateralis from strengthening more. This sounds simple, but does require some pretty specialized exercises, which must be performed correctly to obtain the desired result. We will not attempt to describe the exercises here, contact a good physical therapist and have a professional get you fixed up.

Bracing also plays a role. The patella can physically be moved and held in proper alignment by a good patella stabilizing brace. This allows you to exercise and function with significantly less pain while the VMO becomes stronger. The brace is not a cure, but does provide excellent pain relief while you are being cured by physical therapy. See the knee section in The Sports Medicine Shop's web site for some excellent choices.

Ligament Instabilities

Ligament instabilities are also quite common, although they usually arise from an injury rather than a muscular problem. There are four main ligaments in the knee that work to keep the tibia (the shinbone) directly under the femur (the thighbone). If any one of these four ligaments is damaged, your knee will become unstable. The damaged ligament(s) can heal, although if the damage is extensive, surgery may be needed to repair the damage. Sometimes, unless you are a competitive athlete, you can get away without the surgery. That is something that would need to be discussed with your doctor. One word of advice, if any doctor recommends surgery, get a second opinion just to be on the safe side. Once you've been cut on you will never be the same, so be sure you know it's the right thing to do.

Braces are tremendously effective at increasing the stability of a knee with a compromised ligament. LCL and MCL braces are quite inexpensive and effective. (the LCL and MCL are the ligaments on the sides of you knee) ACL and PCL braces require significantly more technology, and thus significantly more money. (the ACL and PCL are the ligaments inside the knee) Bracing for the ACL or PCL is a difficult proposition, which can only be accomplished by a reasonable complex assembly. The Sports Medicine Shop has quite a variety of braces for all these ligaments. Visit the web site section on knees for details, pricing and comparisons.

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