This is a transcript of a Dr. Jay Show broadcast on 1560TheGame in Houston, TX. Knee Specialist Dr. J. Michael Bennett is a Board Certified Orthopedic Surgeon and a
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| Typical locations of arthroscopic surgery incisions in a knee joint following surgery for a tear in the meniscus. (Photo credit: Wikipedia) |
Fellowship Trained Sports Medicine Physician serving patients from Katy, Fort Bend County, Metro Houston and Southeast Texas from offices in Houston and Sugar Land, TX. Call 281-633-8600 for an appointment.
Our special guest is Dr. Terence Chang, a family practice physician Board Certified in Sports Medicine from Physicians at Sugar Creek in Sugar Land, TX. Bob Lewis, from 1560TheGame, is also participating.
Here’s the transcript of the fifth portion of the Show:
DR J. MICHAEL BENNETT: So we’ve got a phone call here coming at us from Jose. Jose, welcome to Saturdays with Dr. Jay, what can we do for you today?
CALLER: Good morning, Dr. Jay. By the way I love your show, I love listening to all the sports medicine stuff, I injure myself every other time I go and play some ball. I’ve got a little issue. I had an ACL reconstruction and the doctor did a great job, got me back out on the court. But shortly after that I had a small meniscus tear that developed and I kept playing with it, I was playing a lot of league ball, and so now it’s got to the point where I wake up and it looks like somebody hit me in the knee with a baseball bat. I called the doc and they did an MRI and they found out the tear had actually gotten a lot worse. My question is are there any exercises I can do because I’m going to have surgery done probably here within a month or two but obviously I still want to stay active and am I going to cause more damage if I’m out there still playing, you know, at my normal speed?
DR. BENNETT: That’s a great question and I’ll give you my take on it and then we’ll go to Dr. Chang and he’ll give you his take on it. Regarding the meniscus tears, the meniscus is basically for everybody else out there that’s listening, you’ve got two little half-moon shaped discs in the joint and they’re actually made out of cartilage and they help cushion the joint. It sounds like you did the big surgery, the ACL reconstruction, which helps stabilize the knee and the thing is unfortunately as we get older and if we stay active, our cartilage tends to soften a little bit and sometimes it can be more prone to injury. So even though you got your meniscus addressed previously, got your ACL done, even though you can stabilize the knee, you still have injuries. I’ve had patients that tore their meniscus bending down to pick up their kid at a grocery store or even twisting and turning at night sleeping. So
it just depends on how degenerative the meniscus looks how likely you can have a tear. You can also have a small tear that’s propagated or has gotten worse over time. Now as far as doing damage to your knee, having the swelling overnight, a lot of times what happens is that during the day you are probably pretty active or just doing your normal routine and sometimes at night we’re just kind of relaxing and you just prop that knee up and it can swell just because you can get a gathering of fluid in the joint overnight as you’re not using the joint as much. Now some patients toss and turn at night and they actually twist their knee or bend their knee or extend their knee and that can irritate your knee as well and actually cause swelling. Any time you get swelling it’s because of that flap, or that tear there, that’s rubbing up around the surrounding cartilage. And as far as like doing damage what I tell patients is it’s almost like walking around with a piece of gravel in your shoe. That’s something that can be painful and it can kind of disrupt or wear down the surrounding cartilage joints. You have the two little meniscus pads there but on top of that you’ve got another area of cartilage that can be worn down as well and can cause some arthritic changes so usually if you’re active I recommend having something done about it, which sounds like you are doing, which is good. But at the same time if you’re looking at doing something to remain active before the procedure’s done then I’d probably recommend something low impact because what’s going to irritate your knee is the high impact activities, anything that has a kind of cutting or twisting activity to it. So I definitely wouldn’t want to play basketball if you’re about to have the procedure done because you have that tear there and that can get caught again and cause you to have your knee give out on you. If you want to do something in a controlled fashion you can do an elliptical or you can do a bicycle, or something along those lines.
DR. TERENCE CHANG: You know for some of these meniscus tears what we actually do is send them to therapy to get them to strengthen the quads and the hamstrings and
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| Head of right tibia seen from above, showing menisci and attachments of ligaments. (Photo credit: Wikipedia) |
what it does is you already had an ACL surgery so we know that you are likely to develop arthritis later on, in the meantime what you want to do is protect the joint and the surgery itself can get a little bit lax and that doesn’t mean that you need to go back for surgery, per se, to reconstruct that ACL a second time, but what it does mean is that you do need to strengthen the muscles and the tendons around it so that it can help protect the joint.
DR. BENNETT: I agree 100 percent. That’s something called prehab, and the prehab is rehabilitation before the surgery and actually can help you speed up your recovery afterwards. I’m a big believer in the rehabilitation side of it all. Yeah, so Jose, great question regarding that. I think that’s important to take into consideration, just remember, low impact activities are good, you know, a bike or an elliptical or something like that along those lines where you’re not going to be doing a lot of twisting and turning. Definitely don’t get on the court until you get your procedure done because you don’t want your knee to kind of buckle or give out on you.
If you have a question about sports medicine or orthopedics and you’d like to make an appointment with Dr. Bennett, please call our office at 281-633-8600.
