Knee Injuries

Takeaways from Dr. Mason’s Chat on How to Train and Prepare for Summer Running Races

Running Live ChatThank you for attending the live chat on How to Train and Prepare for Summer Running Races on Tuesday, June 9 with Emory Sports Medicine physician Amadeus Mason, MD. We had a great discussion, so thank you to all who participated and asked questions. From tips for preventing shin splints to advice on how to train for a 5K, we were thrilled with the number of people who were able to register and participate in the chat. (You can check out the transcript here).

The response was so great that we had a few questions we were not able to answer during the chat so we will answer them below for your reference.

Question: I have inflammation behind my knee. What can I do?

Amadeus Mason, MDDr. Mason: Inflammation behind the knee can be due to a number of knee conditions. Baker’s cyst are common and can be caused by injury to the knee, arthritis, damage to the cartilage of the knee, and other problems. Sprains (caused by overstretching and tearing of the stabilizing ligaments) can lead to swelling of the knee area as well.

Seek immediate medical attention if you are in serious pain, or are experiencing symptoms such as: paralysis, loss of sensation, absent pulses in the feet, the inability to move the knee joint, severe bleeding, chest pain, difficulty breathing, or uncontrollable pain.

Swelling behind the knee may not produce any other symptoms, but if your condition persists and continues to cause concern, seek an evaluation from a sports medicine physician or knee specialist.

Question: What is the best way to correct an IT band injury that has caused can imbalance and pain while running?

Amadeus Mason, MDDr. Mason: If treated appropriately with conservative treatment and resting of the affected area, IT Band Syndrome is usually curable within 6 weeks. If your injury was not appropriately treated, or not given adequate time to heal, the source of your current complications may be due to:

  • Chronically inflamed tendon and bursa, causing persistent pain with activity that may progress to constant pain.
  • Recurrence of symptoms if activity is resumed too soon through overuse, a direct blow, or poor training technique.
  • Inability to complete training or competition.

Until you are able to seek an evaluation from a sports medicine physician, I would discontinue the activity (ies) that are causing you pain so you do not further damage the iliotibial band.

Question: I get cramps in my calf when I run but not when walking. Is there a remedy?

Amadeus Mason, MDDr. Mason: Cramps are a result of a few factors, but dehydration and improper warm-up are the most common causes.

To prevent muscle cramps, runners need to consume enough fluid before exercising. Some healthy tips are:

  • Drink 16 to 20 ounces 45 minutes before training.
  • Drink 2 to 4 ounces every 15 minutes during a training session.
  • Before you begin your run, warm up with 5 to 10 minutes of low impact activity, like walking to warm up the muscles.

For more information about all our orthopedic and sports-related injuries, visit Emory Sports Medicine Center. Think you need to be evaluated by a sports medicine physician? To make an appointment with an Emory physician, please complete our online appointment request form or call 404-778-3350.

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Understanding Osteoarthritis

OsteoarthritisWhile “arthritis” is a commonly known disease, it is generally misunderstood. In fact, arthritis is not a single disease, rather a way of referring to joint pain or joint disease. There are more than 100 types of arthritis and related conditions. Osteoarthritis (OA), which is also known as Degenerative Joint Disease (DJD), is one of the most common forms of arthritis, affecting nearly 27 million Americans according to the Arthritis Foundation.

Unlike other forms of inflammatory arthritis, OA is most common in older adults. It occurs when cartilage, the smooth, rubbery material that cushions each bone becomes thinned, damaged or worn away. The “wearing down” of cartilage leads to pain, swelling and joint stiffness, and as the disease continues to worsen over time, bone rubbing against bone can lead to joint damage and more intense pain.

Osteoarthritis can affect any joint, but mostly affects the knees, hips, hands and spine joints. While the cause of osteoarthritis is unknown and there is no cure, there are ways to relieve symptoms and improve joint function for those suffering from the disease:

  • Exercise! Just 30 minutes of physical activity five times a week (150 minutes in total) can help significantly reduce joint pain and improve joint mobility in as little as four to six weeks. If you cannot fit in a whole 30 minutes, try breaking your exercise into three, 10-minute increments throughout the day. Any physical activity is better than none!
  • Be SMART when it comes to physical activity:
    • Start low and go slow. Begin with three to five minutes of physical activity twice a day and add activity in small amounts to allow your body to adjust.
    • Modify activity if arthritis symptoms increase, but try to stay active.
    • Activities should be low impact, such as walking, bicycling, water aerobics or dancing.
    • Recognize safe and effective ways to be active. Consider exercise classes designed for people with arthritis. When planning your own activity, make sure to choose safe locations with sidewalks/pathways that are level (e.g., a neighborhood or park).
    • Talk with your healthcare provider to help monitor chronic osteoarthritis symptoms.
  • Watch your weight. If you are overweight, losing one pound can take four pounds of pressure off your knee joints! A weight loss of five percent helps reduce joint pain. Maintaining a healthy weight and physical activity are also beneficial with other chronic illnesses such as high blood pressure, diabetes and heart disease, which often affect those with OA.
  • Eat right. While there is no specific diet for people with arthritis, studies have identified certain foods that can help control inflammation, strengthen bones and boost the immune system. Incorporating foods often found in the Mediterranean diet, which emphasizes fish, vegetables, fruit and olive oil, have been found to promote good joint health.

Can osteoarthritis be prevented? Learn more about risk factors for osteoarthritis >>

Find the right physician

If you are experiencing severe pain, swelling or stiffness in your joints, it may be time to see one of the physicians at the Emory Orthopaedics & Spine Center for further evaluation and treatment.

Related Resources

About Dr. Mason

Amadeus Mason, MDAmadeus Mason, MD, is an assistant professor in the Orthopaedics and Family Medicine departments at Emory University.

He is board certified in Sports Medicine with a special interest in track and field, running injuries and exercise testing. He has been trained in diagnostic musculoskeletal ultrasound, orthopedic stem cell therapy and Platelet Rich Plasma (PRP) therapy. Dr. Mason is Team Physician for USA Track & Field, Tucker High School, and Georgia Tech Track and Field.

Dr. Mason is a member of the American College of Sports Medicine, the American Medical Society for Sports Medicine, the America Road Racing Medical Society, and the USA Track and Field Sports Medicine and Science Committee. He has been invited to be a resident physician at the US Olympic Training Center, a Sports Medicine consultant in his homeland of Jamaica and the Chief Medical Officer at multiple USA Track and Field international competitions. He is an annual speaker at the pre-race expo for PTRR, Publix marathon and Atlanta marathon commenting on a wide variety of topics related to athletics and running injuries.

Dr. Mason is an active member of the Atlanta running community. He attended Princeton University and was captain of the track team. His other sports interests include soccer, college basketball and football, and the National Hot Rod Association (NHRA). A Decatur resident, he is married with three children.

Knee Arthroscopy and Knee Arthroscopy Recovery

knee surgeryKnee arthroscopy is surgery that uses a tiny camera (arthroscope) to look inside your knee. Small cuts are made to insert the camera and small surgical tools into your knee for the procedure.

Your surgeon can use arthroscopy to feel, repair or remove damaged tissue. To do this, small surgical instruments are inserted through other incisions around your knee.

Preparation for Knee Arthroscopy:

Usually no significant pre operative testing is needed. Depending on your heath, your orthopaedic surgeon may order pre-operative tests. These may include blood counts, an EKG (electrocardiogram), and even a complete physical examination to assess your health and identify any problems that could interfere with your surgery.

Surgery for Knee Arthroscopy:

During the procedure, the orthopedic surgeon inserts the arthroscope (a small camera instrument about the size of a pencil) into your knee joint through a small incision in the knee. A sterile solution will be used to fill the knee joint and rinse away any cloudy fluid. This helps your surgeon see your knee clearly so that he may diagnose the problem and determine what treatment is needed.

Arthroscopy for the knee is most commonly used for:

  • Removal or repair of torn meniscal or articular cartilage
  • Reconstruction of a torn anterior cruciate ligament (ACL)
  • Removal of loose fragments of bone or cartilage
  • Removal of inflamed synovial tissue

After your procedure has concluded, a doctor will remove the instruments and close the incisions with a stitch.

Recovery from Knee Arthroscopy

Recovery from knee arthroscopy is much faster than traditional open knee surgery. You may have some slight swelling in the knee after surgery. Keep your leg elevated as much as possible for the first few days following surgery and ice your knee following the instructions given by your doctor. You may or may not be placed on crutches. Your surgeon will make that decision and discuss with you. Your surgeon will most likely prescribe physical therapy for 6-12 weeks, as well.

About Dr. John Xerogeanes

John Xerogeanes MD

John W. Xerogeanes, MD, Chief of Sports Medicine at Emory University, is known as Dr. “X” by his staff and patients. He is an Associate Professor of Orthopaedic Surgery at Emory University as well as an Adjunct Professor at Georgia State and Mercer University. Dr. X has been the Head Orthopaedist and Team Physician for Georgia Tech, Emory University, Agnes Scott College and the Atlanta Dream of the WNBA since 2001. He specializes in ACL and ACL revision surgery performing over 200 of these operations each year. He is board certified in orthopaedic surgery and has his sub-specialty certification in orthopaedic sports medicine.

Dr. Xerogeanes has been recognized as one of US News & World Report’s Top Doctors with a special distinction listing him among the top 1% in the nation in his specialty.

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Knee Replacement Surgery

Knee SurgeryThe knee is a hinge joint which provides motion at the point where the thigh meets the lower leg. Your knee can become damaged by osteoarthritis resulting from wear and tear over time, by rheumatoid arthritis, psoriatic arthritis, or by injury/trauma to the knee. Rest, medication, and therapy are the first lines of treatment, but knee replacement surgery — also known as knee arthroplasty — can help relieve pain and restore knee function for those whose cartilage is too damaged to respond to conservative measures. Although surgery always comes with risks, knee replacement surgery continues to be one of the most predictably successful of all major operations done for any problem. It is however a major surgery and should only be considered when other nonsurgical options are not adequate.

Knee Replacement Procedure

In general, knee replacement surgery consists of replacing the diseased or damaged joint surfaces of the knee with metal and plastic components shaped to allow continued motion of the knee. Knee replacement would be more accurately called knee resurfacing in that only the surface of the femur and tibia are removed and then capped by metal. The ends of the bone are precisely shaped to exactly match the shape of the artificial components. These artificial components mimic the shape of the normal bone. A highly wear resistant plastic insert is placed as the cushion between the two metal components. Usually a total knee replacement also involves capping the surface of your knee cap (patella) with polyethylene. A good result from the operation is very dependent on the accuracy of contouring of bone and placement of components.

What to Expect From Knee Surgery

Recent improvements in materials and techniques have made total knee replacement a common and highly successful surgery, with around 300,000 being performed every year in the U.S alone. The vast majority of people who undergo knee joint replacement surgery have dramatic improvement in pain and range of motion. Approximately 95% of patients after recovering from knee replacement report enough improvement that they would repeat the decision to have surgery. In addition to routing life activities, such activities as walking, cycling, dancing, golf and tennis are comfortable for the majority of patients.

Knee Surgery Rehabilitation

Post-operative hospitalization averages 1 to 3 nights, depending on the health status of the patient. Most people require crutches or a walker for 1 to 3 weeks and a cane for 1 to 3 weeks after that. The average need to see a physical therapist is for 4 to 6 weeks and the time to a better knee overall than before surgery for most patients is about 4 to 6 weeks. Time to safely driving a car is typically 2 to 4 weeks and average time off work is also approximately 4 weeks.

About Dr. Roberson

James Roberson, MDJames Roberson, MD is professor and chairman of the Department of Orthopaedics at Emory. He specializes in total joint replacement of the hip and knee. Dr. Roberson completed his residency training at Emory University followed by a fellowship at Mayo Clinic. He has been practicing at Emory since 1982.

Related Resources

Total Knee Replacement
Revision of Total Knee Replacement
Unicompartmental Knee Replacement

Torn Meniscus and Torn Meniscus Surgery

Torn MeniscusWhen people talk about torn cartilage in the knee, they are usually referring to a torn meniscus. The meniscus is a rubbery, C-shaped disc that cushions your knee and acts as a shock absorber between your thighbone and shinbone. Each knee has two menisci, which help to keep your knee steady by balancing your weight across the knee.

Any person at any time can tear their meniscus, but athletes—particularly those who play contact sports—tend to be at a higher risk, the reason being that a meniscus tear is usually caused by twisting or turning quickly, often with the foot planted while the knee is bent. Players may squat and twist the knee, causing a tear.

As you get older, your meniscus gets worn which can make it tear more easily. Cartilage weakens and wears thin over time, increasing the likelihood of degenerative meniscal tears. One awkward twist when getting up from a chair may be enough to cause a tear, if the menisci have weakened with age.

Torn Meniscus Symptoms
Depending on the severity of the tear, symptoms will vary. Typically meniscal tears are categorized into three groups: minor, moderate and major tears. Generally, most people can still walk on their injured knee after a meniscal tear, but you may feel a “pop” when you tear a meniscus. Often athletes will keep playing with a tear, but over the course of two to three days the knee will likely become stiff and swollen.

Common symptoms of meniscal tears include the following:

  • Feeling a “pop” in the knee
  • Pain
  • Stiffness and swelling
  • Inability to move knee through full range of motion (such as not being able to straighten the knee)
  • Catching or locking of the knee
  • The sensation of the knee feeling “wobbly” or giving way without warning

In severe tears and those without proper treatment, a piece of meniscus may come loose and drift into the joint, causing your knee to slip, pop, or catch.

Torn Meniscus Diagnosis and Treatment
When diagnosing a meniscal tear, doctors will often perform what is known as a McMurray test. Your doctor will bend your knee, then straighten and rotate it. This puts tension on a torn meniscus. If you have a meniscal tear, this movement will cause a clicking sound. Your doctor may also order imaging tests such as an X-ray or MRI to confirm the meniscal tear.

How your doctor treats your meniscus tear depends on several things, such as the type of tear, where it is, and how serious it is. Your age and how active you are may also affect your treatment choices.

Common treatments include:

  • Rest
  • Ice
  • Physical therapy
  • Non-steroidal anti-inflammatory medicines (such as aspirin or ibuprofen)
  • Surgery

Surgical Treatment
Whenever possible, meniscus surgery is done using arthroscopy, rather than through a large cut in the knee. Knee arthroscopy is a commonly performed surgical procedure in which a miniature camera is inserted through a small incision to better view the knee. Your orthopaedic surgeon will then insert miniature surgical instruments through other small incisions to trim or repair the tear.

Depending on the tear, a variety of procedures can be done:

  • Meniscectomy. In this procedure, the damaged meniscal tissue is trimmed away (partial meniscectomy) or, in extreme cases, the entire meniscus will be removed (total meniscectomy). Total meniscectomy procedures are typically avoided because of the likelihood of causing osteoarthritis in the knee.
  • Meniscus repair. Some meniscal tears can be repaired by suturing (stitching) the torn pieces together.

It is preferable to preserve as much of the meniscus as possible. If the meniscus can be repaired successfully, saving the injured meniscus by doing a meniscal repair reduces the occurrence of knee joint degeneration compared with partial or total removal.

Recovery / Rehabilitation
How well the knee will heal depends on how bad the tear is. After surgery, your doctor may put your knee in a cast or brace to keep it from moving, and you may need to be on crutches for a period of time to keep weight off the knee. Your doctor will work with you on a rehabilitation program that helps you regain as much strength and flexibility as possible.

About Dr. Pombo

Mathew Pombo, MDMathew Pombo, MD, is a highly regarded orthopaedic surgeon, speaker, author and researcher who specializes in getting patients with injuries back to an active lifestyle. His professional interests include anatomic single and double bundle ACL reconstruction, rotator cuff tears, shoulder instability, meniscal/cartilage injury and repair, joint preservation in the aging athlete, and minimally invasive joint replacement surgery of the knee and shoulder. Dr. Pombo has conducted extensive scientific research, published multiple journal articles, written several book chapters, and has presented both at national and international meetings on topics related to sports medicine, concussions, and orthopaedic surgery. He is a member of several design teams for orthopaedic companies and enjoys participating in the engineering of the next generation of orthopaedic techniques and equipment. He has been instrumental in bringing awareness to Sports Related Concussions and the new Georgia “Return to Play” Act and is one of the top regarded experts in the area for the treatment of Concussions. He currently serves as the Director of the Emory Sports Concussion Program.

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Dr. Maughon Discusses the Ins & Outs of Joint Replacement Surgery

Joint replacement surgery is a procedure that should only be recommended when all other modes of treatment to eliminate your pain have been exhausted. Almost any joint in the body can be replaced, but most commonly replaced joints are the knee, shoulder and the hip. If you are referred for joint replacement the goal at Emory Orthopaedics, Sports & Spine is to get an athlete back to a similar level of play or activity after a surgery. In an aging athlete, joint replacement is typically done for pain relief so the patient is allowed to lead an active life. Although, many patients will be able to do all the activities they did before the joint replacement, we recommend doing activities that do not put a lot of pressure on the joint such as swimming, ice skating and doubles tennis. Watch this short video about joint replacement and details on what makes joint replacement surgery at Emory different.

When it Comes to Your Health, are High Heels Worth the Price of Looking Good?

High Heels Back PainEmory Orthopaedics, Sports and Spine physicians Kyle Hammond, MD  and Oluseun A. Olufade, MD recently participated in “Ladies Night Out”  at Emory Johns Creek Hospital.

The Ladies Night Out event is an annual health fair held by Emory Johns Creek Hospital for women to talk with physicians and other providers in the Johns Creek and North Atlanta communities and learn about services near them.

At the Emory Orthopaedics, Sports & Spine table, Drs. Hammond and Olufade spoke with women about potential injuries that could occur from wearing high heeled shoes and what women might be able to do to help prevent injuries to their backs, ankles, feet, hips and knees.

As a fun activity at the Ladies Night Out event, we also had a free drawing for high heeled shoes that were displayed at the table.  Five lucky women went home with a new pair of shoes and lots of tips to prevent orthopedic injuries.

Emory Orthopaedics and Spine Team at the Ladies Night Out Event
Below are 5 orthopedic conditions or injuries related to wearing high heels and tips on how you can prevent them:

ACHILLES TENDINITIS

Symptom: Pain & swelling in lower calf and heel cord resulting in decreased calf flexibility

Achilles Tendinitis Prevention:

  •  Calf stretches with towel or band
  • Calf raises / strengthening exercises
  • Heel pads
  • Wear short heels or flats

ANKLE SPRAIN / FRACTURE

Symptom: Pain, bruising, swelling and inability to walk

Ankle Sprain & Fracture Prevention:

  • Wear short, wide heels (no stilettos)
  • Single leg balancing
  • Ankle ‘A, B, Cs’

BUNIONS

Bunion Symptom: Tenderness and prominence inside of the big toe joint

Bunion Prevention:

  • Ensure proper shoe size & fit
  • Wear short heels with wide toe box
  • Use pads to cushion bunions
  • Wear heels for brief periods of time if possible

KNEE AND HIP INJURIES

Symptom: Muscles in your hip and knee have to work harder when you wear heels as muscles become fatigued and more prone to injury

Possible Injuries:

  • Muscle strain
  • Tendinitis
  • Meniscus tear
  • Hip impingement

Hip & Knee Injury Prevention:

  • Stretch hamstrings, quads, & hip
  • Strength training for lower body
  • Alternate heels with flats during the work week
  • Balance exercises

LOW BACK PAIN

Low Back Pain Causes: Normal center of gravity changes, increasing the curvature of your low back and tilting your pelvis forward.

Low Back Pain Prevention:

  • Change into flats for long walking distances
  • Strengthen your core (crunches & low back extension exercises)

Although high heels look nice and are fun to wear at special events, try to limit the high heels to special occasions and stick with flats for your day to day activities.  Your body will thank you!

About Dr. Kyle Hammond

Dr. Hammond is an orthopaedic surgeon new to the Emory Orthopaedics faculty.  He recently completed his fellowship at the University of Pittsburgh Medical Center.  While at the University of Pittsburgh he was the Associate Head Team Orthopaedic Surgeon for both the Duquesne University Football team and the University of Pittsburgh Men’s Basketball team.  He also worked as a Team Physician for the Pittsburgh Steelers, the Pittsburgh Penguins, the University of Pittsburgh athletics, Robert Morris College athletics, as well as the Pittsburgh Ballet.

Dr. Hammond sees patients at Emory Johns Creek Hospital, as well as Emory Orthopaedics & Spine Center in Atlanta.  Dr. Hammond has a special interest in the overhead/throwing athlete, ligament injuries to the knee, Tommy John surgery, joint preservation surgery, and is one of the few fellowship trained hip arthroscopists and concussion specialists in Georgia.

About Dr. Oluseun A. Olufade

Dr. Olufade is board certified in Physical Medicine & Rehabilitation and Interventional Pain Medicine. He completed fellowship training in both Sports Medicine and Interventional Pain Medicine. During his fellowship training, he was a team physician for Philadelphia Union, a major league soccer (MLS) team, Widener University Football team and Interboro High School Football team.

Dr. Olufade employs a comprehensive approach in the treatment of  sports related injuries and spinal disorders by integrating physical therapy, orthotic prescription and minimally invasive procedures. He specializes also in concussion, tendinopathies and platelet rich plasma (PRP) injections. He performs procedures such as fluoroscopic-guided spine injections and ultrasound guided peripheral joint injections. Dr. Olufade individualizes his plan with a focus on functional restoration. Dr. Olufade sees patients at Emory Johns Creek Hospital.

About Emory Ortho, Sports and Spine in Johns Creek and Duluth

Emory Orthopaedics, Sports & Spine has recently opened two new clinics, one in Johns Creek and one in Duluth.  Emory physicians, Kyle Hammond, MD, and Oluseun A. Olufade, MD see patients in Johns Creek.  Mathew Pombo, MD and T. Scott Maughon see patients in Duluth.  Our new clinic locations care for a full range of orthopedic conditions including: sports medicine, hand/wrist/elbow, foot/ankle, joint replacement, shoulder, knee/hip, concussions, and spine.

To schedule an appointment call 404-778-3350

Related Resources:

Understanding IT Band Syndrome

IT Band Syndrome IT Band Injury

Iliotibial band (IT) syndrome, also referred to as IT band injury or IT band pain, is an injury that affects the outside of the  knee and is caused when irritation or inflammation of the IT band occurs.

If you have ever suffered from IT band syndrome, you know IT band pain is a pain you don’t want to feel again.  The good news is that you can prevent IT band injuries with strengthening and stretching exercises. Pay close attention and follow the information/suggestions here and you may be able to steer clear from the pain of IT band syndrome!

What is the IT Band?

The IT band is the long, strong, thick band of tissue that runs along the outside of the leg.  It starts at the hip area and runs all the way down to just below the knee.  The purpose of the band is to provide stability to the knee during movement.

IT Band Syndrome Causes

An IT band injury is an overuse injury,  primarily caused by inflammation of the IT band.   Tightness in the IT band can cause friction  where the IT band crosses the knee joint.   Causes of IT band syndrome can include:

  • Running up and down hill repeatedly
  • Running on a banked or sloped surface (like an indoor track or edge of a road)
  • Running up and down stairs
  • Weak hip muscles
  • Uneven leg length
  • Excessive foot strike force

IT Band Injury Symptoms

  • Stinging sensation above the knee
  • Swelling or thickening of the tissue where IT band moves over femur
  • Pain may intensify over time and may not occur immediately during activity
  • Pain occurs when foot strikes the ground
  • Pain may occur where the IT band attaches to the tibia

Preventing IT Band Syndrome

  • Warm up and stretch before competing or practicing
  • Recover properly between events/competitions/practices
  • Improve core strength with Pilates type exercises
  • Avoid running on banked surfaces
  • Avoid running the same direction on the track all the time
  • If you have flat fee, where arch supports or orthotics

Check out the exercises in this downloadable document: IT Band Stretching & Strengthening Exercises (PDF). And in this blog post, you’ll find more information on preventing running injuries.

IT Band Syndrome Treatment

  • Rest – most runners don’t want to listen to this advice but rest really will help alleviate the pain
  • Anti-inflammatory medication
  • Ice the painful area
  • Improve flexibility by stretching
  • Physical therapy

We hope you can steer clear of IT band syndrome and keep your legs moving!


Peachtree Road RaceEmory Healthcare is a proud sponsor of the AJC Peachtree Road Race.

Emory Healthcare is the largest, most comprehensive health system in Georgia and includes Emory University Hospital, Emory University Hospital Midtown, Emory University Orthopaedics & Spine Hospital, Wesley Woods Center, Saint Joseph’s Hospital, Emory Johns Creek Hospital, Emory Adventist Hospital, The Emory Clinic, Emory Specialty Associates, and the Emory Clinically Integrated Network.

Come visit us at the AJC Peachtree Road Race expo in booth 527 to get your blood pressure checked and learn more about how Emory Healthcare can help you and your family stay healthy!


About Dr. Brandon Mines

Brandon Mines, MD

Brandon Mines, MD, is an assistant professor of orthopaedics. Dr. Mines started practicing at Emory in 2005 after completing his Sports Medicine Fellowship at University of California – Los Angeles. Dr. Mines is board certified in both family practice and sports medicine. He has focused his clinical interest on sports injuries and conditions of the shoulder, elbow, wrist/hand, knee, foot and ankle. He is head team physician for the Women’s National Basketball Association’s (WNBA) Atlanta Dream and Decatur High School. He is also one of the team physicians for the Atlanta Falcons.  His areas of interest are diagnosis and non-operative management of acute sports injuries, basketball injuries, tennis injuries, golf injuries and joint injections.

Understanding Runners’ Knee aka Patellofemoral Pain Syndrome

Knee PainDo you have pain in the front of your knee behind the kneecap? If so, you may have patellofemoral pain syndrome (PFPS for short), commonly known as “runners’ knee”. Typically runners’ knee is not a product of an injury, but is caused by abnormal leg mechanics including weakness in the quadriceps which result in poor tracking of the kneecap.

You can increase your risk of developing runners’ knee if you have tight hamstrings, or do not warm up enough before an event. Runners often experience patellofemoral pain as they increase their running distance and/or frequency.

Symptoms of Patellofemoral Pain Syndrome:

  • Pain in the knee, usually in the front of the knee, behind the kneecap
  • Pain in the back of the knee or also above or below the kneecap
  • Pain that gets worse after sitting for long periods of time
  • Pain that gets worse after going up or especially down stairs or hills
  • Pain that gets worse when wearing shoes with high heels
  • Pain with jumping, squatting, and lunging
  • “Crunching” or “popping” in the knee
  • Minimal swelling

The good news is that this condition is treatable with improving your overall leg mechanics. You should think about incorporating strength training into your running training so that you strengthen the quadriceps and gluteus muscles. It is also important to stretch the hamstrings and IT band. If you have flat feet or foot pronation (fallen arches) you should consider inserting orthotics in your shoes to support your arches.

If you are diagnosed with this condition, you may have to stop running temporarily until the knee pain subsides, but continuing to run will not cause long term damage. You should at least consider adding in cross training with activities such as swimming and cycling which will be easier on the knee with PFPS and maintain your fitness. Make sure to ice your knee after exercise and take anti-inflamatories like ibuprofen. You may also want to try a neoprene sleeve for comfort.  Refer to this Patellofemoral Syndrome document for some exercises you can safely do to strengthen the muscles, increase flexibility and stretch the quadriceps.

If your knee pain has not improved within 4-6 weeks, you should consult your sports medicine physician.


Emory Healthcare is a proud sponsor of the AJC Peachtree Road Race.

Peachtree Road RaceEmory Healthcare is the largest, most comprehensive health system in Georgia and includes Emory University Hospital, Emory University Hospital Midtown, Emory University Orthopedics & Spine Hospital, Wesley Woods Center, Saint Joseph’s Hospital, Emory Johns Creek Hospital, Emory Adventist Hospital, The Emory Clinic, Emory Specialty Associates, and the Emory Clinically Integrated Network.

Come visit us at the AJC Peachtree Road Race expo in booth 527 to get your blood pressure checked and learn more about how Emory Healthcare can help you and your family stay healthy!

About Dr. Jeff Webb

Jeffrey Webb, MDJeff Webb, MD, is an assistant professor of orthopaedics at Emory Orthopaedics & Spine Center. Dr. Webb started practicing at Emory in 2008 after completing a Fellowship in Primary Care Sports Medicine at the American Sports Medicine Institute in Birmingham, Alabama. He is board certified in pediatrics and sports medicine. He is a team physician for the NFL’s Atlanta Falcons, and serves as the primary care sports medicine and concussion specialist for the team. He is also a consulting team physician for several Atlanta area high schools, the Atlanta Dekalb International Olympic Training Center, Emory University, Oglethorpe University, Georgia Perimeter College, and many other club sports.

Dr. Webb sees patients of all ages and abilities with musculoskeletal problems, but specializes in the care of pediatric and adolescent patients. He works hard to get players “back in the game” safely and as quickly as possible. He is currently active in the American Medical Society for Sports Medicine and American Academy of Pediatrics professional societies and has given multiple lectures at national conferences as well as contributed to sports medicine text books. Dr Webb is an avid runner and has completed 16 Peachtree Road Races.

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Learn all about Hip or Knee Replacements

The decision to get a hip or knee replaced is a difficult one for many patients.  Hip and knee replacements are typically advised only when all other options have not worked for you.  If you are considering a hip or knee replacement or already have had one and want to speak to a physician, join Emory Orthopedic Surgeon, Thomas Bradbury, MD on Tuesday, June 11, 2013 at noon for an online web chat on Hip and Knee Replacements.  He will be available to answer questions such as:

• What are hip and knee replacements?
• Why have the surgery?
• Who are candidates for hip or knee replacements?
• What are the newest advances in Hip and Knee replacements?
• What is Emory’s approach on when to get knee or hip replacement surgery?
• What is the recovery after a hip or knee replacement?
• What types of exercise are suitable for someone with hip or knee replacements
• What kind of outcome can you expect?

Come prepared to ask your questions and learn more about your options!

CHAT TRANSCRIPT

About Dr. Bradbury

Thomas Bradbury, MD

Dr. Bradbury is an Assistant Professor of Orthopaedic Surgery at Emory.  He specializes in hip and knee arthroplasty.  He really enjoys this area of orthopaedic surgery because of the consistency of success in the properly selected patient. Dr. Bradbury’s professional goal is the improvement in quality of life for patients with pain secondary to hip and knee problems.

His research interests center around infections involving hip and knee replacements which are rare, but difficult problems. Dr. Bradbury is researching the success rate of current treatment methods for hip and knee replacement infections caused by resistant bacteria (MRSA). Through his research, he hopes to find better way to both prevent and treat periprosthetic hip and knee infections.

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