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Tackling knee troubles

Not just sportspersons, anybody can suffer from a knee strain, which should be treated promptly

Modern life gives knees a hard time, and it is not just sports, old age and high heels we are talking about here. Even something as natural as jumping out of a running bus can damage the knee. And a damaged knee is trickier than most other body parts. Money and even the best of medical expertise cannot always guarantee complete or sustained recovery. Just ask Ronaldo, the Brazilian soccer star who spent nearly two years on the sidelines with torn knee ligaments.

The anterior and posterior cruciate ligaments join the top of the shin bone to the under surface of the thigh bone, and they keep the shin bone from sliding too far forward or backward in relation to the thigh. Along with the collateral ligaments they keep the knee joint stable during movement and injury to them causes joint instability that is difficult to treat because ligaments, unlike skin and muscle, have poor blood supply and low healing potential. Ever played soccer and felt your knee give way with a popping noise after a tackle? That popping noise is the sound of your anterior cruciate ligament (ACL) tearing and your thighbone kissing your shin bone goodbye. ACL tears happen when the shinbone moves too far forward and too fast in relation to the thigh. Examples include changing directions suddenly while running at high speed, slowing down abruptly after jumping from a bus or during a football tackle, and jumping from a height.

Typically, ACL tears are not painful immediately, but within two hours the joint begins to swell up, at which time there may be pain while standing up. Posterior cruciate ligament tears are less common, and the main causes include missteps and blows to the front of the knee. Neglected ligament tears can cause arthritis as the thigh and shinbones grind against each other while walking.

First aid for all knee injuries is Rest, Ice, Compression and Elevation (RICE), but cruciate ligament injuries deserve further investigation and prompt treatment. An MRI or an arthroscopic inspection may be part of the initial work-up, and treatment depends on the person's age, extent of injury and activity level. Non-operative treatment usually is for minor tears, the elderly, sedentary and those with otherwise stable knees. Muscle-strengthening with regular exercise and the use of a knee brace will provide acceptable joint stability.

RAJIV M.

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