6 Things to Know About a Torn Meniscus

Your meniscus protects your knee joint.

Certain knee injuries can cause a meniscus tear. The meniscus is cartilage in the knee joint. You have two in each knee. They provide protection and cushioning that keeps the bones in the joint from rubbing together. Here’s what happens when you have a torn meniscus, what it feels like, and what to do about it.

1. A meniscus tear is an equal-opportunity injury.

Anyone can tear a meniscus. However, people who play sports are more at risk. That’s because sports often involve quick movements and contact. Twisting the knee the wrong way can result in a meniscal tear. This sometimes happens to older people with normal day-to-day activities because cartilage in the knee can weaken as you age. About 70 to 80% of people who tear their meniscus are male. Most tears occur in the right knee.

2. Pain and swelling are common symptoms of a torn meniscus.

You’ll most likely know if you have a torn meniscus. People usually feel pain, but can still walk. Sometimes swelling also occurs and it may get worse over time. You also might feel your knee getting stiffer. Some people feel like their knee is weak or gives way easily at times. See your doctor as soon as possible if you have any of these knee symptoms.

3. Doctors sometimes make a “snap” diagnosis.

Your doctor has many ways to tell if you have a torn meniscus. One of the best ways is the McMurray test. You will lie on your back and your doctor will bend and straighten your knee. With a torn meniscus, this will cause a snapping sound or pain. You might also have X-rays to rule out other possible causes of knee pain. Sometimes doctors order an MRI to get a good look at the inside of your knee.

4. Surgery isn’t always necessary for a torn meniscus.

A torn meniscus might not require surgery. The outer part of the meniscus sometimes heals itself. This is most likely to happen if the tear in this outer area is small. If this is the case, your doctor may want you to rest and elevate the knee. Also, over-the-counter pain medicine like ibuprofen (Advil, Motrin) can help while the knee heals.

5. Sometimes, a meniscus tear requires surgery.

Sometimes doctors recommend repairing or removing the torn cartilage. Today, doctors usually use arthroscopic surgery to stitch the cartilage back together. This type of surgery uses small incisions, a camera, and special equipment. If the tear cannot be repaired, your doctor might remove just the damaged tissue or remove the entire meniscus. The name for that surgery is meniscectomy. Your doctor can do this operation arthroscopically, too.

6. Rehab is necessary.

No matter what treatment you have, you will need to rehabilitate and strengthen your knee afterwards. If you had surgery, you might need to wear a brace for a while. This keeps the knee stable. Your doctor also might want you to do exercises to strengthen the muscles around your knee. Examples include leg raises, walking in a pool and riding a stationary bike. Some people work with a physical therapist during rehab. Recovery time varies, but people who have a meniscectomy tend to heal faster than those who have the tear repaired.

If you’re experiencing knee pain or suspect you have a meniscus tear, make an appointment to see one of our many specialist at Palmetto Bone and Joint to find out what can be done to fix your pain and get you back to an active lifestyle quicker!

Chapin – 803-941-8095

Newberry – 803-321-6254

Clinton – 864-833-3046

Runner’s Knee: How Much Do You Know?

Runner’s knee, the common term for patellofemoral pain syndrome, is a knee problem that affects many people. It happens when your kneecap (patella) is either misaligned because of a defect, or your knee is stressed, causing it to be out of alignment. Although it is painful, runner’s knee is usually not a serious knee injury, although it can have a significant impact on your life by limiting your activity. How much do you know about runner’s knee? Here are some facts about the condition that might surprise you.

1. You don’t need to be a runner to get runner’s knee.

Patellofemoral pain syndrome is called runner’s knee because it affects a lot of runners. However, many people who never run anywhere also develop runner’s knee. It’s like people who don’t golf can get golfer’s elbow, or those who don’t play tennis can get tennis elbow. Anyone who participates in an activity that bends the knee and puts a lot of strain on it is at risk of developing runner’s knee. This includes cycling, walking, jumping or climbing up and down stairs.

2. Repetitive movements can irritate your knee.

Do you have a job that requires you to bend and squat a lot? When you squat repeatedly, your knee makes the same movement and carries your body’s weight in the same places over and over again. You could be squatting to lift boxes, pick items off the floor, or reach lower shelves. Even parents of young children who have to pick them or their playthings off the floor are at risk of irritating their knees to the point of developing runner’s knee.

3. Your hamstring could be causing runner’s knee.

Your hamstrings are really three muscles in the back of your thigh. They help you extend and retract your leg. You may feel your hamstrings pull if you bend at your waist without bending your knees or you straighten your legs in front of you while sitting on the floor. When your hamstrings are too tight, they cause extra stress on your knees and could cause runner’s knee. Exercises and stretches to loosen the hamstrings can help reduce knee pain and keep it from coming back.

4. Your glutes can also cause runner’s knee.

Like your hamstrings, your gluteus medius, a muscle in your buttocks, may also be the culprit behind your runner’s knee. Instead of being too tight, like the hamstrings, if your gluteus medius, or glutes, are not tight enough, the rest of your leg tries to compensate. This puts stress on your knee. The gluteus medius is responsible for helping to pull your leg away from your body and rotate it externally. This is called hip abduction. If the muscle isn’t strong enough, the other muscles respond by trying to pull the leg inward instead.

5. Flat feet can equal knee pain.

Your feet play a vital role in your knees’ health. If you have flat feet, a low arch, or no arch at all, this puts your feet in an unnatural position when you step forward, particularly when you run. The impact of walking or running without arch support can cause extra tension on the muscles in your legs and pull on the knee, causing misalignment and stress. Wearing appropriate shoes and orthotics in your shoes can help fix how your foot lands when you take a step, taking stress off your legs and knees.

6. Where you exercise could cause runner’s knee.

Concrete and asphalt are unforgiving surfaces. If you’re running or playing sports on these hard surfaces, the stress on your legs and knees could cause runner’s knee. The solution is to run or play on more forgiving surfaces, like synthetic tracks, grass or dirt. This is also where good shoes appropriate for the activity are beneficial. They can help absorb some of the shock of running and jumping, taking away some of the stress on your knees.

7. Women are more prone to developing runner’s knee.

Doctors aren’t entirely sure why more women than men develop runner’s knee, but overall women do develop more knee problems. A woman’s pelvis is wider than a man’s. This wider pelvis affects how a woman stands and places a different type of pressure and strain on the knee. As well, women tend to have looser ligaments, the tough fibrous tissue that connects bones. Women also land on their feet differently when they run or jump, adding to the difference in knee stress.

8. Runner’s knee can be easy to treat.

Once you know what is causing your runner’s knee, it can be fairly easy to treat. If it is caused by improper foot support, good shoes or orthotics will help. If it’s caused by too tight ligaments or muscles, physical therapy and exercise can ease the pain and reduce the risk of it returning. Muscles too weak? Strengthening them at home or in a gym will help. Running on a hard surface? Switch locations for a gentler landing when you run or jump. The key is working at it and staying consistent.

9. Surgery is rarely necessary for runner’s knee.

Doctors only consider surgery for runner’s knee if you have tried non-surgical treatment for 24 months and you still have pain. It’s rarely necessary. If you have runner’s knee and you have faithfully tried all the exercises and changes recommended by your doctor or physical therapist, an orthopaedic surgeon will assess you to see if surgery will help.

If you are experiencing knee pain, call and make an appointment with one of our orthopaedic specialists today at Palmetto Bone and Joint.

Knee friendly exercises to help you get healthy and loose weight for the New Year!!

Losing weight can be difficult when pain and stiffness from arthritic knees keep you from being active and makes it tough to burn calories. Studies suggest carrying a few extra pounds can create added pressure on joints causing further stress to your knees which may hamper your exercise level even more. So what exercises can you do to lose weight without irritating your knees? Let’s explore a few.

1. Strength Training

Studies show as you get older, the amount of muscle in your body tends to decrease. Fat accounts for more of your weight which slows down your body’s ability to burn calories. But muscles reportedly burn more calories than fat, so by building up muscle through strength training, you can boost your body’s ability to burn more calories. Developing muscles also increases your body’s ability to absorb shock to your joints, something that can benefit an arthritic knee. Strengthening exercises include lifting weights, using weight machines at the gym, and resistance band training.

2. Water Aerobics

Water aerobics can make a splash when it comes to weight loss and strengthening muscles especially when you have pain in your knees. Fitness experts say water helps un-weight your joints allowing you to move more freely without feeling the impact of hard ground surfaces that stress an inflamed knee joint. There are water weights and assistive equipment to help. And try walking in the pool for an extra workout. Water has much greater resistance than air, which means walking in water requires more effort, thus burns more calories.

3. Biking

Riding a stationary bike is a good way to burn calories and is a nice alternative to running which can irritate your knees.  Experts suggest doing at least 30 minutes of aerobic activity 5 times a week to see the beneficial effects. A bike also addresses the range of motion in your knees, hips, and ankles which is often affected by arthritis. Keep the resistance mild to moderate and vary your speed. Be sure your knees don’t roll in or roll out while pedaling to avoid straining them.

4. Walking

Looking for a low impact exercise that burns calories? Walking typically puts less pressure on your joints compared to running. Be sure to wear cushioned supportive sneakers. Also, avoid walking with your toes facing out to the sides. This puts more pressure on the inner portion of your knee joints. Walking on grassy surfaces will also soften the blow on your knees as you walk. Experts suggest exercising at a moderate pace 30 minutes a day, 5 days a week to help burn fat.

5. High Intensity Interval Training

Depending on your fitness level, try High Intensity Interval Training (HIIT) to shed abdominal fat. HIIT involves performing short bursts of exercise at a high intensity level followed by a longer lower intensity level. You can do these cycles on a stationary bike or an elliptical machine to avoid hurting your knees while exercising outside on pavement.

6. Yoga

Yoga not only burns calories it has added benefits that may help you lose weight and alleviate inflammation in your knee joints. Fitness experts say yoga has been shown to lower cortisol–a stress chemical that some studies link to weight gain. Another study revealed women who practiced yoga showed lower levels of interleukin-6 in their blood, a protein that causes inflammation. Inflammation plays a central role in the painful swelling and stiffness in arthritic joints. Yoga also addresses muscle strength and flexibility which can help keep you moving with other activities.

7. Tai Chi

A recent study found that tai chi can specifically reduce the pain and physical impairment of people with severe knee osteoarthritis.Tai chi offers a way to burn some calories and incorporates range of motion, strengthening, flexibility and balance motions–all of which can be affected by arthritic knees.

8. Swimming

Swimming is a great way to get aerobic exercise with the added benefit of using the water’s buoyancy to help reduce impact on your joints. It also addresses the range of motion of your arms and legs. Swimming strengthens leg muscles which protect your knees throughout the day. Fins and kickboards are available to enhance your swimming routine. If the pool is heated, it can help soothe stiff joints.

Call for an Appointment 

Palmetto Bone and Joint has numerous specialist to take care of your arthritis or any bone and joint problem you may have. Call to schedule an appointment at any of our 3 convenient locations.

 803-941-8095, 803-321-6254, or 864-833-3046.

5 Facts Palmetto Bone and Joint Wants You to Know About Arthritis

Osteoarthritis is the most common type of arthritis, affecting nearly 27 million Americans ages 25 and older. Each day, many people suffering from osteoarthritis will visit our offices, and many of them are confused about what they’ve heard about the disease.

Here are some facts about arthritis that we discuss daily with our patients. 

Fact #1: If one of your parents has osteoarthritis, you won’t definitely get it

You are more likely to get osteoarthritis if one of your parents has it, particularly if they have it in the knees. Women are more likely to inherit it than men. However, genes aren’t a perfect predictor. There’s a lot you can do to lower your risk of developing osteoarthritis, even if it runs in your family. If you live a healthy lifestyle, exercise regularly, and maintain a healthy weight, you can reduce your risk. 

Fact #2: Diet and exercise have a LOT to do with osteoarthritis

Actually, diet and exercise have a LOT to do with preventing osteoarthritis and lessening the pain it causes. With every pound you gain, you add four pounds of pressure to your knees. Being overweight increases your risk of developing osteoarthritis and speeds the rate at which the condition will develop. It’s very important to maintain a healthy weight. In fact, two out of three people who are obese will develop osteoarthritis. People with osteoarthritis can stay active and lessen their pain with low-impact exercises like walking, swimming, cycling, and yoga. These exercises help keep the muscles around your joint strong, and they involve stretching, so you’re able to maintain a full range of motion. 

Fact #3: A doctor can still help me with knee pain if I don’t want surgery

It’s true that there is no cure for osteoarthritis, but surgery isn’t the only option. In fact, about 40 percent of seniors have osteoarthritis of the hip or knee, but only about 5 percent will undergo replacement surgery. You can manage osteoarthritis symptoms through a combination of exercise, weight loss, pain management techniques, alternative therapies, and nonprescription and prescription medications. Some improvement in pain and function is possible in almost everyone with osteoarthritis. 

Fact #4: Osteoarthritis doesn’t happen to everyone when they age

Osteoarthritis is not a normal part of the aging process, but the risk of developing it does increase with age. There are plenty of elderly people who don’t have osteoarthritis, and there’s a lot you can do to prevent it from developing. You can lower your risk by maintaining a healthy weight, exercising regularly, and resting any exercise-induced injuries. 

Fact #5: Osteoarthritis and rheumatoid arthritis are not the same thing

Osteoarthritis and rheumatoid arthritis are two types of arthritis. Osteoarthritis is the most common type. It’s also known as degenerative joint disease or “wear-and-tear” arthritis, because it’s caused by the breakdown of joint cartilage. Osteoarthritis is mostly a consequence of aging, because as we age, the water content of our cartilage increases while the protein composition of our cartilage degenerates. Osteoarthritis can also be caused by the overuse of joints, and by obesity, among other contributors. 

Rheumatoid arthritis, on the other hand, is a chronic, inflammatory type of arthritis. It’s an autoimmune disease that involves multiple joints. Researchers are still working to determine the cause of the abnormal autoimmune response. Common theories point to a genetic predisposition and a triggering event. 

Osteoarthritis is a difficult problem to deal with, but with education and encouragement, patients can feel empowered to improve their daily lives. 

Call for an Appointment 

Palmetto Bone and Joint has numerous specialist to take care of your arthritis or any bone and joint problem you may have. Call to schedule an appointment at any of our 3 convenient locations. 803-941-8095, 803-321-6254, or 864-833-3046.

10 Things Palmetto Bone and Joint Wants You to Know About Fractures

About 6 million people break bones in the United States every year. The most frequently broken bone is the clavicle, or collarbone. Other common bone fractures include those in the arms, wrists and ankles. If you’re over 65, you’re more likely to break your hip than any other bone. You can break bones due to injury or diseases like osteoporosis, which weakens bones. Orthopedic surgeons specialize in treating broken bones in all scenarios. Here’s what three board-certified orthopedists want you to know about bone fractures, risk factors associated with them, and tips for helping them heal properly.

1. “A fracture and a break are the same thing.”

Patients frequently think bone fractures and bone breaks are different, says Dr James Loging, MD. “I hear this all the time,” Dr. Loging says. Sometimes people think “fracture” means a crack while “break” means a clearly separated bone, but this is not true, he says. “Fracture” is simply the term doctors use to refer to any break or crack in a bone.

2. “If you smoke, your fracture might not heal as fast.”

If you ingest nicotine—whether through cigarettes, cigars, chew tobacco, or even the nicotine patch—you may find that your fracture takes longer to heal than for a non-smoker, says , Dr Phillip Milner, DO. This is due to the effect of nicotine on the healing process. If you quit smoking, it will take three months before your body responds to bone breaks like a non-smoker’s would, Dr. Milner says.

3. “Try RICE for non-emergency injuries.”

If you have a broken bone cutting through your skin or your bones are looking crooked and weird (what doctors call a deformity), you need emergency medical care, says Dr Mark Wilson, MD. But if you only have pain and swelling, and aren’t sure if it’s a break, he says, you could try treating your injury at home for a day or two with “RICE”: rest, ice, compression (wrapping with an ace-type bandage) and elevation. “If that doesn’t work, then you should be seen by a doctor,” Dr. Wilson says.

4. “Don’t wait too long to be seen.”

If you wait too long to bring your possible bone fracture to your doctor’s attention, your bone could start healing on its own—and possibly in a crooked way. That makes fixing the problem more difficult than if you’d come in earlier, says Dr. William Owens, MD. Or you could have underlying damage to the surface of the joint or other problems that are harder to treat the longer you wait, says Dr. Owens. Waiting can also make it more likely you’ll need surgery. For non-emergency fractures, Dr. Owens recommends patients be seen within a couple of days. If you require an operation, he says, this gives you time to get it scheduled before bones start knitting back together (which usually happens within a few weeks).

5. “Even little fingers and toes need to be checked out.”

You crack your little toe against a table leg. Should you bother getting it checked for a fracture? “It depends how bad you feel,” says Dr. John Hibbitts, MD, noting that in similar situations, he might wait a couple days and, if still in pain, see a doctor to have it X-rayed. But in general, he says, it’s better to err on the side of caution and see your doctor. After all, broken toes that heal crookedly can cause your shoes not to fit right, resulting in pain, warns Dr. Hibbitts. Similarly, ignoring finger fractures can cause “significant disability” and lead to longer surgeries once patients finally come in, he says.

6. “Moving it doesn’t mean it is not broken.”

Dr. Loging often has patients say they didn’t think their bone was broken because they could still move the affected body part. But, he says, this is a fallacy. “There’s only one way to know if it’s broken and that’s with an X-ray,” he says. Dr. Loging says “The idea that if I can move it, therefore it can’t be broken is not true. You can almost always move it,” even if it is broken. Signs that it could be a bone fracture include significant swelling, tenderness around the site, bruising, and an inability to bear weight on it even after a couple of days’ rest, says Dr. Loging.

7. “I don’t always operate.”

“People think orthopedic surgeons do surgery 99% of the time,” says Dr. Milner. This can cause some patients to avoid seeing him, he says, because they think they’ll wind up in the operating room. It’s perhaps an understandable misconception, given that “surgeon” is part of his title. But, Dr. Milner says, “Most of what we do isn’t surgery.” Instead, he says, orthopedists do the least invasive procedures possible first to promote bone fracture healing, only moving up to surgery if more conservative measures don’t work.

8. “When we tell you to elevate it, take us seriously.”

“We’ll have folks come in a couple of days after a broken ankle, for example, and they may have been laying around on the couch but not with the ankle truly elevated—which is above the level of your heart,” says Dr. Wilson. If you’re lying down, you can put two or three pillows under your leg to achieve proper elevation, she says, but if you’re sitting, you’re going to have to use more than that to get your leg high enough. Elevation is key to preventing swelling, which also could delay surgery, if that’s needed, Dr. Wilson says.

9. “Splints are not second-class citizens.”

Casts are non-removable and go all around your broken bone, while splints go only halfway around and can be taken off and on. Both casts and splints are used to immobilize your broken bone and both can be written on and decorated. Yet some patients think casts are best and get disappointed if they get a splint instead, says Dr. Hibbitts. “A lot of times patients don’t give the splint a lot of respect.” Doctors use splints for several reasons, says Dr. Hibbitts, including when a cast is difficult to place due to the location of the break or when doctors want to leave room for swelling.

10. “Forget the ‘6-week rule’ of bone healing.”

Dr. Owens says he often has patients tell him they know fractures are cured in six weeks, which he says is “an incredible piece of misinformation; no adult is going to heal in six weeks.” Most bone fractures take anywhere from 2 to 6 months to heal, depending on many factors, he says. “There’s not just one rule for every broken bone,” says Dr. Owens. “It’s important to understand there is specificity and details matter,” such as where a bone is broken, what bone it is, what the fracture pattern looks like, and so on. “It’s difficult to generalize.”

Call for an Appointment

Palmetto Bone and Joint has numerous specialist to take care of any fracture or bone and joint problem you may have. Call to schedule an appointment at any of our 3 convenient locations. 803-941-8095, 803-321-6254, or 864-833-3046.

Are Knee Injections Right for Me?

The fluid in your knee joints have a natural lubricant between the bones called hyaluronic acid. The lubricant acts as a shock absorber. In many people, this lubricant wears away with time, causing knee pain. Your doctor may prescribe nonsteroidal anti-inflammatory drugs (NSAIDs) to provide relief. But if over-the-counter or prescription strength NSAIDs don’t provide relief, your doctor may recommend injections. Your options include synthetic hyaluronic acid and corticosteroids. Each acts in a different way.

Viscosupplementation Injections

Viscosupplementation injections infuse your problem joint with synthetic hyaluronic acid. Depending on the product your doctor uses, he or she may give you an injection once a week for three to five weeks. As part of the procedure, your doctor will likely remove a small amount of your own joint fluid to make room for the synthetic version. According to the American Academy of Orthopaedic Surgeons (AAOS), you are not likely to experience pain relief immediately. You may even have some swelling, pain, and a feeling of warmth at the site of your injection. Applying an ice pack will help, and your symptoms should go away quickly. For the first 48 hours, you should stay off your leg as much as possible and avoid heavy lifting. 

You should find that your pain lessens as you receive more injections. Hyaluronic acid is not an anti-inflammatory, but it may stimulate your body to make more of its own hyaluronic acid. It seems most helpful for those with early, mild-to-moderate knee conditions. Viscosupplementation is not recommended for people who have had osteoarthritis for a long time. 

Corticosteroid Injections

Sometimes doctors will inject corticosteroids into your knee joint to relieve pain. Cortisone is a specific kind of steroid that your adrenal glands make naturally. These glands are located above each kidney. Cortisone decreases inflammation and, in turn, reduces pain. 

People with moderate-to-severe knee pain are likely candidates for corticosteroids. According to the AAOS, corticosteroid injections are most helpful if you have a lot of swelling. They are not as useful if your osteoarthritis affects your joint mechanics—your ability to move. Your doctor has a choice of corticosteroids to use. 

As with viscosupplementation, the site of your injection can become inflamed immediately after the injection. Icing and avoiding strenuous activity can help with cortisone injections as well. 

Manufacturers say that corticosteriods can provide relief from pain and inflammation, anywhere from a few days to more than six months. However, studies find the benefit is short-lived, from one to four weeks. 

While cortisone injections don’t have the same side effects as oral steroids, they still have risks. If you get too many injections, your cartilage can break down, causing more joint damage. For this reason, your doctor is likely to limit the number of injections.

Viscosupplementation Versus Cortisone Injections

Both approaches have mixed reviews. A 2009 analysis of studies on both types of injections revealed that people had better initial benefits from the cortisone injections than from viscosupplementation. After four weeks, the results were about the same. At the three- and six-month marks, however, relief was better from the hyaluronic acid (viscosupplementation).

Another analysis in 2012 offers a different viewpoint. It found that injections of hyaluronic acid have little effect on pain, and when they do, results start to fade after eight weeks. The study also suggested that the injections had side effects, including gastrointestinal and cardiovascular events. Doctors still don’t know the long-term effects of hyaluronic acid injections, and more research needs to be done in this area.

The bottom line is that there is uncertainty surrounding both types of knee injections.  

Talk to your doctor to make the right decision for you. 

Key Takeaways

  • If you’re not getting the relief you need from oral medications for knee pain, your doctor may recommend injections into your joint.

  • There are two main kinds of injections, viscosupplementation and corticosteroids.

  • Viscosupplementation is suggested for people with mild-to-moderate osteoarthritis. Corticosteroids are suggested for people with moderate-to-severe pain.

  • Both injections have side effects, and the benefits may be short-lived. Talk to your doctor to help make the right decision for you.

Call for an Appointment

Palmetto Bone and Joint has numerous specialist to take care of any fracture or bone and joint problem you may have. Call to schedule an appointment at any of our 3 convenient locations. 803-941-8095, 803-321-6254, or 864-833-3046.