By: Victor Palomino | Category: Health & Fitness | Issue: October 2008
Dr. Victor Palomino of The Orthopaedic Center in Tulsa offers tips on preventing knee injuries for women.
Did you know that women can be six times more likely than men to suffer from knee injuries? More and more young women are actively participating in athletics and sporting events that were once dominated by men. Knee injuries occur in both sexes; however, females are two to six times more likely to tear their anterior cruciate ligament (ACL) in contact and non-contact sports than their male counterparts. Reasons for this may be related to hormone levels, muscle imbalances, skeletal structure and strength differences.
Ironically, female athletes are more likely to have a knee injury when estrogen levels are at their highest. In addition, the skeletal structure of women – a wider pelvis – means that women’s thighs slant inward and create a greater quadriceps, or Q angle. The Q angle places extra force on women’s knees, especially during high impact activities.
Common knee complaints among women include:
• Your knees pop, grind and ache when climbing stairs or after prolonged sitting. This problem – called chondromalacia – can occur even among couch potatoes and results from a misalignment of the kneecap that forces it to grate against the lower end of the thighbone. What to do: Cut back on high impact exercises like running or playing tennis, but don’t stop altogether since these exercises play an important role in keeping the muscles that support your knees strong. Add non-impact activities like swimming to your fitness routine. Make sure your athletic shoes still provide adequate cushioning and support.
• You feel a sharp pain between the kneecap and shinbone during physical activity. This is typically tendonitis, which can occur when the tendons connecting the kneecap to the shinbone become inflamed because of overuse and repeated stress. This is patellar tendonitis, also known as runner’s knee or jumper’s knee. What to do: To ease pain and reduce swelling, take a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen. Elevate the aching knee. Cut back on high impact exercises temporarily. If the problem is consistent, ask your doctor about use of a patellar tendon support band placed just below the kneecap to take pressure off the tendon.
• Your knee is swollen and puffy and it is painful to straighten or bend it. This may be caused by osteoarthritis, when age or excess weight causes the cushioning joint cartilage to break down, and your body responds by increasing production of joint fluid. Or, you might have a meniscus tear. What to do: Use NSAIDs, rest, and use cold compresses on the joint to relieve the pain and swelling. If your knee becomes warm to the touch, contact your physician. Losing just 11 pounds can take pressure off your knees and reduce arthritis pain by 50 percent. If the pain is persistent, an MRI, arthroscopic surgery (minimally invasive surgery using a camera to work inside the joint), or perhaps joint replacement surgery on the knee may be recommended.
• When stepping or landing on the leg, your knee buckles and you feel excruciating pain. You may even feel or hear a pop. The cause is typically a tear in the ACL, the elastic band of tissue that stabilizes the knee, and it usually occurs when landing on the leg with the foot turned to the side and the knee twisted. What to do: Contact your doctor or an orthopedic surgeon. About a third of those who injure their ACL regain strength and motion with about eight weeks of rest and physical therapy. But, in some cases, arthroscopic surgery may be needed. Your sports medicine professional may also recommend exercises to help stabilize the knee.
With the increasing number of women engaging in more physical activity, research is focusing on early functional training to reduce stress on knee ligaments. Manufacturers of athletic braces and implants have also begun focusing on gender-specific products such as functional bracing and implants to provide the best possible outcome.
Of course the key to this rising problem is prevention. Maintain a healthy weight and good muscle balance in the legs. Strengthen the muscles supporting the knee; good strengthening exercises include walking up stairs or hills or riding a stationary bicycle. When actively participating in sports, wear the proper foot attire, and replace your athletic shoes when they no longer provide the stability and support you need, typically when the sole begins to show wear. Warm up before and after exercise with stretches targeting your leg muscles. Take it slow when starting a new exercise program.
If you experience knee pain, make an appointment with an orthopedic surgeon who specializes in knees, and follow any prescribed treatment to ensure you are able to maintain a healthy and active lifestyle. Orthopedic surgeons with special training in arthroscopy and sports medicine commonly perform reconstructive surgery on female athletes and weekend warriors. The surgical reconstruction and rehabilitation of knee injuries is the same for men and women.
Dr. Palomino makes bi-weekly visits to Elliott Medical Plaza in Pryor to see patients in an outpatient setting. For more information or to make an appointment, call The Orthopaedic Center in Tulsa at (918) 582-6800.