Meniscal Tears

meniscus

What’s up ? This is THE stephane ANDRE. With my training, I’m interested in biomechanics to avoid injuries. I read « Sport Medicine Media Guide » and I learned some good stuff.

Meniscus tear

meniscus tear

Meniscal tear is one of the most common knee injuries in athletes. This is caused after a contact injury or a traumatic twist. The meniscus is a wedge-shaped cartilage that provides a cushion in the medial and lateral portion of the knee joint and acts as a « shock absorber ». It’s located in the area of joints contact to prevent the bones rub between them because of the bodyweight. It’s hard and rubbery to help cushion the joints and keep the knees stable.

It’s important to also know that the meniscus helps to nourish the knee by facilitating the diffusion of joint fluid. With this injury, athletes can experience acute pain with a swelling and often a catching or locking sensation.

Diagnose

A meniscus injury can be diagnosed on the basis of the story that the patient provides and a physical examination of the knee.

An orthopedic surgeon my also use other techniques to further diagnose such as magnetic resonance imaging (MRI), which gives a 3-dimensional image of the inside of the knee joint. In some cases, a surgeon can perform an arthroscopic inspection of the articulation, this is a minimally invasive surgical procedure.

Treatment

knee brace

A small meniscus tear can be treated with rest, ice and anti-inflammatory medications. When a meniscus tear causes a significant loss of movement or catching, the appropriate treatment is often a surgical operation. Depending on the location and type of tear, the treatment may be a simple arthroscopy to remove the torn fragment. Depending on how quickly the inflammation disappears, athletes can return to a full activity after a week or months.

For athletes with a repairable tear, sutures are used to sew the meniscus. In this situation, the knee is braced for 6 weeks. These athletes take at least 3-6 months to back to their activities but maintain the full cushion in their knees.

Prevention

There is not really any way to prevent a meniscus tear apart from a conditioning program to try to prevent an acromioclavicular ligament (ACL) tear and knee instability.

Stats

Women have meniscus tears more often than men and at an earlier age. These tears are often associated with an acromioclavicular ligament injury (ACL)

There are some variables of meniscus tears can be repaired and despite repair, they aren’t always heal. But arthritis can be avoided in the majority of cases when repair is successful. One study shows that 60% of patients who undergo meniscectomy (partial elimination) had some degree of progressive arthritis.

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-Steph

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Acromioclavicular Joint Injury

acromioclavicular joint injury

What’s up ? This is THE stephane ANDRE. With my training, I’m interested in biomechanics to avoid injuries. I read « Sport Medicine Media Guide » and I learned some good stuff.

Acromioclavicular joint is a joint between the clavicle and the scapula. Acromion is a continuation of the scapular spine and hooks over anteriorly. It articulate with the clavicle (collar bone ) to form the acromioclavicular joint.

Problems types

The most common problems are arthritis, fracture and separation. Arthritis is characterized by a loss of joint’s cartilage. Arthritis of acromioclavicular joint is common with weight lifter, especially with bench press and a little less with shoulder press. When there is a problem with the rotator cuff, it’s possible that there is also acromioclavicular joint’s arthritis.

Acromioclavicular separation

acromioclavicular joint injury type grade

When there is an acromioclavicular joint separation, it means that the ligament that connects the acromion and clavicle is damaged and that the 2 structures don’t align properly. Separation’s state can be weak or severe, that is why there is a system of « grade » according to which ligament is torn and the severity of the tear.

Grade I Injury – This is the weakest damage and the acromioclavicular joint is still aligned.

Grade II Injury – This is an average damage. Ligaments are only stretched but not fully torn. In case of stress (physical effort), the acromioclavicular joint becomes painful and unstable.

Grade III Inury – This is a serious damage. Ligaments are completely torn and the collar bone is no longer attached to the scapula, which creates a visible deformity.

Treatment of acromioclavicular joint arthritis

If the rest, ice, medications and change of the training program (changing the exercises) don’t work, the next step is a shot of cortisone. A shot of cortisone in the joint may have calmed the pain and may be permanently swollen. As each individual is unique, the effects may vary and it’s possible that it doesn’t swell permanently.

If non-surgical methods fail, it’s possible to perform a surgical operation. The pain is localized at the bones end that make contact with each other and the goal of the operation is to remove some of the end of the clavicle. This ambulatory surgery can be done with a small incision of 1 inch (2.5 cm) long or with the arthroscopy technique with 2-3 incisions. The results and recovery of these 2 surgical techniques are about the same. Most patients have a full movement by 6 weeks and can return to do sport by 12 weeks.

Treatment for acromioclavicular separation

Separation can create very painful injuries, so the first thing to do is to decrease the pain. Hold the arm in a sling, put ice and pack the shoulder for 20-30 minutes every 2 hours as needed. Acetaminophen and non-steroidal anti-inflammatory medications can also help calm the pain.

When the pain begins to subside, it’s important to move the fingers, wrists and elbow (and eventually the shoulders) in order to avoid having stiff or « frozen » shoulder. The length of time needed to regain complete movement and function depends on the severity or injury’s grade.

Recovery from Grade I acromioclavicular separation usually takes 10-14 days while Grade III takes 6-8 weeks.

When surgery

Grade I and II separations require very rarely surgery. With a Grade III injury, after surgery, it’s possible to have full body physical activity with some restrictions.

Statistics

  • More males than females suffer acromioclavicular joint injuries

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-Steph

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Acromioclavicular Problems

acrominioclavicular problem

I read a Frederic Delavier’s book « Strength Training Anatomy » and there is good stuff.

Frequent bodybuilding’s athletes are often confronted with acromioclavicular diseases.

This doesn’t happen in the same way as with sports like rugby, football, riding or combat sport with projections where the shoulder joint can be damaged by a fall or violent contact which leads to acromioclavicular dislocation with a ligament tear.

In bodybuilding, it’s micotraumatism caused by excessive, repetitive and poorly controlled work of the shoulder joint.

The pain happens little by little and after a while, pain prevents doing exercises like bench press or dips.

When doctors examine the acromioclavicular joint, it’s painful to pressure and slightly swollen.

It’s a problem without real gravity but the cure is long. The joint capsule and ligaments stretched because of inflammation, which give play to the joint. It takes some times for the entire articulation to return to its inital size.

Firstly, it’s necessary to stop the upper body training for 2 weeks

Note : from a bone view’s point, the upper limb connected to the bust by the clavicle which goes from the sternum to the scapla. In bodybuilding workouts, clavicular joints are often over-solicited and this create inflammatory pathologies of wear and tear.

Back to train

When upper body workout starts again, it’s necessary not to do bench press, dips and all movements with pushed down for at least 2 months. This is important to avoid re-stretching acromioclavicular ligaments.

Military press with barbell/dumbbell, inclined bench press and all movements with pusched up are allowed as they stabilize acromioclavicular joint. These movements limit the risk of ligament stretching.

If these tips aren’t respected. The joint inflammation will continue causing intra-articular calcifications and seriously compromising a sport career.

acrominioclavicular problem

Prevention :

These acromio-calvicular inflammations often occur after excessive training with the bench press due to a poorly controlled movements, with a too rapid descent, rebounding on the torso, sets too long and jerky.

The bench press in powerlifter’s style can also trigger inflammatory pathologies.

It’s for this reason that, at the least suspicious pain, it’s necessary to stop these movements for a time and to replace them by cable chest fly, dumbbells movement with a certain inclinaison of the bench for continue working chest.

Share this articles if you think it can help someone you know. Thank you.

-Steph

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