Did you know that knee injuries are the killer?

As the concept of Healthy China continues to deepen, a wave of national fitness has been set off in China. General Secretary Xi Jinping pointed out: "National fitness is the foundation and guarantee for all people to strengthen their physique and live a healthy life. People's physical health is an important connotation of building a well-off society in an all-round way, and it is an important foundation for everyone's growth and realization of a happy life."

Most of our friends are keen on mountain climbing, running, ball games, etc. However, have you ever thought about what kind of damage will be caused to your body if you do not warm up sufficiently before exercise, or if your posture is not appropriate, or if the exercise is too intense? Let's take a look at a common knee disease, a knee injury caused by improper exercise - anterior cruciate ligament tear.

The knee joint is composed of three compartments, the medial and lateral tibiofemoral compartments and the middle patellofemoral compartment. The three compartments share a synovial cavity. Inside our knee joint, the surface of the tibia and femur are covered with hyaline cartilage, which plays a shock-absorbing role. There is a meniscus filling between the two, which can increase the stability of the knee joint and play a buffering and protective role. The stability of the knee joint is maintained by multiple ligaments, mainly including the medial and lateral collateral ligaments and the anterior and posterior cruciate ligaments. Of course, our protagonist today, the anterior cruciate ligament, is crucial.

What is the anterior cruciate ligament?

The anterior cruciate ligament (ACL) is an important ligament for knee stability and is also the most vulnerable part for athletes. In the United States alone, there are 100,000 to 200,000 cases of ACL tear each year. In my country, the number of ACL tears caused by sports is also increasing, which has attracted widespread attention. Anterior cruciate ligament injuries account for a large proportion of knee injuries (20.5%) and often lead to catastrophic consequences. In addition to the economic burden of surgical treatment, ACL injuries also increase the risk of knee osteoarthritis, resulting in limited knee joint movement, which seriously affects the patient's daily life.

What is an ACL tear?

The main function of the anterior cruciate ligament is to limit the anterior displacement of the tibia, and secondly to control the hyperextension and rotation of the knee joint. When we exercise and suddenly change the direction of movement, the knee joint will "pop", followed by swelling, followed by knee instability or "soft legs". At this time, you may be infected. Patients with acute ACL injury have joint effusion, sometimes accompanied by other ligaments, meniscus, articular cartilage or subchondral bone contusion.

Which sports are likely to cause anterior cruciate ligament injury?

Sports are the main cause of anterior cruciate ligament injury. In common sports such as football, basketball, tennis, dancing and skiing, when we stop suddenly or change direction suddenly during exercise, anterior cruciate ligament injury will easily occur. Among them, ball trauma is the most important factor of anterior cruciate ligament injury. In the early stage of ACL injury, the patient's knee pain is not obvious. Most patients have slight knee swelling, which is easy to be ignored. When the patient runs or goes down the stairs and feels obvious knee discomfort, he will come to the hospital for treatment.

How to prevent anterior cruciate ligament injury?

1. Choose a good form of exercise

You need to choose a suitable exercise method for yourself. Everyone's physical condition is different, so you can't use the same method for everyone. For the elderly, you can do some gentle, small-amplitude exercises and stay away from intense confrontational exercises. Obese friends should reduce weight-bearing squats to prevent cartilage damage caused by improper exercise. So you need to choose the right exercise method according to your physical condition.

2. Warming up before exercise is important

Before engaging in sports such as hiking, running, and ball games, do a thorough warm-up, including stretching and strengthening balance exercises. Correct and thorough warm-up can activate the muscles around the joints, make the muscles and ligaments around the knee joints full of strength, and effectively prevent joint stiffness. Stretch and relax appropriately after the exercise.

3. Take good protection during exercise

You should pay attention to the protection of your knee joints. You can wear knee pads when exercising. Also, be careful not to over-fatigue the knee ligaments, especially when going up and down stairs or climbing mountains. If you feel tired during exercise, you should rest in time to reduce the chance of ligament injury. The movements during exercise should be standardized, and collisions and other dangerous movements should be avoided as much as possible.

4. When jumping or doing other exercises, the landing should be stable

To avoid knee joint injuries caused by excessive rotation and forward movement, the knee flexion angle should be slightly larger when jumping and landing. At this time, the gluteal muscles and posterior thigh muscles will play a greater role, which will enhance the stability of the knee joint, effectively control the shaking and eversion of the knee joint, and avoid knee ligament injuries.

5. Exercise according to your ability

When exercising, you must do what you can. When exercising, you must pay attention to the reaction of your knee joints. It is better to be comfortable. Fatigue exercise is a taboo. In addition, you need to improve your concentration and avoid high-risk actions during exercise. You can do some exercises to increase the strength of your thigh muscles, enhance the stability of your knee joints, improve the flexibility of exercise, improve your reaction speed, and avoid falls. Please remember that if you feel unwell, you must stop exercising.

How to treat anterior cruciate ligament injury?

The first step is emergency treatment, including rest, ice, pressure bandage on the injured knee joint, and raising the affected limb to promote swelling to subside. For patients with mild injuries, the anterior cruciate ligament has not been completely ruptured and the stability of the joint has not been affected. You can wear a knee brace and keep the knee slightly bent to reduce activity. If you need to get out of bed, it is recommended to use crutches to avoid weight bearing, especially when the knee joint is unstable. At the same time, use nonsteroidal anti-inflammatory drugs to control pain. Generally, after 2-3 weeks of rest, joint swelling and inflammation will subside and can recover on their own.

Some patients with serious injuries should wear a brace and wait until the swelling of the affected knee subsides and the acute phase of 2-3 weeks passes before deciding whether to undergo surgery. Whether to undergo surgery depends on the patient's condition, including knee instability and activity level.

If the anterior cruciate ligament is unfortunately torn, minimally invasive arthroscopic technology can be used to reconstruct the anterior cruciate ligament. The anterior cruciate ligament can also be reconstructed under computer navigation and robot-operated arthroscopy. The reconstructed ligament is taken from the autologous tendon. It takes a short time and has little trauma. It is a minimally invasive treatment with satisfactory results. After the operation, the brace is fixed and functional exercises are given strictly according to the rehabilitation requirements. Free movement can be restored in about 3 months.

Finally, I would like to remind you

When exercising

If the knee joint is injured acutely

Or recurring knee pain and swelling

Go to the hospital promptly

See a professional doctor for diagnosis and treatment

Procrastination is futile

Expert introduction

Fang Dan, a master's student, head nurse, member of the Science Popularization and Health Education Working Committee of the Chinese Medical Education Association, and member of the Pain Committee of the Shanghai Nursing Society. She was the head nurse of the emergency ward and the head nurse of the anesthesia and surgery department of Tongren Hospital. She presided over a key nursing research project of the School of Medicine of Shanghai Jiaotong University and a research project of Changning District, and published 10 papers. She was selected for the second Changning District Nursing Talent Training Program and the Shanghai Nursing Society's Excellent Youth Seedling Program. She represented the department in various national and Shanghai competitions many times and won the third prize in the national competition.