Knee injuries

[doc]

He started somewhere. He also obviously trains just about every day, and trains rigorously. He's on level with the professional guys. And even though he trains like that, he's still at risk for injury. Thre rest of us mere mortals don't train that extensively, and therefore are at increased risk.

[LeiYunFat]

With all due respect Doc, what does lifting heavy at 500 have to do with lifting heavy at 200? We've all heard stories of people injuring themselves with just the bars weight for crying out loud.

I lift for a majority of the week, and I am by far not a professional athlete of any kind. Whenever I do lift, however, I keep in mind my form at all times. And when I do it, I do it like that. I may not be using the same weight of the people in those videos, but I am lifting heavy for myself, and that's the similarity between me and them.

Look, I'm not trying to argue with you or anything, I just want to know what specifically is being damaged when performing a full squat (back or front) with form like this. Is there just a risk of being injured, or is there something actually happening that does hurt you, as opposed to can?

[doc]

Let me put it to you this way.

One reason why I had a lucrative career, is because of young healthy athletes such as yourself.

Doing knee and shoulder arthroscopies on the youngsters is a very lucrative, fast, and easy way to make money in medicine. Weekend warriors, high school athletes, all the way up to the pro's.

Easy money. Taking care of young healthy individuals. Easy. A lot of them, and a lot of it.

The knee joint has fluid filled sacs within it. And like all fluid filled sacs, they are subject to distortion, rupture, and damage when subjected to stresses in which they have not been designed to withstand. It also has other ligamentous structures that do not heal easily or within a timely fashion, as compared to other structures in the body. And these function well, again within various design limits.

It's lke a car. A Ford Escalade was designed to operate within certain limits, speed, turning, handling. A Porsche Cayenne, other more far reaching limits. Exceed the limits of either, and you have problems.

I'm not saying that what you're doing can't be done. All I'm saying, is that you increase your risk of injury when you attempt to put stressors on the body, that it either is not accustomed to, not prepared for, or not designed for.

Be careful with your "temple". You only get one. Exercise is great, within limits, to make it strong. Exercise without limits can damage it.

Now, if you'll excuse me, it's time for breakfast. Got to feed my temple some Sugar Smacks.

The dog likes them too.

[kunoichi2003]

not sure if I should start a new tread

This deals with a knee injury so I put it here. About 5 months ago someone fell on my knee during sparring. I went to the hospital and was put on crutches and they gave me this huge knee brace thing that went up to my thigh. I couldn't walk for 2 and half weeks. After that I went back to the doctor, he said that it was most likely a sprain and nothing serious, so I left it at that. But I still feel pain sometimes, sometimes when I am walking it feels like it locks out or something and that causes excruciating pain for a minute or so. Also I have still have stability problems and such when I am jumping and landing on the leg that was sprained. ( this causes a lot off pain too) So any Idea what is wrong?

kunoichi

[doc]

I think I mentioned this in the thread, but, I'm not sure. Just so damn fuzzy in the mornings....

The knee has structures in it (menisci, etc), that don't heal well after injury, primarily because they're made of cartilage, that has a relatively poor blood supply as compared to other tissues. Once injured, sometimes, forever impaired. Which is why I have said in the past, you have to be careful with these joints. They get worn, they get injured, they don't repair that well sometimes.

You might have a torn meniscus as a result of this injury in the past, or, a partially torn or stretched ligament. Further medical evaluation is warranted, as usual, preferably non-invasive initially. MRI these days is absolutely phenomenal; in the hands of a good radiologist, a good interpretation can lead to the diagnosis that you need. Orthopedic surgeons, depending upon how aggressive they are, might suggest an arthroscopy.

Whatever you do, choose wisely. I have stories of orthopedic surgeons that have done some fairly horrendous things all in the aim of making money. But, then again, this is Las Vegas...

[kunoichi2003]

Forever impaired I hope not. So I should get a mri done? My friend had surgery for a meniscus tear, and now she says she has arthritis in the joint. When they do surgry will it heal to be almost as good as it was before the accident? What can happen if left untreated?

Kunoichi

[doc]

Depends upon what type of injury you have, if you have any injury at all. And, "forever impaired" is probably not what I meant, lol. No, chances are you won't be "crippled" for life because of this. What I meant, is that sometimes, when you have certain types of joint injuries, you can feel the results of that injury, for a long time. For example, I have chondromalacia from running and biking many years ago, along with some minor degree of menisceal injury. I still get knee pain with certain types of activity.

Ah, arthroscopy of the knee. When I was functioning as chief of Anesthesiology here, we had an orthopedic surgeon who routinely and deliberately destroyed knee cartilage, by drilling into it, with the explanation that it caused "regrowth" of the cartilaginous surfaces. Well, he was also performing total knee replacements in healthy 25 year olds too. You put it together... Choose your doctors wisely; not everyone is "dedicated". And, sometimes, surgery is an option that is more aggressively pursued than it should be. Sometimes, conservative care is the better way to go. Sometimes, surgery is absolutely necessary to repair a joint (ACL reconstruction for tear), sometimes, menisceal injuries do fine with, without, and regardless of, arthroscopic surgery.

Personally, finding out what the injury is is paramount; then, dealing with it in the most conservative, least invasive manner, is the best way to go.

Getting an MRI of the knee is non-invasive, non-harmful, and very informative. It should give you an idea as to what kind of injury, if any, you are dealing with. Once you know what you have, take it from there. And, don't worry about it. No sense worrying about things that we don't know. We eventually figure it out, and deal with it.

[kunoichi2003]

forever impaired" is probably not what I meant, lol. No, chances are you won't be "crippled" for life because of this.

Being crippled for life is one of my biggest fears. Anyway, I guess I will have to find sometime to get an mri done to see if anything is wrong or if I just need to give it more time to heal.
Thank you,
kunoichi

[LeiYunFat]

Doc, did said surgeon ever face negative consequences for his actions?

[doc]

Said surgeon went on to make millions, at the expense of destroying young athletes knees, and eventually, putting total knee replacements in them. Every time we tried to take his privileges away, he found some scumbag attorney to sue us.

As he had more money to "play" with than we did, he always seems to have gotten his way.

I have far more stories about medicine in Las Vegas. It would make your head spin.... Another day, another time, I'm sick with the flu.

Kunoichi, get the MRI so you know what's going on. Knowledge is paramount. In everything.

[michael289]

My knees, too make that crackling sound when I do squats. Always have. Out of fear of injury, I have never previously done many squats even though I did MA. That changed this summer when I began gong fu. My Sifu always begins class by leading us in exercises, but the first exercise we do is squats. We haven't warmed up or anything.

-The difference between "crackling" and a "pop"-
While squatting, the crackling of my knees begins at about 85 degrees and continues all the way down (if standing with locked-knees is 180 degrees and knees to butt is 10). Just short of the stopping point where my butt almost touches my heels, there is one additional very loud "pop" in each knee that I can feel as well as hear. As I get almost all the way down, it feels as though my knees are encountering unusual resistance that immediately dissapears when each knee pops. It's as if the squatting builds some kind of pressure in the knee that reaches a maximum and is released when the knee "pops." Does your medical knowledge suggest any injury/weakness here Doc?

If this is just normal and the result of me having weak leg muscles, what exercises (and how many reps) would you recommend to get my legs and knees strong enough to do squats without fear of knee injury?

[doc]

You usually can't tell if there's any sort of knee injury unless A it's bad enough to diagnose by clinical exam or B you get an MRI.

Crackling noises usually arise from tendons sliding over bony surfaces. Pops and other sounds can be from the pressurization and rapid depressurization of joint fluid during the range of motion exercise.

The flexion extension machines in the gym are pretty good at strengthening those leg muscles, provided you don't start with too much weight or too many reps. Go slowly, and work your way up. Your body is the best judge when it comes to deciding "how much" exercise you should do.

[michael289]

Thanks, Doc. -And that doesn't sound unusual to you about the resistance building up and then immediately releasing with the pop?