Friday, March 11, 2016

Weekend Warriors – Common Knee Injuries

By: Samuel R. Goldstein, M.D. with Andrews Sports Medicine and Orthopaedic Center

With spring upon on us, many of us are becoming more active, spending considerable time outside enjoying the warmer weather.

Unfortunately, when it comes to physical activity, many of us “Weekend Warriors” jump right into “too much, too fast, too far” mode.

We feel committed to a sport or activity, but, based on life, work and family demands, find ourselves with limited time to participate. We try to squeeze in rigorous physical activity on our off days – usually the weekend – and all too often this results in aches, pains and even more serious injuries.

As an orthopaedic surgeon, I see a lot of serious Weekend Warrior injuries to the knee. The knee is at high risk for injury because of its complexity and the enormous amount of force it absorbs and stress it takes. Knee injuries often result from a blow to the knee, twisting or turning or an improper landing.


The most common knee injuries I treat are intra-articular (inside the knee), including meniscal tears and ligament tears.

Meniscal Tears

The meniscus is a “C” shaped cartilage cushion, which is like a wedge within the knee. There are two in each knee which cushion, support, and aid movement. Injury to the meniscus is very common and is one of the most frequently occurring cartilage injuries of the knee. Menicus tears can occur from wear and tear over time or from a sudden twist, turn, or even slowing down when running. As we age, our meniscus gets worn. This can make it tear more easily. Like a lot of knee injuries, a meniscus tear can be painful and debilitating.

Common Symptoms

• Pain in knee

• Swelling and stiffness

• Fluid build-up inside on top of knee

• Sensation that knee is getting stuck or locking

Ligament Tears

The majority of stabilization in the knee comes from the ligaments. The cruciate ligaments are made up of the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL), which cross to form an “x” shape inside the knee. The collateral ligaments provide additional stability on the inside of the knee through the medial collateral ligament (MCL) and outside the knee through the lateral collateral ligament (LCL).

Ligament injuries in the knee - such as an anterior cruciate ligament (ACL) -- are dreaded by pro and amateur athletes alike. They can be painful and debilitating. They can even permanently change our lifestyles. But there's good news. While an ACL injury or other ligament damage once ended the career of many an athlete, treatment has become much more successful for all of us.

Common Symptoms

• Pain, often sudden and severe

• A loud pop or snap during the injury

• Swelling

• A feeling of looseness in the joint

• Inability to put weight on the point without pain


The form of treatment used for both meniscal & ligament tears will be dependent on the severity of the injury.

Conservative Treatment

1. Physical Therapy – We work closely with physical therapists to create an individualized program to maximize healing and restore function, strength and mobility.

2. Supports - A variety of supports such as a brace, crutches or other advanced support can help restrict movement and allow the cartilage to begin the healing process.


Meniscus - When conservative treatment fails, and the knee continues to be painful and locks in place, arthroscopic surgery may be recommended to repair, trim or remove the damaged meniscal cartilage.

Ligament - Depending on the severity and type of ligament injury, surgery may be recommended.

• For ACL injuries, arthroscopic or open surgery is done using a graft to replace the damaged ligament.

• For certain PCL cases where the ligament is no longer attached properly to the shinbone, surgery is considered.

• For MCL injuries when the ligament is completely torn, surgery can help to repair it.


The risk of injury does not mean we shouldn’t be active, but avoiding these injuries requires some common-sense prevention.

• Exercise

1. If we don’t exercise on a regular basis and are not conditioned for a particular sport or activity, we put yourselves at greater risk for injury.

2. Regular exercise helps maintain our muscle strength to help prevent arthritis and keep our joints flexible and better protect them from damage.

• Warm-up and stretch.

• Gradually increase our activity level – and intensity level – on a week-to-week basis.

• Use proper technique.

• Use proper gear and safety equipment.

• Listen to our bodies. The “no pain, no gain” theory is not a good mantra.

Samuel R. Goldstein, M.D. is an orthopaedic surgeon and sports medicine specialist at Andrews Sports Medicine and Orthopaedic Center. Dr. Goldstein specializes in sports medicine, arthroscopy of the knee and shoulder, knee joint replacement and general orthopedic surgery. He has been practicing medicine in Birmingham since 1989 and provides sports medicine coverage to various high school athletic programs in the Greater Birmingham area.

For more information, contact Andrews Sports Medicine and Orthopaedic Center at 205.939.3699 or visit 

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