June 14, 2017
Today’s elite athletes push the boundaries of what is humanly possible. Countless train, day and night, strengthening their muscles and improving their techniques hoping to win championships and smash records.
Unfortunately, injuries—particularly those related to the knee or shoulder— are a reality at every level of athletics. Even when taking all of the right precautions, the most seasoned athlete can tear their anterior cruciate ligament (ACL) or sustain another serious injury.
However, athletes can take some comfort in knowing that there are minimally invasive surgical options for many of the most common sports injuries. For athletes who do not require open surgery, an arthroscopy is the ideal surgical option because it targets the injured area, while keeping healthy bone and tissue intact.
How Does Arthroscopic Surgery Work?
Arthroscopy, also called arthroscopic surgery, is a minimally-invasive and highly effective technique for treating joint problems. During an arthroscopy, the surgeon makes a few small incisions at the affected area and uses these openings to insert a small camera (Arthroscope), and surgical instruments. The surgeon can then see and explore the inside of the joint to repair or clean out the joint using the inserted instruments. The benefits of arthroscopy over open surgery include:
- Smaller incisions are used
- Less invasive to surrounding, healthy areas of the joint
- Faster recovery
- Less post-operative pain
- Less scarring
While these benefits apply to both athletes and non-athletes alike, they can make all of the difference for someone who wants to return to a sport or needs to return to work as soon as possible.
Commonly Treated Knee Injuries
Anterior Cruciate Ligament (ACL) Tears
The anterior cruciate ligament (ACL) is one of the four primary ligaments in the knee, and despite being the smallest of the four, it serves the most important role: it allows the knee to rotate. When the ACL is injured, full bend or extension of the knee becomes difficult. A torn ACL can cause the knee to give out at any moment—both on and off the field—without warning.
The ACL can be sprained or torn by a number of factors, including:
- Sudden changes in direction
- Rapid deceleration
- Incorrect jumping and landing techniques
- Blunt force applied to the front or back of the knee
In the United States, there are an estimated 100,000 to 200,000 ACL ruptures each year, with the highest numbers occurring among football and soccer players. Females between the ages of 15-19 years old are actually more susceptible to ACL injuries compared to their male counterparts.
Posterior Cruciate Ligament (PCL) Tears
The posterior cruciate ligament (PCL), similar to the ACL, connects the thigh bone to the shin bone. While the PCL is larger and stronger than the ACL, it can still tear. The PCL is most likely to be sprained or torn by a sudden blow to the front of the knee while it is bent. When the PCL is injured, athletes will experience knee instability. This will make walking and bearing weight on the knee difficult. If left untreated, a PCL tear can lead to osteoarthritis.
Collateral Ligament Injuries
The collateral ligaments are thick, fibrous bands located on the sides of the knee joint. Both the medial collateral ligament (MCL), which is located on the inner side of the knee, as well as the lateral collateral ligament (LCL), which is found on the outside of the knee, hold bones together and control how the knee moves. The MCL is more likely to be damaged by an impact from the outside of the knee, pushing it inward; whereas the LCL is at greater risk of injury by an impact of the inside of the knee, pushing it outwards.
A dislocation occurs when the bones of the knee—the thigh bone, shin bone, tibia, and kneecap—are forced partially or completely out of alignment. While some dislocations are caused by abnormal knee structures, the most prevalent causes are sports-related contact and falls.
Commonly Treated Shoulder Injuries
Rotator Cuff Tears
Sports that involve repetitive overhead movements—such as baseball, tennis, or basketball—can cause the muscles in the shoulder to fray over time and eventually tear. Rotator cuff tears can also occur suddenly due to blunt trauma. In either case, athletes will experience shoulder pain, muscle weakness, and joint stiffness or tenderness.
Shoulder Impingement Syndrome
Shoulder impingement, which is sometimes called swimmer’s shoulder or thrower’s shoulder, is the result of inflammation due to chronic and repetitive movements. Specifically, inflammation occurs when connective tissue rubs on the shoulder blade. Considering its alternative names, it should come as no surprise that shoulder impingements are likely to occur in swimmers as well as track and field athletes.
A sudden injury or overuse can cause the upper arm bone to be partially or fully forced out of the shoulder socket. In sports, a shoulder dislocation is often caused by contact or a fall.
Once a shoulder has been dislocated, the ligaments, tendons, and muscles around the joint can remain loose or torn, resulting in chronic shoulder instability. This also causes the shoulder to be more susceptible to further dislocations if not properly treated.
When Should I See a Specialist?
While the majority of minor acute knee and shoulder conditions improve with rest, it is imperative that you see an orthopedic specialist if symptoms do not resolve after a few weeks, or as soon as possible, if the injury is traumatic.
Be sure to seek treatment for your knee if you:
- Hear a popping noise
- Cannot move the knee
- Begin limping
- Feel your knee give out
- Feel severe pain
Be sure to seek treatment for your shoulder if you:
- Feel pain while resting at night
- Feel pain when applying pressure on the affected shoulder
- Feel weakness when lifting or rotating your arm
- Experience difficulty reaching up behind the back
- Experience a crackling sensation when moving the shoulder
- Experience a persistent sensation of the shoulder feeling loose
Dr. Steve Hamilton, of Beacon Orthopaedics and Sports Medicine, is one of the most recognized arthroscopic surgeons in the Greater Cincinnati and Northern Kentucky area. His focus on sports medicine and joints give him key insight to the best ways of improving functionality after a sports injury. He discusses with patients whether minimally invasive joint surgery is the best option or not and provides specific expertise regarding knee, shoulder, hip, and ankle injuries.