Category: Knee fractures

If you weigh yourself on a scale and receive a number, how do you understand the value? How do you know if you are overweight, underweight or normal? Who do you compare yourself to?

To determine what’s normal and understand your own score, you’ll likely compare your weight to other people who have similar characteristics to you, such as gender, age, and height. There would be no point in comparing yourself to someone with different characteristics, since what is normal for him or her is likely different for you. This same concept applies to normative values.

Normative data identify what is common or typical and describe observed characteristics of a specific population at a specific time.^[1] Using normative values ​​allows you to give meaning to your test scores by comparing your score to scores of people with similar characteristics to you.^[2]

As explained in part 1 of the KOOS blog series, the Knee Injury and Osteoarthritis Score (KOOS) is a questionnaire specifically designed for people with various knee conditions.^[3] By completing the KOOS you will gain insight into the course of your knee injury and you and your healthcare provider can monitor the effects of the treatment over time.^[3] While comparing your own preoperative and postoperative KOOS scores provides insight into your recovery process, you can also compare your scores to normative KOOS values ​​to determine your degree of disability or your level of progress compared to people who have had a similar injury, surgery, or have undergone treatment. .

View the normal KOOS scoring blog for populations that have suffered an ACL injury,^[4][5][6] total knee replacement (TKR) surgery, ^[7][8][9] as well as those who have knee osteoarthritis,^[10] and populations without known knee disorders ^[11] in part 2 of the KOOS blog series.

If you have had a knee injury or surgery, try our Curovate app for your daily recovery. Curovate offers video-guided daily exercises, progress tracking, the ability to measure the range of motion of your knee and hip, and the ability to complete the KOOS outcome measurement, all within the app.

If you need more tailored help during your surgery or recovery from your injury, check out our Virtual Physiotherapy page to book your 1-on-1 video session with a physiotherapist.

Other recommended blogs

References

Do you have pain on the inside of the knee after receiving a direct hit on the side of your leg? Does your knee feel unstable or loose when you step or turn sideways?

If you have pain in the “medial” or inner side of your knee, an injury to the Medial Collateral Ligament, also known as the MCL, may be the reason for this.

The MCL is a stabilizing ligament in the knee that can be acutely injured by an awkward fall or sudden contact with another person or object. It can also become injured gradually through repetitive stress.

If you have medial knee pain and have not fallen or hit the knee, you may be making a crucial mistake in your daily activities that is putting stress on the MCL.

Read this quick guide to the MCL sprain to find out what it is, what you can do about it, and how to prevent it.

What is the medial collateral ligament (MCL)?

The MCL consists of connective tissue that connects the femur to the tibia at the medial portion of the knee joint. The femur is the bone in the thigh and the tibia is the weight-bearing bone of your lower leg, also called the tibia.

The MCL stabilizes the knee during everyday movements, such as walking, running, and going up and down stairs. The MCL also provides important structural support for your knee during athletic movements such as cutting, twisting, jumping and landing. Like the anterior cruciate ligament, or ACL, the MCL provides support and stability to the overall structure of the knee. Unlike ACL, MCL often heals on its own without the need for surgery.

What can cause an MCL sprain?

Sprains occur to ligaments when they are stretched beyond what they are capable of. The result can range from micro-tears of the fibers to a full-thickness tear of the ligament.

• A grade 1 sprain involves an overloaded ligament with micro-tearing of some fibers.
• A grade 2 sprain involves a partial tear of the ligament, while the ligament is still largely intact.
• A grade 3 sprain involves a more extensive or complete tear (rupture) of the ligament.

Think of a sprain as a spectrum of severity, and therefore some recovery time will be required and treatment may vary. No two sprains are exactly the same.

Acute or sudden MCL sprains usually happen during a slip and fall, a twist of the knee, or from a direct blow to the knee (usually from the outside of the knee), such as a tackle in football or soccer. Pain, swelling, loss of range of motion, and/or difficulty walking may follow the injury.

Another way to aggravate MCL is through poor mechanics during daily activities. A mistake that many people make without realizing it is allowing their knee to drop into valgus, a medial direction, during normal movements such as getting in or out of the car, walking up or down stairs, and running. This extra stress on the inside of the knee can cause the MCL to break down over time, be more vulnerable to injury and likely become more painful. This type of injury can start as pain or tenderness along the medial knee, and over time can progress to degenerative joint disease or osteoarthritis if left unchecked. Watch this video to see how daily activities can contribute to knee problems.

What is the best treatment for MCL sprains?

MCL sprains are normally treated non-operatively, meaning they usually do not require surgery. In some cases, surgery is only recommended if there is other knee damage as a result of the injury.

An avulsion fracture occurs when trauma to the knee causes the ligament to disrupt a piece of bone at the bony attachment, causing a piece of bone to pull away with the ligament. Still, some MCL sprains with associated avulsion fractures are treated nonoperatively because the area receives good blood flow and the body can heal these structures on its own.

With rehabilitation exercises that focus on range of motion, balance, stability and strengthening of the leg, the MCL will normally heal after a short period of immobilization to the knee.

Immobilization is an important first step in the non-operative treatment of an MCL sprain. Medical professionals often recommend treating the injury by keeping the knee straight (in a brace) and walking with crutches. This strategy allows the area to heal without stretching or straining the sprained fibers.

Once the knee immobilizer is removed, physical therapy is recommended to begin moving the knee and promote circulation so that the tissue continues to heal. Deep knee bending is usually avoided, but walking and other gentle activities are recommended to increase blood flow to the area, which can help speed the healing process. Physiotherapy and progressive increases in activity are crucial to returning to normal life and preventing a similar injury.

By strengthening the muscles around the entire leg, hip and torso and improving the body’s ability to withstand forces in multiple directions, you can bulletproof the knee for a safe return to lifelong sports and activities.

What Exercises Should You Do to Recover from (or Prevent) an MCL Sprain?

Exercises after an MCL sprain should include strengthening the leg muscles and working on balance and stability of the knee. A lot of stability at the knee actually comes from the hips and core, so targeting the hips and core is essential.

Strengthening the hip musculature allows force to be absorbed into the legs more efficiently, which can help protect the knee from injury during athletic maneuvers. Strengthening the muscles of the lower and upper legs also allows the body to better withstand the forces of athletic movements. By incorporating an ACL Strong course into your routine, you can reduce your risk of not only an MCL sprain, but also other knee, hip, or ankle injuries.

Whether you’re recovering from an MCL injury, trying to prevent another one, or want to be the best athlete you can be without knee problems, the ACL Strong courses can help you focus on your knee health from the comfort of your own home. , without you having to figure anything out yourself. The process was designed by physiotherapists and is educational and useful, so you can do that too transform from not knowing where your weaknesses are, to becoming stronger and more balanced in the right places, so you’ll be more resilient in the long run.

The goal of ACL Strong is to help you reduce pain, prevent knee injuries, perform better and get you on your way to doing what you love for as long as possible. The courses are intended for anyone who wants to protect their lifestyle and have the freedom to do what they want without being limited by pain, injury or aging.

Not convinced yet? Read our testimonials or frequently asked questions to see how ACL Strong can help you. Once you’ve made the decision to get exactly the exercises you need and expert support, don’t wait any longer because in just 6 weeks you can experience a transformation like never before and protect your lifestyle in the long term.

How long exactly does it take to regain muscle mass after ACL surgery? It may take up to 1 year after your ACL surgery to regain your muscle mass! This sounds like a very long time, but there are some very important reasons why this is the case. Muscle loss, also called muscle atrophy, is normal after ACL surgery. Read this blog for more information about muscle loss after ACL surgery.

Listen to Andrew Veley, a physiotherapist, talk about the reasons why it can take up to a year to regain your muscles after ACL surgery in the video below.

Want to find a way to quantify your muscle loss? Or better understand the difference between your surgical ACL leg and your non-surgical leg? Read this blog about how to measure the difference between your two legs by simply measuring your thigh circumference. If you need a video explanation of what thigh circumference measurements are and how they can be used to track your progress, watch this short video.

Here is Andrew’s full blog on muscle loss after ACL surgery.

Read all 6 Andrew’s blogs here!

If you are recovering from an ACL injury or ACL surgery, download our Curovate physiotherapy app from the links below. Curovate offers daily video-guided exercises, the ability to measure knee range of motion, in-app chat with a physiotherapist to answer your questions, and educational blogs and webinars.

If you need more tailored help during your ACL recovery, check out our Virtual Physiotherapy page to book your 1-on-1 video session with a physiotherapist.

Other blogs related to ACL surgery and rehabilitation

References

1. Gerber JP, Marcus RL, Dibble LE, Greis PE, Burks RT, LaStayo PC. Effects of early progressive eccentric exercises on muscle size and function after anterior cruciate ligament reconstruction: a 1-year follow-up study of a randomized clinical trial. Phys Ther. 2009;89(1):51-59. doi:10.2522/ptj.20070189

2. Erskine RM, Fletcher G, Folland JP. The contribution of muscle hypertrophy to strength changes after resistance training. Eur J Appl Physiol. 2014;114(6):1239-1249. doi:10.1007/s00421-014-2855-4

3. Suchomel TJ, Nimphius S, Stone MH. The importance of muscle strength in athletic performance. Sports Med. 2016;46(10):1419-1449. doi:10.1007/s40279-016-0486-0

4. DeFreitas JM, Beck TW, Stock MS, Dillon MA, Kasishke PR. An investigation of the time course of training-induced skeletal muscle hypertrophy. Eur J Appl Physiol. 2011;111(11):2785-2790. doi:10.1007/s00421-011-1905-4

5. Thomas AC, Wojtys EM, Brandon C, Palmieri-Smith RM. Muscle atrophy contributes to quadriceps weakness after anterior cruciate ligament reconstruction. J Sci Med Sports. 2016;19(1):7-11. doi:10.1016/j.jsams.2014.12.009

6. Bryant AL, Kelly J, Hohmann E. Neuromuscular adaptations and correlates of knee functionality after ACL reconstruction. J Orthop Res. 2008;26(1):126-135. doi:10.1002/jor.20472

7. Lepley LK, Davi SM, Burland JP, Lepley AS. Muscle atrophy after ACL injury: implications for clinical practice. Sports Health. 2020;12(6):579-586. doi:10.1177/1941738120944256

8. Fowler Kennedy. Physiotherapy according to the ACL reconstruction protocol. 2015. http://fowlerkennedy.com/wp-content/uploads/2015/11/PHYSIOTHERAPY-FOLLOWING-ACL-RECONSTRUCTION-PROTOCOL-November-2015.pdf. Accessed July 18, 2021.

9. van Melick N, van Cingel REH, Brooijmans F, et al. Evidence-based clinical practice update: practice guidelines for anterior cruciate ligament rehabilitation, based on a systematic review and multidisciplinary consensus. Br J Sports Med. 2016;50(24):1506-1515. doi:10.1136/bjsports-2015-095898

If female athletes still start training with “two laps and static stretches,” it’s time to expand their warm-up routine and set them up for success, not injury. Discover how to prevent injuries and improve performance with a step-by-step dynamic warm-up, like professional coaches and trainers do with elite athletes.

For years, the warm-up for football, basketball and soccer players was to jog a lap or two and then sit in a circle for static stretching. However, times have changed and research shows that relying solely on the traditional static stretching method can actually contribute to the high frequency of injuries in youth athletes. We are now in the age of dynamic warm-ups, which have been proven to improve performance and reduce injuries.

Unfortunately, the value of a good warm-up is often underestimated or misunderstood. Most people don’t learn how to maximize the first 15-30 minutes of practice or pre-game, and the result can ultimately be detrimental to your athlete.

In this article we are going to discuss

• The difference between static and dynamic warm-ups
• How warm-up activities affect game performance
• How a warm-up can help prevent injuries
• How to design a dynamic warm-up using an 8-point process
• Tips for implementing a warm-up and maximizing time spent
• How coaches and parents can help athletes go from struggling with adversity to charting their path to a dynamite college career

Static vs. dynamic stretching

Unlike static stretching, which stretches the muscles and holds them for an extended period of time, a dynamic warm-up involves continuous active movements that mimic the movements and intensity of the sport or activity to be followed. These movements typically involve a combination of stretches, bodyweight exercises, and exercises that improve mobility, increase blood flow, activate the central nervous system, and increase body temperature. Read more about the benefits of a dynamic warm-up here (available soon).

Impact on gaming performance

Athletes on a field or court are expected to give 100% in games, right? They sprint, jump, cut, spin, plant, accelerate, decelerate and react with full intensity during competition. So why not prepare their bodies for this level of play during the warm-up? First, those who don’t maximize their warm-up time may spend the first half of the game ramping up to full intensity, and in the meantime, they’ll fall behind on the leaderboard and have to play catch-up to have a chance at victory. . We’ve all seen that happen.

A proper warm-up will not only prepare athletes to dominate from the first whistle, but their chances of sustaining a season-ending injury, such as a torn ACL, will also be significantly reduced.

Injury prevention

On practice or training days, maximizing “warm-up time” can effectively reduce the risk of injury, improve performance, build strength and resilience, and sharpen athletic focus without wasting time.

Designing an effective warm-up involves creating a targeted series of exercises that target the specific movements and muscles used in the sport. As a direct result, athletes experience the benefits of increased blood flow, better flexibility, neuromuscular activation, and both physical and psychological preparedness.

8-point process to amp up your warm-up, plus 4 bonus tips for dynamite results

To enhance your warm-up, follow this 8-point process, using dynamic stretching and neuromuscular training elements, and watch your team rise to a higher level of play and achieve greater success as a result.

1. Start with light cardio

Start your warm-up with 5-10 minutes of light cardio exercise such as jogging, jumping rope or a sport-specific activity to increase heart rate, body temperature and circulation. This helps prepare the cardiovascular system for activity, prepares the muscles for movement and delivers an increase in blood and oxygen to the muscles for the performance ahead.

2. Dynamic stretching exercises

Keep moving! Perform dynamic stretches that continuously move the joints through a full range of motion, focusing on movements used in the specific sport you are preparing for. Examples include open/close ports, hip hugs, leg swings, walking lunges, arm circles, and trunk rotations. This improves muscle flexibility, lubricates the joints and prepares the tissues for sport-specific movements.

3. Multi-directional movement

Then incorporate movements that mimic the actions and demands of the sport, introducing movements in multiple directions. For example, lateral shuffles, zigzag movements and other changes in speed and direction, which are relevant in most field and field sports. This helps simulate sports-like scenarios in offensive and defensive plays and activates pathways from your brain to your muscles so that your body responds quickly and efficiently in a controlled environment. Remember, if you can’t move well in a controlled environment, you certainly won’t be able to move well in an unpredictable environment when the players and the ball are moving quickly.

>> Now we get to more advanced elements that are usually overlooked. This is the strength and neuromuscular training phase. You don’t have to do this hard every session, but you can choose to put more emphasis on training days rather than competition days. <

4. Strengthening

Athletes need targeted strengthening for the hips, core and muscle groups relevant to the sport. The old-fashioned methodology didn’t value strengthening for female athletes, but we know better now. Because strength and stability in athletic movements come primarily from the core and hips, focus on glute activation or other strength-based exercises during this phase of your warm-up. As always, adjust this to your age, fitness level and sport. Resistance bands are convenient and easy to transport for extra resistance.

5. Balance exercises

Go deeper into the neuromuscular training phase and challenge balance and stability by balancing on one foot or using an unstable surface. This stimulates the neuromuscular system, improves proprioception and improves overall balance and coordination. You want to prepare the brain and muscles for a potentially awkward cut or landing so that the body can recover safely without getting injured. Focusing on reactive balance can facilitate faster communication pathways from your brain to your limbs.

6. Plyometrics and landing mechanics

As you delve deeper into sport-specific strength movements, add in some explosive exercises such as jumping and jumping as needed, as it will further prepare the muscles, tendons and nervous system for faster acceleration and better performance. ALWAYS check proper landing mechanics, especially with youth female athletes, to ensure they land with good form, which will reduce the risk of a torn ACL. Proper acceptance of force throughout the body is a key factor in preventing serious non-contact injuries.

7. Agility exercises

Speed ​​up now! Add agility, coordination or footwork activities to improve reaction time, speed and body control. Use tools such as agility ladders or cones to develop quick and precise movements in different directions. This improves the ability to reduce and produce force, which benefits overall athletic performance.

8. Reaction and cognitive exercises

This is groundbreaking stuff! Introduce an exercise that challenges rapid decision-making and cognitive processing. Use cues such as colors or numbers to indicate directions or actions, requiring athletes to think, make a decision, and execute in a moment of high intensity. This helps train the brain to process information quickly and improves reaction time and performance on the field. Have fun with this!

Bonus Tips – Remember These Concepts for HOT HOT HOT Results:

1. Good form and body control should be a priority during the warm-up.
2. Encourage mental focus during the warm-up. Visualize successful passes, plays, attempts and what success looks like. Deep breathing and positive affirmations can support mental preparation, especially on game days when the stakes are higher.
3. After a break (rest, sit-out, etc.) it may be necessary to repeat a mini warm-up on the sidelines before play resumes, especially if players have been out in the cold.
4. Aim for 15-20 minutes for a standard warm-up, while this can be up to 30 minutes on days when more time is spent on strength, balance, plyometrics, agility or cognitive exercises (steps 4-8). You don’t have to get all these points during every warm-up. That’s where the art comes in. Balance art and science to maximize warm-up time and you’ll develop strong, resilient athletes.

Coaches and Parents: How to Support Developing Athletes

A well-designed dynamic warm-up can be a game-changer for your team and one of your best tools for preparing athletes mentally and physically while reducing injuries on the field or court.

Most people don’t know what to do, especially with neuromuscular training exercises (4-8). It can be overwhelming and confusing because there are so many variations to choose from and it’s hard to know which is best. We’ve seen people struggle through this without being sure they’re doing their best for themselves or their players.

To provide clarity and simplicity, we have drawn up a step-by-step plan so that you do not have to figure it out yourself. If you are a coach or parent of youth female athletes, these exercises can easily be performed at home in 15-20 minutes, or on the field or track during warm-ups, and will help take your athletes from good to excellent. to take. , and from battling injuries to paving their way to a dynamite college career.

We hope you enjoyed reading this perspective on the value of a dynamic warm-up and how to maximize the first 15-30 minutes with your team.