Articular Cartilage Injuries

articular cartilage injury

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

Definition

Articular cartilage is difficult to understand because there are 3 types of cartilages in the body : articular of hyaline cartilage (covers joint surfaces), fibrocartilage (knee meniscus, vertebral disk) and elastic cartilage (outer ear). These cartilage’s types differ in their structure, elasticity and strength.

Articular cartilage is a complex element, it’s a living tissue that is on the joint’s surface. The function is to provide a low friction surface to allow the joint to withstand weight loads through the range of motion needed to perform activity of daily living. To put it simply, articular cartilage is a very thin shock absorber. It’s built in 5 distinct layers and each layer has a structural and biochemical difference.

Injury

articular cartilage injury

Articular cartilage injury may be due to trauma or progressive degeneration (wear and tear). This can be mechanical destruction, a direct blow or other trauma. The healing of articular cartilage cells depends on the severity of the damage and the location of the lesion. Articular cartilage has no direct blood supply so it has very little ability to repair itself. It the lesion penetrates the bone under the cartilage, the bone provides blood in the area which improves the chances of healing.

Mechanical degeneration (wear and tear) of articular cartilage occurs with progressive loss of normal cartilage structure and function. This loss begins with the softening of the cartilage, then progresses to fragmentation. As the loss of articular cartilage lining continue, the underlying bone no longer has any protections against normal wear and tear of daily life and begins to get damaged leading to osteoarthritis.

In many cases, a patient experiences knee swelling and vague pain. At this stage, continuous physical activity isn’t possible. If a loose body is present, words such as « locking » or « catching » might be used to explain the problem. With wear and tear , the patient often experiences stiffness, decreased range of motion, joint pain and/or swelling.

Diagnostic

The physician examines the knee to look for a decrease in range of motion, pain along the joint line, swelling, fluid on the knee, abnormal alignment of the joint’s bones, and ligament or meniscal injury.

Cartilage lesions are difficult to diagnose and it’s possible that the use of magnetic resonance imaging (MRI) or arthroscopy may be necessary. Plain X- rays don’t usually diagnose articular cartilage problems but they used to rule out other abnormalities.

Treatment

articular cartilage injury treatment

 

Articular cartilage injury that doesn’t penetrate the bone doesn’t repair itself. A lesion that penetrates the bone can heal but the type of cartilage created is structurally unorganized and doesn’t work as well as the original cartilage.

Lesion less than 2 cm have the best prognosis and the best treatment options. These options are arthroscopic surgery using techniques to remove damaged cartilage and increase blood flow from the underlying bone (drilling, pick procedure or microfracture ).

For smaller lesion of articular cartilage surgery is not required.

For larger lesion, it’s necessary to transplant the articular cartilage from another area of the body. Talk to your doctor or specialist to have more information about the decision to have a surgical operation.

For patients with osteoarthritis, non-surgical treatment consists of physical therapy, lifestyle modification (for example reducing activity), bracing, supportive devices, oral and injection drugs (like non-steroidal inflammatory drugs, cartilage protective drugs) and medical management.

Surgical options depend on the severity of osteoarthritis and may provide a reduction in symptoms that are usually short-lived. Total osteoarthritis may relieve the symptom of advanced osteoarthritis but this usually requires a change in the lifestyle and/or level of activity of the patient.

Statistics

Based on published studies, the overall prevalence of articular cartilage injury in the knee is 36% among all athlete and 59% among asymptomatic basketball players and runners.

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-Steph

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Ankle Sprain

ankle sprain inversion lateral

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.

A sprain is a stretch injury of the ligament that supports the ankle. This sprain often happens to the ligament outside the ankle when the foot is twisted inward (inverted). It’s a « lateral » ankle sprain that localized to the ligaments in the outer/lower part of the ankle.

A « high » ankle sprain (or syndesmosis injury) is a ligament stretch injury that holds the tibia and fibula together in the lower leg. This type of sprain happens when the ankle is twisted outward, it’s an eversion injury.

ankle sprain inversion eversion syndesmatic lateral medial high

When there is a sprain, the ankle is tender and swollen on the outside, above and at the front of the ankle bone, but the pain doesn’t come from the ankle bone. A sprain can create moderate or severe pain that can prevent the foot from supporting the body weight.

ankle sprain stretch injury grade

Treatment of sprained ankle

ankle sprain rice rest ice compression elevation

The basic treatment is what we call RICE (rest, ice, compression and elevation). During a severe sprain, it’s advisable to use a walking boot to help support the ankle.

Recovery time for a « lateral » sprain is usually 1-3 weeks and for a « high » sprain is usually 3-6 weeks.

Rehabilitation can begin a few days after the sprain when swelling decreases. The rheabilitation has 3 goals :

  1. Restore movement and flexibility

  2. Restore strength

  3. Restore balance

How to avoid a ankle sprain

It’s possible to use a brace to help prevent sprains. There are several types of neoprene or elastic materials. Here are some models on Amazon, click here .

Statistics

  • Ankle sprains are more common in all sport that involve cutting and pivoting

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-Steph

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Tear Of Hamstring Muscle

hamstring muscle anatomy tear

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

In bodybuilding, tears of hamstring muscles are common. This often happens during squat when the torso is too much inclined. All hamstrings muscles (except biceps femoris short head) are extremely stretched and squeeze strongly to straighten the pelvis. Precisely at this point, there may be a muscle tear in the upper or middle part of this muscle group.

It’s possible that the tear of hamstring muscle occur with machine (leg curl). There may be a muscle tear with a heavy weight at the beggining of the movement when legs stretched and muscles stretched.

Usually, tears of the muscular fibers of hamstrings are small and not serious (it’s rare to see a major muscle tear or tendon disinsertion) but these tears are always painful and causes complications.

Indeed, often after a tear on this muscle group, there is a fibrous scar that causes a painful and disabling rubbing for sport practices. And it’s important to note that this scar isn’t elastic and can tear again during an intense effort.

Tip to avoid hamstring tears

To avoid theses muscle tears during squat or deadlift, it’s important to make specific stretching movements for hamstrings, before or between sets.

There are also other exercise like « Good-morning », stiff-legged deadlift or Romanian deadlift which helps because of their combined actions of muscle building and stretching.

After a tear of hamstrings

To avoid having a fibrous scar, it’s necessary to do a re-education a week after the tear. It’s important to do stretching exercises for the back of the thigh slowly. This allows you to stretch the injured muscles and to soften the scar so that it doesn’t tear when you start again the training.

feedback of hamstrings muscles

hamstring muscle anatomy tear pelvis

In modern societies, we sit for several hours. This can create in some people a feedback of hamstrings muscles. This muscles retraction of the back of the thigh puts the pelvis in retroversion and this creates a bad position of the spine.

This poor position of the spine causes the natural curvature of the spine to be lost over time. This results in poor posture, flat buttocks and round back that can trigger spinal pathologies.

To limit this feedback of hamstrings muscles, it’s recommended to do exercises that have a combined action of muscle strengthening and stretching at the back of the thigh as the « Good-morning », stiff-legged deadllift and Romanian deadlift. Then after this exercise session, it’s advisable to do some sets of stretching for hamstrings.

Action of hamstrings at squat

hamstring muscle anatomy tear squat

During squat, hamstring muscles squeeze to straighten the pelvis. This prevents the torso (in this phase the torso is bound to the pelvis by the contraction of the abs and lumbar) from bending too much forward.

hamstring muscle anatomy tear

Note

Fibrous scars can also be treated in parallel by a physiotherapist with manual or mechanical massages to soften the lesion.

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-Steph

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How To Do Box Squat

box squat

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

Box squat is often used by powerlifters to gain strength to do squat.

This exercise involves doing a squat sitting on a bench for 1-2 seconds and returning to the standing position .

In classic squat the tension accumulated in the muscles during the negative phase when you get down (as a stretched elastic ) and this tension restored during the positive phase when you get up. With box squat, sitting on the bench relaxed thighs muscle, there is not tension accumulated when you get down to be used when you get up.

For the same weight, quadriceps should provide more effort for box squat than classic squat. It’s a great exercise to target work on thighs.

This exercise can be included in a training program for people who have long legs and don’t feel their quadriceps work with classic squat.

box squat

Starting squat in sitting position allows push automatisms for the classic squat which has the effect of having the positive phase to get up faster and more powerful.

Attention : It’s necessary to be careful for this exercise in controlling the movement to get down to sit gently on the bench. If get down too fast, the butt crash on the bench and this can create serious trauma due to shock and excessive compression of spinal joints.

Note: There are special benches adaptable for different morphologies with a very padded seat to limit the risk of spinal injuries and the possibility of adjusting the height. To have a good execution of the movement, it’s necessary to have your back slightly incline. If your back is too vertical at start of the bench, the exercise will be impossible to do.

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

-Steph

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