Knee Pain and Skiing

Knee pain is a common complaint among skiers, and often knee pain in skiers is the result of an injury. The location and severity of the pain depends on the cause of the problem. Signs and symptoms that often accompany knee pain include redness, warmth, weakness, instability, swelling, stiffness, œlocking, and œpopping.

Be sure to notify your orthopedic specialist if you have knee pain accompanied with swelling, cannot fully extend of flex your knee, notice a deformity, have a fever, or if the knee œgives out.

Knee Injuries from Skiing

Because of the mechanics of the sport, knee injuries are quite common for skiers. These injuries can range from simple to complex, with 25% of all ski injuries affecting the knee.

MCL Injury – The most commonly injured knee structure is the medial collateral ligament (MCL). This is because of the type of stance and turn skiers use that places serious stress on the inside of the knee.

ACL Injury – The anterior cruciate ligament (ACL) is injured in more advanced skiers or from those who have a specific type of fall. ACL injuries are associated with sudden direction change with a twisting injury accentuated by the long lever arm of the ski.

Torn Meniscus – Another common skiing injury is a torn meniscus. The meniscus is a rubbery tough cartilage that acts a shock absorber for the joint. It is torn when you suddenly twist your knee with weight on it or from a direct contact blow during a fall.

Knee Bursitis – Certain knee injuries lead to inflammation of the bursae, the small sacs of fluid that cushion the knee joint. This condition is painful, especially with bending of the knee, and swelling is common.

Patellar Tendinitis – When one or more tendons are irritated and inflamed, patellar tendinitis develops. The tendons are the thick fibrous cords that attach bone to muscle. Skiers are prone to inflammation of this tendon that connects the quadriceps muscle on the front of the thigh to the tibia (shinbone).

Knee Dislocation – Pain from dislocation of the knee joint is rare and is a true emergency. The displacement of the leg stretches and tears the knee ligaments and may involove injuries to the arteries and/or nerves. This painful condition often produces an obvious knee deformity and requires immediate medical attention.

Kneecap (Patella) Dislocation – Dislocation of the patella is caused from direct trauma or forceful twisting of the knee. Obvious patella deformity occurs with this condition, and you should seek medical care immediately.

Runner’s Knee (Patellofemoral Pain)

Skiers put heavy stress on their knees that causes a condition called runner’s knee. This knee pain syndrome causes pain around the front aspect of the knee. The pain occurs with walking up or going down stairs, squatting, kneeling, or sitting.

Patellofemoral pain is caused by malalignment of the knee, partial dislocation, injury, flat feet, or tightness and weakness of the thigh muscles. Runner’s knee can be the result of soft tissue irritation in the front of the knee.

Treatment for Knee Pain

Treatment of your knee pain will depend on the particular problem that is causing the pain.

Basic First Aid for Knee Pain

Stop skiing and use the RICE formula:

Rest – Avoid putting weight on the painful knee.

Ice – Apply cold packs or ice wrapped in a towel for short intervals of time frequently.

Compression – Use an elastic bandage, like a simple knee sleeve with the kneecap cut out that fits snugly.

Elevation – Keep the knee raised up higher than your heart.

Nonsurgical Treatment

If you have knee pain, you should see an orthopedic specialist. The doctor may recommend physical therapy for you to learn reconditioning to regain full range of motion, power, strength, speed, and endurance. These exercises help the front thigh muscles (quads) and the back thigh muscles (hamstrings).

Another thing the doctor may recommend is a special brace to help protect and support the knee. Certain knee pain syndromes respond to injections of corticosteroids to reduce inflammation. The doctor may recommend a hyaluronic acid injection for joints that need extra lubrication.

Surgical Treatment

There are several surgical knee procedures for knee pain.

Arthroscopy – This is done when there is significant damage to the cartilage or meniscus. The orthopedic specialist uses a pencil-sized instrument (called an arthroscope) to look inside the knee joint to diagnose and repair your condition.

Realignment – This is done to reduce the pressure on the cartilage and supporting structures of the front aspect of the knee.

Partial Knee Replacement Surgery – This procedure is done when there is serious damage to the knee. The orthopedic specialist replaces the damaged portion with parts made of metal and plastic.

Total Knee Replacement – This surgery is done when the doctor must remove significant damaged bone and cartilage and replace it with an artificial joint.

Knee Pain Prevention

Keep weight normal – Maintaining a healthy weight is the best thing you can do to prevent knee pain and injury.

Get strong and stay limber – Weak muscles lead to knee injuries, so keep your quads and hamstrings strong. Balance and stability training allows the muscles of the knees to function properly. Also, avoid injury by stretching to increase flexibility.

Stay in shape – Prevent knee pain and injury by keeping yourself well-conditioned.

Use proper gear – Make sure your skiing shoes are good shock absorbers and of quality construction. Also, be sure your shoes fit properly.

Elbow and Shoulder Arthritis

I see three major types of arthritis that affect the elbow and shoulder joints. Osteoarthritis is the “wear-and-tear” arthritis caused from degenerative conditions, and occurs most frequently. Rheumatoid arthritis is less common and is a systemic inflammatory condition of the joint lining (the synovium). Posttraumatic arthritis is a form of arthritis that develops from an injury, such as a dislocation or fracture.

Elbow Arthritis

Many patients wonder, “What is arthritis”. For any joint, arthritis means, “joint inflammation”. In the case of the elbow, if the cartilage surface of the elbow becomes worn from age or damaged, elbow arthritis occurs. If you have elbow arthritis, you probably have pain, swelling, stiffness, and loss of normal range of motion. Some people complain of a “locking” or “grating” sensation in the joint.

These sensations are related to the loss of normal smooth joint surface and when pieces of loose bone or cartilage lodge between the joint surfaces interfering with normal movement. Often, my patients may notice numbness of the ring finger and pinky finger. This is related to the pressure placed on the ulnar nerve or funny bone from the swelling.

How is elbow arthritis diagnosed?

I can diagnose elbow arthritis based on your symptoms, a simple physical examination, and standard X-rays. This disease tends to be more common in men than women, and it generally occurs in people over the age of 50 years. You are at increased risk for elbow arthritis if you have a history elbow injury, inflammatory arthritis, or a family history of arthritis. Others at risk for elbow arthritis include people who have jobs or participate in activities that place demands on the elbow joint, such as professional baseball pitchers.

How is elbow arthritis treated?

I treat elbow arthritis predominantly based on your symptoms. Factors to consider include the stage of the disease, patient goals, and your overall medical condition and physical health. Nonsurgical treatment for elbow arthritis involves measures to alleviate or reduce pain, increase range of motion, and restore function. This includes physical therapy, activity restrictions and limitations, and oral anti-inflammatory or pain medications. If these conservative measures do not work, many patients benefit from corticosteroid injections, which can give several months of relief and can be both therapeutic and diagnostic.

Surgery may be necessary if nonsurgical measures do not control and alleviate symptoms. If the damage is not too severe, I can do minimally invasive and sometimes even arthroscopic procedures to remove loose bodies and degenerative, inflammatory tissue from the joint. This smoothes out the irregular joint surfaces and provides symptom relief. If the joint space is severely worn, I may suggest a joint replacement for you.

Shoulder Arthritis

The shoulder is made up of two joints. One of these is the acromioclavicular (AC) joint, located where the collarbone (the clavicle) meets the tip of the shoulder blade (the acromion). The other is located at the junction of the upper arm bone (the humerus) and the shoulder blade (the scapula), and this is called the glenohumeral joint. Both of these shoulder joints are often affected by arthritis. The symptoms of shoulder arthritis include pain, stiffness, decreased or limited range of motion, and crepitus. Crepitus is a “clicking” or “snapping” sound made with shoulder movement.

How is shoulder arthritis diagnosed?

I diagnose shoulder arthritis based on a thorough physical examination, symptoms, and basic X-rays. Most people with shoulder arthritis have a narrowing of the joint spaces, formation of bone spurs, and changes in the bone structure. People over the age of 50 years are at increased risk for shoulder arthritis. Also, having a history of an injury to your shoulder joint puts you at risk for developing this condition.

How is shoulder arthritis treated?

I treat shoulder arthritis based on the severity of the disease, health status and overall condition, activity level and work responsibilities, and prior history. Nonsurgical measures include oral medications, physical therapy, and activity restrictions and limitations. Patients that do not respond to these methods could have a corticosteroid or hyaluronic acid injection. When the joint is severely damaged or worn, or if the patient does not improve with conservative measures, the glenohumeral joint can be replaced with a prosthesis in a procedure called a total shoulder arthroplasty.

If necessary, the head of the humerus is replaced. For arthritis of the AC joint, a resection arthroplasty could help. I do this by taking a small piece of bone from the collarbone to leave room for movement.

Dr. Jonathan Franklin Named to Prestigious Best Doctors in America 2013

Dr. Jonathan Franklin, a board-certified orthopedic surgeon with Orthopedic Specialist of Seattle, was named to the Best Doctors in America 2013. Only doctors who earn the support and recommendation from their colleagues are included in this prestigious database, a registry of the top 5% of physicians in the United States.

The Best Doctors community is made up of doctors in a variety of clinical programs focused on ensuring the right diagnosis and treatment. Over 30 million individuals have access to the best medical providers through Best Doctors. Additionally, the community provides services to many philanthropy organizations focused on medically under-served international populations. … read more

OSS Offers New Online Bill Payment

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OSS is Collecting Children’s Books for March Book Drive

During the entire month of March, OSS will be collecting gently used children’s books for a local book drive. We are working in coordination with Family Works – Family Resource Center and Food Bank.

Come in to either OSS location with your gently used children’s books for donation during the entire month of March. OSS would like to collect as many books as possible with your help!

Ballard Location:

5350 Tallman Ave NW Ste. 500 Seattle, WA 98107
Directions to our Ballard office

Seattle Orthopedic Center:

2409 N 45th Street, Seattle, WA 98103
Directions to our SOC (Wallingford) Location

For more information about Family Works visit them online: FamilyWorksSeattle.org.

April Update: OSS was able to donate four full boxes of donated children’s books to Family Works. We would like to thank the Seattle area community for your contribution.