Getting Back in the Game

Charles Gatt, MD, Chairman and Associate Professor of Orthopedic Surgery at Rutgers Robert Wood Johnson Medical School, Robert Wood Johnson University Hospital and University Orthopedic Associates, LLC

One minute you’re running around the field scoring goals and dodging players, the next, you feel a “pop” in your knee and you’re watching the game from the sideline. For young athletes and older weekend warriors alike, sports-related knee injuries can take even the most active players off the field and into rehab with just one twist of the knee.

These minor and sometimes season-ending, or even career-ending injuries include any trauma to the bone, cartilage, ligaments and tendons associated with the proper and fluid movement of the knee. With continuous twisting, bending and jumping required in many sports, fracture, dislocation or tearing can occur during regular play. When the intricate system of the knee is disrupted by an injury, athletes can find regular movement limited, or completely impossible.

One of the most common knee injuries for athletes is a sprain or tear of the anterior cruciate ligament (ACL), which affects roughly 200,000 people each year. The ACL, which connects the thighbone to the shinbone, is a key ligament that aids in stabilization of the knee. When this ligament is strained or torn from sudden stops and changes in direction, the ligament can be torn off the thighbone or split in half. This results in the distinctive “popping” sound at the time of injury and causes progressive swelling and pain while walking. Although the injury can be an isolated tear of the ACL, tears often occur in conjunction with injuries to the medial collateral ligament (MCL) and meniscus.

If you suspect you or a teammate has a torn ACL, remove the player from the game immediately and seek medical attention. Anti-inflammatories such as ibuprofen, ice and raising the leg may help to relieve pain and swelling until medical attention can be sought.

An orthopedic surgeon will be able to properly diagnose the injury to prevent further damage to the joint. These specialists treat sports-related injuries on a daily basis and are highly trained in the care of injured ligaments, bones, tendons and joints. An orthopedist will perform a series of tests to determine the severity of injury and decide the course of treatment. Surgery may be necessary to regain stability with a complete tear of the ACL, but the decision for an invasive procedure is ultimately based on age, activity level, degree of instability and associated injuries. Young, active athletes will require surgery to return to previous activity levels while older patients with less serious tears can often resume active lifestyles with nonsurgical treatment.

Regardless of the need for surgery, all patients will participate in an aggressive rehabilitation program to regain strength and stabilization of the ACL and surrounding muscles. Physical therapy will begin just days after surgery and will have patients biking, squatting and performing leg presses in less than three weeks. An aggressive rehabilitation program contributes to faster recovery and better outcomes.

Full care for joint, bone and muscle injuries is provided by an experienced team of sports medicine physicians, orthopedic surgeons, therapists, trainers and specialists affiliated with Robert Wood Johnson University Hospital (RWJUH) in a variety of locations throughout Central New Jersey. An aggressive sports rehabilitation program is available for patients seeking to enhance athletic performance, whether to prevent injury or recover from it. For more information about sports rehabilitation at RWJUH, call 1-855-SPRTS-MED or visit http://www.rwjuh.edu/ssp/sportsmedicine.aspx.