Teenagers who love sports: Scientific protection to protect the health of knee joints

Author: Yuan Feng, Chief Physician, Shanghai Sixth People's Hospital

Ling Yan Shanghai Sixth People's Hospital

Zhang Chengyuan, attending physician at Shanghai Sixth People's Hospital

Reviewer: Zhao Jinzhong, Chief Physician, Shanghai Sixth People's Hospital

Teenagers are a group that likes sports, but it is inevitable to encounter sports injuries during exercise, and even cause articular cartilage damage.

Xiao Li, a middle school student, is a sports enthusiast who likes to play football. Two years ago, he accidentally injured the anterior cruciate ligament of his knee while playing football. At that time, he chose conservative treatment, with plaster immobilization for 1 month, and then rest for another 2 months. He resumed exercise 3 months later, but his knee joint would feel tingling after each exercise. After an exercise not long ago, his knee joint suddenly could not straighten and the pain was obvious. Xiao Li went to the hospital for a check-up, and the results of the knee MRI showed: the anterior cruciate ligament tear was completely absorbed, the articular cartilage was obviously damaged, the medial meniscus was torn, and the lateral meniscus had a bucket handle tear, which was incarcerated in the intercondylar fossa. Compared with the knee MRI 2 years ago, the current knee injury is significantly aggravated. Xiao Li was immediately hospitalized and underwent arthroscopic anterior cruciate ligament reconstruction and meniscus suture surgery. Although the operation was successful, due to the severe meniscus tear, nearly 50% of the meniscus could not be retained, and the cartilage damage could not regenerate, leaving regrets.

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For teenagers who like sports, knee sports injuries are inevitable. So, how should we protect our knee joints during sports?

1. Be sure to warm up before exercise

Knee joint injuries caused by sports are to some extent related to insufficient warm-up exercises before sports. The most common injury is anterior cruciate ligament injury. Ligaments and muscles need to work together to protect you during sports. If you don't warm up enough and the muscles don't protect you enough, the ligaments will be stressed beyond their maximum load and tear. In clinic, we often see patients with anterior cruciate ligament tear, patellar tendon rupture or posterior cruciate ligament tear due to insufficient warm-up.

2. Necessary sports protection measures

Knee pads can be worn during exercise, which have a certain protective effect on the knee joint. During exercise, you should try to avoid sudden stops and turns, such as turning to shoot, turning to shoot, etc. Such actions are more likely to cause meniscus injuries or ligament injuries. However, such actions are unavoidable when teenagers are kicking or playing football. At this time, it is recommended to train more coordination and buffering skills of the lower limbs, such as paying attention to the coordinated rotation of the sole of the foot and the hip joint while turning, which can reduce the rotational stress on the knee joint; you can also train some sports skills, such as soft landing techniques of knee flexion and hip flexion, proprioception function and neuromuscular training, and training to avoid extreme eversion of the joints when jumping and squatting.

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3. Avoid excessive exercise

Avoid excessive exercise. Human joints are like car parts. Excessive exercise will accelerate wear and tear. For example, the degeneration of knee cartilage in many athletes is usually more obvious than that of ordinary people.

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4. Engage in a sport that suits you

You should choose the right sport for yourself according to your own situation. Many teenagers with congenital diseases are not suitable for certain sports. Teenagers with congenital genu valgum, genu valgum or discoid meniscus are not suitable for excessive weight-bearing sports, which can easily cause local cartilage wear in the knee joint; teenagers with a tendency for the patella to deviate laterally in the knee joint are not suitable for strenuous sports such as tennis and badminton. Therefore, for teenagers who love sports, if they often experience knee discomfort, they can choose the right sport after consulting a doctor or undergoing relevant examinations.

5. Avoid exercise when you have knee pain

Many teenagers, because they love sports, still insist on exercising when they have knee pain, which is very undesirable. Knee pain is generally caused by cartilage wear, synovitis or soft tissue injury. In these cases, the best way is to rest. Exercise will only make knee pain worse. Of course, if rest is ineffective, it is recommended to see a doctor as soon as possible.

6. Seek medical attention as soon as possible for knee injuries

Teenagers should seek medical attention as soon as possible after sports injuries. When diagnosed with ligament tear, meniscus injury, patellar dislocation and other diseases, they should seek medical attention as soon as possible and avoid delays to receive regular treatment. For ligament tear or third-degree meniscus injury, arthroscopic surgery is recommended.

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7. Exercise recommendations for overweight adolescents

Many overweight teenagers run and skip rope in a short period of time to lose weight, but they often experience knee pain after a short period of time. For overweight and obese teenagers, it is not recommended to do too much weight-bearing exercise. Non-weight-bearing exercise such as swimming or cycling should be preferred, and diet should be controlled. After losing weight, consider running or ball games.

8. Teenagers need to be alert to tibial tubercle epiphysisitis

Many adolescents in their growth and development period also need to be alert to a disease - tibial tubercle epiphysisitis. Tibial tubercle epiphysisitis is common in adolescence. The tibial tubercle is swollen and painful, and worsens after activities, especially when actively extending the knee, passively flexing the knee or squatting. The symptoms are mostly caused by the patellar tendon pulling the epiphysis. This disease is self-limiting and can heal on its own without drug treatment, but patients need to rest more, limit knee joint activities, and avoid strenuous exercise to avoid obvious protrusion of the tibial tubercle.

Funded Projects:

1.Shanghai Xuhui District Science Popularization Innovation Project (xhkp-HM-2024009)

2. Shanghai Health Science Popularization Youth Talent Capacity Enhancement Project (JKKPYC-2024-B06)

3. "City Six-Lingang" Close-knit Health Consortium Science Popularization Project (JKLHT002)