Knee Injuries on the Job

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Driving down Interstate 5 through the Pacific Northwest, you see a lot of logging trucks pass you by.

Loggers and truck drivers do a lot of heavy lifting and/or climbing, but so do other professions, like nurses, construction workers, doctors or even chefs who walk long distances while lifting items they may need on the job.

You may not think of these jobs as a place where a knee injury might occur, but in fact, occasionally injure a person.

A knee injury might not be apparent at first, but over time, may become swollen and painful. The knee injury now becomes an impediment, and you are unable to lift things because your stance is unstable.

Think about the last time you wobbled a little because your knee gave out and developed a nagging pain soon after. Did you do anything to alleviate the pain you felt in your knee?

Common Knee Injuries

Meniscus Injuries: Meniscus tears can cause intense pain and instability in the knee depending on the severity of the tear. Clients with tears to the meniscus describe a sensation of their knee “giving out” or “coming out from under them” while walking or climbing stairs.

The knee will most likely swell in order to protect itself, which can be intensely painful and can limit movement. Although physical therapy, anti-inflammatory medication and cortisone injections can help reduce symptoms, an orthopedic doctor will often recommend arthroscopic surgery to repair the tear.

Ligament Injuries: Injuries to the cruciate ligaments – such as the anterior cruciate ligament (ACL), medial collateral ligament (MCL) and posterior cruciate ligament (PCL) – are sometimes referred to as sprains, but they can be much more complicated than simple muscle strains. These injuries can require months of treatment to recover, and some cruciate ligament injuries — e.g., anterior cruciate ligament (ACL) tears – may require reconstructive surgery.

Chondromalacia: Chondromalacia is a disorder caused by softening of the articular cartilage of the kneecap. It can be caused by traumatic injury or overuse or repetitive motion on the job. Signs and symptoms of chondromalacia include dull, achy pain in the front of the knee, increased pain when walking up or down stairs, pain in the knee when kneeling or squatting, knee pain after sitting for long periods of time, a grating or grinding sensation when you extend your knee and knee stiffness.

To diagnose the problem, an OSS physician may require you to attempt simple knee exercises or recommend X-rays or other imaging tests such as an MRI or CT scan. Treatment options include rest, pain relievers or physical therapy. In rare cases, arthroscopic or realignment surgery may be options.

According to Dr. Watt, “Knee problems and injuries may be job-related or not. Sometimes it is obvious and sometimes not obvious and this may be part of the initial evaluation. I have extensive experience on all types of knee problems and injuries and would love to help anyone with a knee problem to try and regain a healthy knee.”

Dr. Watt is a board-certified orthopedic surgeon here at OSS who works with patients dealing with a wide range of orthopedic issues. Dr. Watt carefully weighs conservative and aggressive methods of treatment to devise a plan tailored to the specific needs of the individual. This personalized approach creates excellent outcomes, with patients working as close partners in the treatment process.

Seattle Seahawks WR, Percy Harvin and His Hip Labral Tear

Percy Harvin, Seattle Seahawk’s Wide Receiver is waiting out another week before he can return to the football playing field. NFL Spinzone reports, “Harvin was able to return to practice a couple of weeks ago, but the Seahawks have prudently decided to rest him. He has recovered quickly and well from off-season hip surgery, but Pete Carroll is 100% correct in being as cautious as possible with their new star receiver. The last thing they need is for the oft-injured Harvin to have a setback, especially since the 8-1 Seahawks clearly have their eyes set on a Super Bowl-winning season.”

The labrum is a unique structure found in the hip. The labrum is a specialized structure that lines the edge or rim of the hip socket. The shape and function of the labrum can be most easily understood as being similar to a bumper cushion on a pool table. The shape of the labrum is triangular in cross-section. The labrum acts as a cushion between the ball and socket of the hip joint during flexion of the hip.

The labrum is filled with nerve fibers that make tears in the labrum very painful.

What causes a labral tear?hip-labral-tear

Labral tears typically occur from:

  • Repetitive motion. Physical activity that requires one to repeatedly pivot the body can lead to joint wear and tear. This is common in athletes such as golfers and baseball players, who must repeatedly twist their bodies to hit a ball.
  • Osteoarthritis. Increased friction from osteoarthritis symptoms inside the hip joint may lead to labral tear.
  • Trauma. Dislocation or violent, direct impact to the hip joint may cause labral tears. This is common in athletes and victims of car accidents.
  • Birth defects. Some people are born with abnormal hip structures, which increase the progression of wear and tear on the hip joint. These problems may lead to labral tears.

What does it feel like?

Some labral tears cause no signs or symptoms; however, when symptoms are present, they include:

  • Radiating pain in the hip and groin
  • A catching or locking sensation in the hip joint
  • Stiffness in the joint
  • A limited range of motion

How do I know if I have a labral tear?

A physical examination by your doctor will help diagnose the cause of your symptoms. X-rays will allow your physician to take a closer look at the bone and rule out other possible underlying conditions. Magnetic resonance imaging (MRI) may also be used to further examine the soft tissues.

How are labral tears treated?

The level of treatment depends upon the severity of the condition. Some patients recover in only a few weeks using conservative treatments. However, patients with severe labral tearing may require surgery. One or a combination of these treatments may be used:

  • Rest and activity modification. By resting and allowing the inflammation of the joint to settle down, symptoms may be alleviated.
  • Medication. Anti-inflammatory medicines may help alleviate the pain and inflammation associated with labral tears. Your doctor may also recommend cortisone injections.
  • Physical therapy. Learning new exercises can help maximize hip range of motion, strength, and stability.
  • Surgery. In general, labral tears can be either repaired or trimmed during an arthroscopic procedure. Depending on the severity of the tear, the surgeon may cut out and remove the torn piece of labrum or repair the torn tissue by sewing it back together.

According to Dr. Watt, “Hopefully Percy will continue his recovery and return to the field soon. If you think you have labral tear or hip condition that is not getting better, I would be happy to evaluate your hip and devise an appropriate treatment plan.”

 

In the words of Russell Wilson, “Go Hawks!”