Athletes depend on their excellent, strength, flexibility and mobility to be able to perform effectively in their specific sport or physical activity. They undergo rigorous training in order to prepare for competitive seasons. While many athletes understand and use preventive measures to avoid experiencing an injury or developing a condition, the constant utilization of the different structures of the body can gradually cause the degeneration of the tissues, eventually resulting in an unexpected injury. Many athletes commonly experience sports injuries, however, one type of injury can cause tremendous hardships for the affected athlete: a torn meniscus.
Within an incidence ratio of 60 to 70 for each 100,000 visits, meniscal tears of the knee are a common diagnosis among many sports injury scenarios. Meniscal tears have accumulated great amounts of lost time from physical activity and even employment, which is why understanding the risk factors for meniscal tears is essential, allowing for a quicker and more accurate diagnosis of this type of sports injury.
Lesions to the meniscus frequently occur in sport settings where tremendous dynamic demands are placed against the knee during specific movements. Moreover, meniscal tears may also occur during workplace environments where repetitive, constant motions can develop complications.
Basic activities, such as standing, lifting, squatting, kneeling and sitting, are believed to increase the chances of damage to the meniscus. The time between ACL, or anterior cruciate ligament, ruptures and surgical reconstruction procedures have also been acknowledged as a risk factor for meniscal lesions. Numerous elements contributing to this type of injury have been recognized, however, there’s limited research to support them.
Scientists at the University of Amsterdam, published a systematic review along with a meta-analysis, which investigated several key risk factors for meniscal tears.
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The menisci are two semilunar ridge-like structures, which are positioned on the medial and lateral surface of the tibial plateau. The menisci function by allowing the convex surface of the femur to articulate on the concave surface of the tibia. Additionally, the menisci enable the conversion of weight as well as the absorption of shock during dynamic movements, acting to protect the articular cartilage. Meniscal lesions can be characterized as acute or degenerative, manifesting in different forms, such as a bucket handle tear, a horizontal tear, or a degenerative tear.
Anterior View of the Right Knee
Superior View of Tibial Plateau and Forms of Meniscal Lesion
Degenerative Risk Factors for a Torn Meniscus
Two research studies concluded that an individual’s body mass index, or BMI, may be consequential with degenerative meniscal alterations. Scientists from Boston University analyzed the BMI of 991 participants, of which 565 were female and 426 were male. The evaluation demonstrated that females with a meniscal tear had a considerably higher BMI, approximately 29.9 percent, than females without meniscal damage, approximately 27.9 percent. Nonetheless, there were no statistical differenced in body mass index for males, with or without meniscal damage. An identical research study distinguished a considerable difference in meniscal tears among participants with a BMI of 25 to 30 kg/m2, a 76 percent of incidence, when compared to participants with a BMI of less than 25 kg/m2, with a 34 percent of incidence. It was concluded, through statistical analysis, that a BMI greater than 25 kg/m2 produced a greater disposition for meniscal damage than those with a lower BMI. It’s essential to keep in mind that these statistics don’t simply involve individuals of obese proportions but it also includes those who maintain a greater muscle mass as well as increased body mass.
As previously recognized in other studies, age is considered to be a critical element for these particular knee injuries. Researchers have confirmed that older individuals may in fact experience greater meniscal trauma. For instance, approximately 19 percent of females and 32 percent of males ranging from 50 to 59 years of age, faced meniscal destruction, in comparison to 51 percent of females and 56 percent of males ranging from 70 to 90 years of age, who presented meniscal trauma. The researchers concluded that people aged 60 years old and over were considerably more probable to suffer from degenerative meniscal tears than someone under 60 years of age. Regardless, the results of the study failed to explain that individual’s younger than the age group provided for the study could also sustain meniscal tears. As a matter of fact, knee complications can also be considered to be some of the most prevalent types of youth injuries, although further research is required to properly determine the statistics of youth athletes with meniscal lesions.
Furthermore, gender has also been considered to be an important risk factor for injuries to the meniscus, as identified in other studies. Additional research from the Boston University evaluated the relationship between meniscal tears, pain and osteoarthritis in 154 patients with identified symptoms of knee osteoarthritis. Using MRI scans, the end results demonstrated that 91 percent of individuals presented a medial or lateral meniscal tear, in which males were identified with a significantly higher prevalence of meniscal lesions than females. Another study distinguished the features of meniscal lesions in 991 individuals through the utilization of MRI scans. Again, males demonstrated a considerably higher incidence of meniscal tears among all age groups, although females diagnosed with meniscal degeneration were categorized within the 70 to 90 years of age group. Whether the higher occurrence of injury in males was due to greater participation in sport or due to occupational activities was not determined in the study.
Three distinct research studies found that kneeling and squatting for more than one hour per day could influence the development of meniscal tears. Individuals whom participate in certain trades or professions, such as carpentry, electrician and plumbing, positions which have widely been occupied by males, repetitively and constantly kneel and squat as a part of their average work day. Research carried out at Southampton University in England determined that 59 participants experienced locking of the knees where 29 were exposed to kneeling and 30 were exposed to squatting in their workplace. Of these 59 individuals, some which may have crossed over in both categories, 69 percent and 73 percent correspondingly consulted an orthopedic surgeon. These participants reported engaging in frequent kneeling and squatting positions while at work, however, several participants also reported participating in specific sports, such as football, which is also considered another risk factor for meniscus lesions.
Sitting for more than two hours per day was believed to decrease the risk of meniscal tears. Two studies conducted by the same leading author from Southampton University, focused to determine the risks of sitting. Also, sitting for extended periods of time was believed to incline an individual to develop other knee conditions, such as patellofemoral pain, also referred to as movie/theatre sign, of which sitting is believed to be a risk factor. Although studies concluded that sitting doesn’t increase the chance of further damaging meniscal tears, it was determined to potentially create issues on other areas of the knee.
Standing or walking for more than two hours per day for 12 months before experiencing symptoms, as compared to less than two hours per day, were thought-out to influence the development of meniscal lesions. Two additional research studies evaluated the effects of standing and walking for extended periods of time. The results concluded that from 71 participants who were disclosed to prolonged standing or walking for more than two hours per day, 54 percent had consulted an orthopedic surgeon due to symptoms of meniscal damage. In comparison, walking and standing was concluded to be effective, in terms of energy expenditure, mechanical bone loading, cardiovascular fitness and overall health, apart from other perspectives.
Walking more than two miles per day within 12 months before symptoms, was determined to have a very low chance of causing meniscal lesions. The health benefits of walking outweigh the possibility of knee injuries and therefore, should not be excluded otherwise unless the symptoms prevent the individual from participating.
Moreover, climbing more than 30 flights of stairs per day within the 12 months prior to the onset of pain and discomfort, was found to considerably affect the individual, aside from climbing stairs 30 times per day, lead to an increased possibility of knee injuries. During a study, 17 male participants reported meniscal related symptoms, such as locking, when climbing stairs, with 59 percent resulting in a consultation with an orthopedic surgeon.
Carrying an excess of 10 kg, 25 kg and 50kg more than 10 times per week concluded in two studies that there was a significant effect against the structures of the knees, increasing the risk of a meniscal lesion.
Acute and degenerative meniscal tears were investigated in a current research study. Utilizing a community sample of 2,806 males in the south of England, by means of a questionnaire, 1,404 participants responded where 762 reported experiencing prior symptoms of knee injury. Of the 762 participants with symptomatic knees, 127 reported symptoms of locking during one or more occupational activities, which lasted longer than 24 hours. The results confirmed a potential increased risk of meniscal lesions within the 20-59 age category.
Acute Risk Factors for a Torn Meniscus
In one study, weight bearing after an individual experienced trauma, concluded to pose a moderate danger for the occurrence of meniscal tears. Researchers from Lund University in Sweden determined that individuals with an ACL injury who engaged in non-weight bearing activities were less likely to sustain further damage to the meniscus. Frequently, ACL injuries occur in load bearing positions which often result in greater joint compression forces of the tibiofemoral compartment. Thus, the well-known term, the unhappy triad, has been more appropriately termed the unhappy compression injury. The unhappy triad refers to trauma involving the ACL, medial collateral ligament and the medial meniscus. It’s ultimately important to stabilize the joint of the knee through the use of conservative or surgical procedures to prevent additional compression against the meniscus. It was therefore concluded that weight bearing during an injury disclosed a moderate chance of injury to the meniscus, however, the authors were unable to determine whether a considerable effect existed.
The participation in any sport or physical activity in general is considered to be a comparably high risk factor for meniscal tears. Two research studies assessed the prevalence of knee injuries during football, rugby, swimming and running. Both football and rugby were concluded to be considerably high components in the incidence of meniscal tears. In comparison, swimming and similar sports were considered to pose a moderate chance of causing meniscal tears. Furthermore, a lack of evidence was unable to determine if running could develop knee complications. Due to the demands of the transfer of mass and the rotational forces applied, it’s not difficult to note how football and rugby could be a potential danger for further injury in athletes with previous meniscus trauma.
Laxity of the Knee Joint
Anterior cruciate ligament, or ACL, injuries where there’s an extended period of time till an athlete will receive reconstructive surgery have been well recorded as an influence towards the development of meniscal lesions. An ACL deficient knee requires the menisci to function accordingly as a stabilizing component along the posterior-anterior, valgus-varus and internal/external rotation movements. While rehabilitation methods such as chiropractic adjustments and manual mobilization and manipulation techniques, or physical therapy may be utilized to help improve an individual’s symptoms as well as increase the strength of the surrounding structures. However, a majority of meniscal injuries may require surgical interventions to properly repair them. Researcher’s findings coincided with previous research concluded that an ACL deficient knee posed a risk to meniscus trauma but identified that this was consistent with the medial but not lateral meniscus. The authors of the research study stated that this altered consistency may be due to the medial meniscus being fixed to the joint capsule. In comparison, the lateral meniscus is not firmly attached to the joint capsule, acquiring more mobility within the joint which explains the difference in injury incidence.
It was recognized that from 3,475 individuals with previous ACL injuries, 1,638, approximately 47 percent, were diagnosed with meniscal tears. The authors added that for each month that went by for individuals that experienced an ACL rupture, there was an exponential chance of meniscal trauma of only 1 percent. Additionally, the presence of a degenerative meniscal lesion increased an individual’s risk of suffering further trauma to the knee by 1.6 to 2.0 percent.
The Risk of Playing Sports with a Torn Meniscus
In conclusion, a wide variety of factors have been identified as potential risk components which might incline an individual to experience a greater incidence of meniscal tears. An injury to the meniscus can be sustained by anyone within the general population and athletes alike and these should not be ruled out to only develop in a single sub-group based on other research studies. Ultimately, the risk factors identified tremendously increase the chance for an individual to experience specific types of knee injuries. Although several research studies covers a large variety of risk factors for the general population and athletes, these were very limited as the majority were only supported by a few studies.
A torn meniscus can greatly affect an athlete’s optimal performance, challenging their efficiency to practice and compete in their specific sport or physical activity. As analyzed above, the gradual degeneration of the body’s structures and tissues can impact whether an athlete will suffer an injury during their lifetime. There are a variety of treatments available to help individual’s recover from a torn meniscus, such as chiropractic care, although surgical interventions have also been preferred by some athletes. Aside from the type of treatment you receive, understanding the anatomy of the meniscus and how an injury can affect it can help teach athletes on better ways to care for their sports injuries.
For more information, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
Sourced through Scoop.it from: www.elpasobackclinic.com
By Dr. Alex Jimenez
These canons of professional ethics are based upon fundamental principles of moral and professional behavior and recommended for all doctors of chiropractic and chiropractic assistants. The following basic principles should be guiding factors in the practice of chiropractic and upheld at all times:
Consider the well-being of the patient. The primary effort and ultimate goal is for the greatest good of our patients.
- Dr. Alexander D. Jimenez D.C., C.C.S.TChief Clinical DirectorPhone: 9155408444Email: email@example.comSpecializing in Severe Pain: Sciatica, Neck-Back Pain, Whiplash, Headaches, Knee Injuries, Sport Injuries, Dizziness, Poor Sleep, Arthritis. We use advanced proven therapies focused on optimal mobility, health, fitness, and structural conditioning. We use Patient Focused Diet Plans, Specialized Chiropractic Techniques, Mobility-Agility Training, Cross-Fit Protocols and the "PUSH System" to treat patients suffering from various injuries and health problems.
Message from: Dr. Alex Jimenez D.C., C.C.S.T
( Biography and my promise to you )
My name is Dr. Alex Jimenez, I am Chiropractic Doctor specializing in advanced therapies focused on total joint health, strength training and complete fitness conditioning. We use patient Focused Diet Plans, Advanced Chiropractic Techniques, Agility Training, Cross-Fit and the PUSH System to treat patients suffering from various injuries and health problems. Our goal too is to help your body heal itself naturally. When your body is truly healthy, you will arrive at your fitness level and proper weight efforlessly. We want to help educate you on how to live a new and improved lifestyle. Our doctors have spent over 25+ years researching and testing methods with thousands of patients. We strive to create fitness and better the body through researched methods and total programs...
My goal too is to help the body heal itself naturally. When your body is truly healthy and balanced, you will move pain free and ultimatly arrive at your optimal fitness levels and proper weight effortlessly. We want to help educate you on how to live a new and improved lifestyle. Our doctors have spent over 25 years researching and testing methods with thousands of patients. We strive to create fitness and better the body through researched methods and total programs. These programs are natural, and use the body's own ability to achieve goals of improvement, rather than introducing harmful chemicals, controversial hormone replacement, surgery, or addictive drugs. We want you to live a life that is fulfilled with more energy, positive attitude, better sleep, less pain, proper body weight and educated on how to maintain this way of life.
The focus on spinal and skeletal adjustments is what makes doctors of chiropractic unique in their approach to treating patients with spinal complaints. This hallmark chiropractic adjustment, however, is not the only procedure a chiropractor may employ in managing a patient's care. I am very proud to bring my patients a variety of treatment options beyond the typical scope of care. With the advances in physical therapies and modalities we bring El Paso option that better aid in the rehabilitation process. Tissue healing is a wonderful process that begins the moment an injury occurs. How the injury is managed determine the final outcome in terms of healing. It is critical we implement immediate procedures as soon as we can in order to gain optimal recovery. The old day of let it rest until it gets better is not the only option.
Letting it rest may even be an irresponsible approach considering what we now know. The implementation of active and movement based treatments have clearly shown increased and improved outcomes in many instances.
As a doctors focused on the greater good for a patient, we must assess each patient individually and apply the appropriate protocols. It is also very important to denote, that El Paso has fine doctors in many specialties of healing and repair. The direct relationship we have with specialist of these disciplines is clearly what allows us to bring the highest quality of care to our patients.
My promise to my patients is clear for all to read here. I, with Gods help, will do what ever it takes to assist you in your recovery. I too will draw upon all the specialist in this town to find you the collaborative care that is required with the disorders being tended to.
With Great Regards to you.Read moreRead lessEducation:
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Truide Torres (Bio)
Driven by the passion of doing what is in the best interest of the patient, I wake up every morning with the drive to help those in need. The claims process for health care is full of pits, valleys and difficult obstacles designed to strike fear in those in need. My duty is to do what is within the confines of the law, "what ever it takes" to get those involved to pay attention to those who need help. That is what I am honored to do for our patients.
Personally, I have seen great injustices transpire on those that do NOT have a voice. Whether, a language barrier or just not knowing the rules. My job is to find out how I can help. If I personally can not help, I will find the right sources to open the possibilities. I get the job done.
As a wife and mother of 2 children, 3 dogs and 2 Cats. My passion is for God, Family and the mission of serving my fellow man.
Let it be clearly stated... I am here to help. My phone 915-850-0900Read moreRead less
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- Mike ContrerasPersonal TrainerPhone: 915-203-8122Big Mike was born and raised in El Paso and is an excellent personal trainer and CrossFit coach. Mike works hand in hand with each patient’s clinical care plan in order to achieve optimal outcomes. A trusted clinical representative of the PUSHasRx System along with his advance protocols. Mike not only trains the injured and recovering. Mike is a sincere human that has great talent of brining out the best in every individual he works with. He will never admit it, but we will share with you a secret. He with his God given talents trains the greatest athletes and champions in El Paso. Many champions in our community know of his commitment. As a youth, he also played football (wide receiver), basketball, and track at Bel Air High School. Educated in Clinical Human Kinesiology at UTEP and loves playing football and basketball with his little nephews in his free time. Mike has three sisters and one brother, most of which live nearby in El Paso. When he’s not watching the Cowboys or Spurs play, he’s usually lifting, sleeping or watching movies. We are blessed to have this soul on our team.Read moreRead less
- Alexander Isaiah JimenezCollegiate Athletic Consultant & NCAA Wrestling ChampionPhone: 915-820-9443Email: email@example.comAlexander Isaiah Jimenez leads the power and agility education programs for the high school athletes. While still studying for his medical degree he provides physical performance testing in order to collaborate with clinicians. He is gifted in creating physical performance programs no matter what the clinical presentation is. As national fitness champion and collegiate wrestler, he too understands what performing at high levels entails. He too has had to recover from debilitating injuries only to return better then before an win national titles. He understand how the recovery process is different for clients, patients and extreme athletes. We are blessed to have his counsel.Read moreRead less
- Ethan PadillaPersonal Trainer & Strength CoachPhone: 915-203-8122Ethan was born and raised in El Paso and is one of our most outgoing and friendly coaches. Ethan earned his nickname “rampage Ethan” from his years at El Dorado High School, where he played inside linebacker. He has placed twice in the Strongman Competition and also recently competed in the Desert Games with his fellow PUSH Athletes as a team and placed 4th overall! Ethan is currently pursuing his Bachelor’s Degree in Kinesiology at UTEP. His focus on clients is obvious to all. Ethan is able to manage very large groups of individuals like no other. His awareness of the dangers while exercising is his greatest concern. When he’s not coaching or studying for class, he likes to spend time with his family (who are here in El Paso) or with his weimaraner puppy. Fun fact: Ethan loves any food with sprinkles (especially donuts with sprinkles) and is a diehard Seattle Seahawks fan.Read moreRead less
- AndresRecovery & NutritionAndres has been at PUSHasRx for two years. He brought his company Recovery and became the official juicer. Andy will fix you right up. Andres, will make sure that your nutritional recovery programs fits within your standards. Also, there is great care in making sure the nutritional requirement are clinically met. Patients and high performance athletes depend on high performance nutritions. Upon your completion of the physical medicine portion of therapy you will be offered specialized organic recovery drinks and supplementation to help aid in your recovery. You will be confident that from your pushing to recovery, you will be taken care of.Read moreRead less
- Iylene AvalosPUSHasRx TrainerPhone: 915-203-8122ylene has been working with us for over 4 years. In her spare time she enjoys working out and running. She has 2 dogs and loves movies. Iylene is extremely aware of body mechanics and mindfully watches rehabilitation movements. She is always standing ready to assist and respond to client needs. Her commanding voice is always clear to all, no matter what floor you are on. Iylene is always ready and willing to answer any question you may have regarding fitness and recovery.Read moreRead less
- Rick CanoPersonal Trainier Level VPhone: 915-203-8122Most early-rising PUSHasRx members know Rick well as a fantastic coach who focuses strongly on form and will always make you laugh. He was born and raised in El Paso and loves to train his athletes and coach CrossFit. Rick is a very diligent, kind and considerate trainer. He is always mindful of client techniques and aware of client goals. When he’s not coaching, Rick loves to work on cars, especially his ’69 Chevelle (his next car will hopefully be a ’69 Charger). He not only became a certified Automotive Mechanic at 17, but while working on his certification at EPCC, he won 1st place in a bench competition when he was 16 (approx. 56 reps at 155#). His favorite movements are clean & jerks and snatches. He loves oreos (eats them every night), loves watching the CrossFit games, and loves his three bulldogs. He spent one year full-time personal training before he started coaching CrossFit two years ago. He is CrossFit Level 1 Certified and hopes to get his Level 2 Certification soon. Rick has competed in several competitions, including WOD for Toys in 2014, where his team placed 1st.Read moreRead less
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- AdamVideographer & Graphics SpecialistPhone: 915-850-0900Adam has been at Injury Medical & Chiropractic Clinic for about a year. He enjoys designing and various forms of art. A story teller by trade he can see things people don’t see until his masterpieces are revealed. Adam is a director of many medias using the top graphics, audio and video medias to tell the story of our patient. Modest to the core, you would never know what he is about to create. We are blessed to have his talents telling the world about Chiropractic using any and all medias available.Read moreRead less
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Purpose & Passions: I am a Doctor of Chiropractic specializing in progressive cutting-edge therapies and functional rehabilitation procedures focused on clinical physiology, total health, functional strength training and complete conditioning. We focus on restoring normal body functions after neck, back, spinal and soft tissue injuries.
We use Specialized Chiropractic Techniques, Balanced Diet Plans, Agility Training programs, Cross-Fit techniques, the PUSH-Rx Rehabilitation System and a highly specialized program for our Veterans.
We've been blessed to use our methods with thousand of El Pasoans over the last 27 years. This has allowed us to improve health and restore true fitness through researched non-surgical methods and wellness programs. These programs are natural and use the body's own ability to achieve goals of improvement, rather than introducing harmful chemicals, controversial hormone replacement, surgery, or addictive drugs. We want you to live a life that is fulfilled with more energy, positive attitude, better sleep, less pain, proper body weight and informed on how to maintain this way of life.
As an extension to dynamic rehabilitation, we too offer our patients, disabled veterans, athletes, young and elder a diverse portfolio of strength equipment, high performance exercises and advanced agility options. We are very proud to have teamed up with the cities premier therapist and trainers in order to provide high level competitive athletes the option to push themselves to their highest abilities within our facility.
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