the bone and muscle (hip,leg and knee)
My grandmother broke her hip recently for no apparent reason. Why do hip fractures seem to be so common among the elderly?
With age comes greater sesceptibility to falls, which account for many hip fractures. However, most hip fractures in older people are caused by osteoporosis, which may decrease bone strength to the point that fractures ocur with little or no trauma. This may very well have been the cause of your grandmother`s problem.In fact, in some cases-and it`s not always easy to tell-it is a spontaneous break in the hip that actually causes an elderly person to fall. Although preventing such falls in difficult, some protective measures can be taken: spectacle prescriotions should be kept current, furniture disposed to permit clear passage, slippery floors carpeted, and rugs fastened down. An older person whose balance is precious may benefit from a walking stick or frame, and shoes should be confortable and well-fitted.
I know of several people who have had hip-replacement surgery. When is this operation needed?
Surgeons can now replace several different joints with prostheses, devices made of plastic and metal. Of these procedures, hip replacement is the most common and productive. If successful, as most such operations are, hip replacement can alleviate the patient`s pain and improve mobility. The typical condidate for hip replacement is an older person whose hip joint has been severely damaged by degenerative arthritis, and who is not likely to overwork the artificial joint. Hip prostheses can wear out; if one does, another replacements operation may be needed. However, the technology used to create and implant artificial joints has advanced a great deal in recent years, and hip replacements are now being performed with greater frequency on younger patients, including those afflicted with rheumatoid arthritis and certain congenital hip deformities.
How does one `pull a hamstring`?
The hamstring is not a single muscle, but a group of muscle that together fill and provide power at the back of the thigh. Unfortunately, the hanstring group is weaker than the quadriceps muscles, which make up the quadriceps muscles, which make up the front of the thigh, and such imbalances sometimes lead to troublesome injuries. Particularly in cold weather, when the muscles are tight, one or another of the hamstring group or their tendons may tear.The basic treatment for a pulled hamstring is to stop whatever activity caused the injury and to apply an ice pack to the affected area right away. This should be followed by extended rest and warm baths or judicious use of a heating pad. Hamstrings are especially difficult injuries to treat. Gentle stretching exercises can help with rehabilition, however, and guard against subsequent pulls, an all too common problem. Among athletes, prevention should be emphasised through appropriate warming-up and cooling-down exercises, proper clothing, and conditioning to ensure balanced deevelopment of the quadriceps and hamstring muscles.
After a trenuous work-out I sometimes wale up at night with a severe leg cramp. What causes this, and how can I relieve the pain?
Sudden, painful cramps, or spasms, in the muscles of the leg often occur at night and are common among athletes and people with circulatory problems.Cramps may be caused by an injury to the muscle, by overworking or overstretching the muscle, or by an abrupt constriction in one of the arteries supplying blood-and oxygen-to the muscle. When the muscle does not get the oxygen it needs, it goes into spasm, causing intense pain.Treat a cramp gently. Don`t jump up and down on the affected leg or slap the area that`s cramping. Stretching the muscle will help to relieve the pain. Gentle massage is also useful, as is walking about the room. Fotunately, the cramp will disappear on its own within a minute or two. If you are troubled by persistent, recurring leg cramps, see your doctor. Cramps that occur after exercise may have a serious underlying cause; most night cramps in older people, however, are not serious and can be relieved with simple medications.
I recently read about a football player who had arthroscopic surgery on his knee and was walking again a few days later. What does this operation involve?
Arthroscopic surgery is a relatively new technique for diagnosing and sometimes treating joint problems, especially those involving the knee. It is performed by an orthopaedic surgeon, who makes a small incision in the knee and inserts a thin, lighted viewing tube (arthoscope) that enables him to examine the joint.In some cases, the surgeon may also be able to remove bits of cartilage or repair damaged tissues by means of special surgical instruments which are inserted through separate incisions in the knee; the surgeon views the procedure through the arthroscope itself.Arthroscopic surgery may be done wnder local or general anaesthesia and, when appropriate, has obvious advantages over other types of knee surgery in that the amount of cutting is less, and recuperation is simpler and swifter.
Why are knee injuries so common among sportsmen?
As an engineering project, the interlocking bones, muscles, tendons and ligamnets of the knee are a true marvel. Nevertheless, the knee`s strength is not always equal to the demands placed upon it. The joint is held together mainly by four ligaments, two to limit sideways movement, two to limit back and forth movement. Whether from a side tackle in football, a fall on a ski slope, or some other unexpected trauma, these ligaments may be stretched or torn, often with additional damage to surrounding tissue and to the cartilage within the joint. One way of lowering the risk of knee injury is to strengthen the leg muscles with suitable exercises before engaging in sport activities. A mild sprain may be treated with ice packs, an elastic bandage and rest. A more severe injury to the ligaments of the knee requires prompt medical attention.
What causes knee cartilage to tear, and how is this injury treated?
The two wedge-shaped, washer-like cartilages of the knee are located at the outer edges of the joint and act as shock absorbers. They are especially vulnerable to tearing as a result of a sudden twisting of the knee. Acute pain, swelling and tenderness follow; depending on where the piece of torn cartilage settles, the knee may lock, requiring surgery to remove the fragment.Although worse injuries can occur to the knee, the difficulty with cartilage damage is the likelihood of recurrence. This may happen immediately after the injury has healed, or else not for years afterwards. And once torn, knee cartilage may eventually wear out and lead to osteoarthritis.Treatment for torn knee cartilage depends on the extent of the damage, on whether there have been previous tears, and on how they have healed. If the tear is small and knee movement is not impaired, a period of rest and elevation of the knee may suffice. With each recurrence, and the accompanying shifting and scraping of cartilage fragments, damage may accur in the joint. At some point, surgery to remove part or all of the cartilage may be required, followed by physiotherapy to strengthen the thigh and shin muscles.
I have heard taht a kneecap can become spontaneously dislocated. Is it true, or is a dislocated kneecap always the result of injury?
Knee injuries often dislodge the patella from its proper setting in the thighbone, but in some people this slippage occurs for no apparent reason. (Structural kneecap problems do, however, tend to run in families.) With luck, a dislocated patella will slip back into position of its own accord, but if it locks out of its normal location, the pain and swelling it causes can be severe.The first step in treatment is rest and carefully monitored quadriceps-strengthening exercises. If problems continue, surgery may be needed to prevent disablement and forestall chondromalacia.
I am 22, yet my knee hurts when I sit for a long time. What could be wrong?
You may have what is known as chondromalacia of the patella, or kneecap, a condition in which the cartilage lining the underside of the cartilage linig the underside of the kneecap deteriorates. Typical of the problem is pain in the front of the knee that becomes more severe during long periods of sitting, or while squatting or climbing stairs, together with a creaking or popping noise when the knee is straightened.Chondromalacia affects young men and women. It may result from injury or overexertion, a loose or dislocated kneecap, or cogenital abnormality in the knee. In some cases, it is impossible to establish the cause. If cartilage injury is severe, chondromalacia may lead to osteoarthritis.The initial treatment of chondromalacia consists of rest and anti-inflammatory drugs, followed by a programme of exercises to strengthen the quadriceps, which supports the kneecap. If this standard therapy doesn`t work, either traditional or arthroscopic surgery may be needed to shave, or smooth, the underside of the patella. In extreme cases, tendon surgery to change pressure on the kneecap may be performed. Surgical removal of the kneecap is a treatment of last resort. Although such surgery almost invariably cures the problem, it also permanently weakens the knee.
My wife took up joging recently and promptly developed shin splints. Was it her shinbone or the surrounding muscles that suffered the injury?
Shin splints is an imprecise term for the lower leg pain that runners frequently get as a result of overexertion or inadequate conditioning. As a rule, it`s not the shinbone that is injured, but the muscles that extend from it to guide the movements of the ankle and foot. Worked too hard, or jolted repeatedly by running on hard surfaces, these muscles begin to pull away from the bone; this causes shooting paints along the shaft of the shinbone.The usual treatment for simple shin splints is time off from exercise, with applications of ice to rilieve the immediate pain. When activity cannot be avoided, horizontal taping of the front of the leg may help. If pain persists for more than two weeks, medical attention should be sought.
What is a stress fracture?
A stress fracture is a hairline break in a leg or foot bone, caused when the bone has been forced to bear too great a load. This often occurs in amateur athletes who push themselves too hard too fast, and at the onset may be confused with shin splints. Because X-rays may not reveal a stress fracture for up to two weeks, diagnosis can be delayed; sometimes a bone scan is required for proper diagnosis. A stress fracture is treated with rest (up to six weeks) and pain medication. Use of a cast may help to reduce pain in some cases, but is usually not needed to hold the bones in place.
the bones and muscles (hip,leg and knee)
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