Diagnosing A Fluid In The Knee
Visually, a knee with fluid will usually look swollen and puffy. If your physician suspects that fluid in the knee may be an issue, he or she may extract some fluid from the knee using a sterile syringe to assess what type of fluid is present. A lab test may be requested to test for the presence of infection or other types of issues. Your doctor may also suggest an imaging test, such as X-ray , MRI or ultrasound which will help him or her evaluate the situation.
Stretch To Improve Range Of Motion
There are four main types of stretching: Static, dynamic, ballistic, and PNF. Of these four, you are most likely to have performed static stretching . The stretch you have probably heard least about is PNF stretching, yet for rehabilitating your knee, its the most important one!
PNF stretching usually requires a partner. Using the lying hamstring stretch as an example, lie on the floor while your partner straightens your leg and raises it up in the air until your hamstring feels tight. After 10 seconds or so you flex your hamstrings to create force against your partner. You continue pushing into your partner for 10 seconds before relaxing.
As you relax your partner will be able to take advantage of the stretch reflex to move your leg into a deeper stretch. Over time, this will eventually lead to a permanent increase in your range of motion, more so than static stretching . Check out the quick demo above.
While recovering from a knee injury, its crucial that you regain your full range of motion so that you knee function is not inhibited by muscle tightness. Use PNF to stretch your hamstrings, quadriceps, and possibly your gastrocs at least twice per week .
On A Scale Of 1 To : How Bad Should A Knee Feel Before Getting Knee Replacement
Each persons pain tolerance is different.
It is hard to say when someones pain level reaches a certain point that TKR is necessary. You have to assess your own quality of life and your own ability to tolerate knee pain.
The clincher for me was not so much the pain but the quality of life. I could no longer walk the beach, participate in golf or pickle-ball without swelling and severe pain.
As I have mentioned before, my pain increased slowly over a period of 40 years and I just accepted it and learned to live with it. The last two years before my surgery I did notice a marked increase in pain during walking and recreational activity.
I did not experience pain while trying to sleep or while doing everyday things around the house. Other people noticed that I limped more and looked like I was in pain.
It was at my son-in-laws suggestion that I finally saw an orthopedic surgeon and made the decision to have TKR.
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Indications Of Knee Aspiration For Diagnostic Purposes Include
- To evaluate joint effusion
- To assess unexplained monoarticular arthritis
- To evaluate possible infective or septic arthritis
- To evaluate type of arthritis and joint related conditions
- To determine presence of crystal induced conditions like gout
- To determine the nature of accumulated fluid and cytology studies in synovial fluid analysis.
What Is The Recovery Time For A Knee Injury
The recovery time for a knee injury depends on the type and severity of the injury. If the injury is significant enough to require surgery and/or physical therapy, the recovery time will be longer.
Simple strains or sprains can last for one to two weeks. More extensive injuries requiring arthroscopic surgery may take one to three months to heal.
Major traumatic injuries to the knee may take up to a year to heal.
Physical therapy can also speed recovery time. It is important to follow directions of your physical therapist to insure you are doing the exercises correctly and attaining the best results.
Chronic knee injuries that do not require surgery may flare up from time to time. Physical therapy, anti-inflammatory medications, and cortisone injections are used to provide temporary relief.
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What Are The Symptoms Of Knee Pain In Teens
Symptoms depend on whats causing your teens knee pain.
Anterior knee pain:
- Pain begins gradually worsens with activity.
- Dull, aching pain behind the kneecap, below the knee or on sides of the kneecap.
- Pain flares and grinding sensation with repeat knee bending .
- Thigh muscle weakness .
- Knee buckles .
Trauma to knee:
- Popping, clicking, crackling in the knee when bending .
- Knee that locks or buckles.
- Pain on the bony prominence.
- Pain that varies and gets worse during or just after the activity.
- Reduced range of movement.
- Pain, tenderness and swelling at the bottom of the kneecap.
- Balance problems.
- Trouble putting weight on the affected leg limps first thing in the morning.
- Redness, swelling, warmth, stiffness and soreness in joints, including the knee.
- Symptoms come and go.
- Dull ache, stiffness and swelling at the knee.
- Joint clicking.
Indications Of Knee Aspiration For Therapeutic Purposes Include
- Relieving Tense Effusion When knee swelling is large or tense or pain causes discomfort, drainage of fluid helps to relieve the pressure and pain.2 Reduction in swelling and decreased tension aids in improving joint movement.
- Drainage of Infected Fluid In a known infective condition, drainage of septic effusion can help in providing relief, improve joint movement and prevent damage to the joint.
- Injection of Medications into the Knee Joint Knee aspiration and injection is at times performed to provide relief in joint conditions.3
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Is My Knee Injury Serious 5 Signs To Look For
Your knee twists, you hear a pop, and now you have knee swelling and pain when trying to walk or with bending your knee. Perhaps you were struck by another player and have bruising, but no swelling. Are these severe knee injuries? When should you consider seeing a Sports Medicine Doctor following a knee injury? Lets go over 5 things that trained professionals look for to determine if your knee injury is serious.
As an active athlete or competitor, you know that severe knee injuries are common. Both contact and non-contact knee injuries can be severe. This post will cover five signs to look for to help determine if you might have a severe knee injury. In general, the most common and worrisome finding is immediate, significant swelling.
Even though most of the injuries I see in the office turn out to be mild, it is essential for you to know what the warning signs are to look for a potentially severe knee injury.
What Other Symptoms May Be Associated With Knee Pain
If you have knee pain, you may get other symptoms such as:
- swelling, redness or heat in the knee
- bruising around the knee
- locking or clicking
- inability to straighten your knee
See a doctor if the pain doesnt improve in a few weeks, if you cant move your knee or put any weight on it, or if your knee locks or gives way.
Go to an emergency department if your knee is very painful, is badly swollen or has changed shape, or if you have a fever and a red and hot knee.
The Anatomy Of The Knee
Before looking into how to rehab your own injury, it is important that you understand a bit of the anatomy of the knee. This will make it easier to follow the instructions later on.
There are several main muscles that surround the knee. The first set is the Quadriceps muscles, which are grouped on the anterior side of your thigh and attach to the knee via the Quadriceps Tendon. On the posterior of your thigh you have the Hamstring muscles, which attach to the knee via the Hamstring tendon.
The bone structure of the knee is made up of the Femur , the Patella and the Tibia . There are two types of ligaments in the knee. The Collateral ligaments are found on the sides of your knee, while the Cruciate ligaments cross over the knee.
Finally, the Meniscus is a type of fibrous cartilage that provides support, stability, and shock absorption for the knee.
Prevention Of Knee Injuries
There are several things you can do to reduce your chance of damaging your knee ligaments. This will help to prevent other sports injuries too.
- Exercise regularly to keep your fitness levels up, and include some resistance training . Regular exercise will make your muscles stronger and more flexible, so they can support your joints, including your knees. If you haven’t been active for a while, start off gently and gradually increase the number, length and intensity of your exercise sessions.
Housemaids knee is the common name for prepatellar bursitis. Its often caused by the pressure of kneeling forwards for long periods. These days, prepatellar bursitis is often seen in carpet fitters or roofers anyone who spends a lot of time working on their knees.
See our Types of knee injury section for more information.
Causes Of Knee Bruises
Bruises to the knee generally occur from direct and blows to the body involving something blunt. This may occur due to a fall or when a person bangs their knee into something hard.
Bruising can also develop alongside other types of injury, such as fractures, broken bones, torn tendons, or dislocated joints.
Older adults are more likely to bruise than younger adults. Additionally, people may bruise more easily than others.
How Is Knee Pain In Teens Diagnosed
Your healthcare provider will ask about your teens knee pain:
- Is there a known cause for the knee pain does it happen with certain movements or is there no specific known event?
- How long has the pain been present?
- Where on or around your knee do you feel pain?
- Does the pain wake you up at night?
Your provider will perform a physical exam, checking:
- Kneecap and knee stability.
- Alignment of lower leg, kneecap and thigh.
- Range of motion of hips and knees.
- Thigh muscle strength, flexibility, firmness.
Your provider may order imaging tests including X-rays or a CT scan or MRI .
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Youre Overdoing The Wrong Exercises Putting More Stress On Your Knee Joints
Although everyone with osteoarthritis is different, Halpern says that exercises that tend to aggravate knee osteoarthritis are deep squats, lunges, and any movement that pounds on the joint. Additionally, some people with osteoarthritis are simply too active, says Wayne Johnson, MD, an orthopedic surgeon in Lawton, Oklahoma. For example, runners might need to cut back on running, while people who do other active things like gardening, for example should spread out their activities instead of trying to do it all in one day. Talk to your doctor about what types of exercise are safe for you given the severity of your osteoarthritis and the amount of pain you experience.
Revision Total Knee Replacement
According to what I have read, total knee replacement is one of the most successful procedures in all of medicine. In most cases it allow patients to live an active pain free life.
A knee replacement can fail for several reasons. Symptoms may include pain, swelling, stiffness, and lack of stability.
If your knee replacement fails or wears out your doctor may recommend that you have a second surgery called revision total knee replacement. In this procedure, your doctor will remove some or all of the parts from the original implants and replace them with new parts.
Just like your first surgery, the goal of revision surgery is to relieve pain and improve the function of your knee.
Revision surgery is longer and a more complex procedure.Most patients who have revision surgery experience good long-term outcomes.
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You Have Significant Weakness Trying To Straighten Your Knee
Severe weakness when trying to straighten the knee, even a few days after the injury, could mean that you suffered a severe tendon injury. Common causes of weakness include patella dislocations, patella tendon tears, and quadriceps tendon tears. Patella tendon and quadriceps tendon tears are not common in youth or collegiate sports, but we will see a few of these every year.
In older weekend warriors who are wondering why their knee is weak after a serious injury, patella tendon and quadriceps tendon injuries are far more common. If you are over 35 and felt a loud pop in your knee while pushing off during tennis, or basketball then you need to consider that you have seriously injured your patella or quadriceps tendon.
After an injury to one of these large, critically important tendons, you will find that the knee will feel unstable. You will think that the knee is unable to support your weight without giving way. You should be promptly evaluated by a Sports Medicine physician to determine the type of injury you had. Both quadriceps and patella tendon injuries require surgery to repair these large essential tendons.
What Is Synovial Fluid Analysis Or Knee Aspiration Fluid Analysis
Synovial Fluid Analysis or Knee Aspiration Fluid Analysis When there is a suspicion of a particular condition, a diagnosis needs to be established. The synovial fluid, which is drained or aspirated from the joint, is examined and analyzed in the laboratory for its nature and presence of certain factors that aid in diagnosis of the condition. Specific findings help in determining the condition causing knee swelling.
The type of fluid and its detailed analysis guides in making a diagnosis of the condition. Some of the general findings include:
- Fracture or ligament injuries may show blood in the fluid.
- Meniscus injury or osteoarthritis may show straw colored or pale yellow fluid.
- Presence of crystals may mean gout or pseudogout.
- Turbid fluid or presence of pus may mean there is an infection.
- Gram staining and culture tests of the fluid can help in detecting the microorganism causing infection.
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Things No One Ever Tells You About Getting A Knee Replacement
Heres what you need to know thats not in the brochure: 1. You might not be a good candidate.A study published last year by researchers from Virginia Commonwealth University in Richmond questioned the value of knee replacement for some of the people rushing to get it. After analyzing data from a large study of men and women who had the operation, the researchers found that fully one-third of them were not actually good candidates for the surgery, which is why they got only a very modest benefita 2-point improvement on a common measure of knee function, compared with a 20-point improvement for people who started out with really bad knees.
“Pain that doesnt go away and moderate to severe arthritis are necessary for a knee replacement to do its job,” Lajam says. “If you have the surgery, but its actually a problem of nerve pain, hip pain, or circulation, its not going to help you.” The advice here is not to wait until your knees are completely destroyed before seeking surgery, but to make sure that youve tried other measures first and that you meet both criteriaconsistent pain and advanced arthritis.
What Else You Can Do To Prevent Knee Surgery
Knee surgery is rarely a first choice. Besides targeted exercises, there are other things you can do to prevent having to have knee surgery:
- Weight loss: Every extra pound you carry feels like four extra pounds on your knee joints.
- Acupuncture: This alternative treatment could reduce pain and swelling. Its not always a fix, but it may help as part of your treatment.
- Injections: Various injectable medications, such as corticosteroid and hyaluronic acid , may reduce knee inflammation and pain.
- Medications: Manage your knee pain with over-the-counter nonsteroidal anti-inflammatory drugs . Medications like ibuprofen and naproxen can help lessen swelling and pain.
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Other Treatment Options For Knee Sprain
RICE Therapy: If you have suffered a sprained knee, it is important to allow a period of rest to allow the knee to heal. For mild to moderate sprains, doctors recommend RICE therapy. This includes R , I , C , and E .
Pain Medications: You can use nonsteroidal anti-inflammatory drugs such as ibuprofen. They provide short-term relief of pain and swelling. These drugs can help reduce symptoms and allow you to begin a rehabilitation exercise program. This is important to strengthen and stabilize the knee and prevent you from injuring it again.2
Bracing: Sometimes doctors recommend wearing a knee brace for a short period. This takes the load off the ligaments and supports the knee while it heals.2
Surgery: A torn ligament sometimes needs surgical repair. This can usually be done with a minimally-invasive approach called arthroscopy. A tiny camera is inserted into the joint to guide the surgeon in repairing the ligament.2
Types Of Knee Sprains
Most knee sprains can be treated without surgery, but severe sprains may require surgical intervention. Below is a list of types of knee sprains and are graded on a severity scale.
- Grade 1 Sprains: The ligament is mildly damaged and slightly stretched but is still able to help keep the knee joint stable.
- Grade 2 Sprains: The ligament is stretched to the point where it becomes loose, often referred to as a partial tear.
- Grade 3 Sprains: Referred to as a complete tear of the ligament the ligament has been split into two pieces, and the knee joint is unstable.
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