Now that the weather's warming, many of you have ventured into the great outdoors, your gardens, or prepared for that summer softball league. It's also a time we start seeing an increased number of joint issues in our office. If you're not careful, getting into the swing of summer can get the better of your active body parts. Specifically, ankles, knees, and shoulders.

Now that the weather's warming, many of you have ventured into the great outdoors, your gardens, or prepared for that summer softball league. It's also a time we start seeing an increased number of joint issues in our office. If you're not careful, getting into the swing of summer can get the better of your active body parts. Specifically, ankles, knees, and shoulders.

Every day in the U.S., 25,000 people sprain their ankle. And more than 1 million people visit Emergency Departments each year because of ankle injuries. Ankle injuries occur when the ankle joint gets twisted out of its normal position. While sports activities account for many, simply walking on an uneven surface can lead to rolling the ankle and causing a sprain. High-heeled shoes or walking in unstable, loose or faulty-fitting clogs or sandals are also factors contributing to ankle injuries.
Knee injuries, primarily ligament tears or meniscal tears are also something we associate with sports. But, again, you don't have to be an athlete or "weekend warrior" to suffer from these injuries or from knee pain. There are four major ligaments found in the knee, the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), the medial collateral ligament (MCL) and the lateral collateral ligament (LCL). The menisci are two c-shaped structures that help provide cushion and stability to the knee. Any or all of the above structures can be acutely injured or become damaged over time with everyday wear and tear.
Ligaments typically tear when they become overstretched through abrupt stops or twisting injuries while running, jumping, or landing. The injuries can be a contact or non-contact type injury and can occur at any age. Ligament injuries are often associated with the sensation of instability.
An injury of the meniscus can also be associated with a sensation of instability, but can also give the feeling of catching or locking of the knee. Meniscal injuries can be degenerative or from acute trauma. Degenerative changes are often associated with arthritis and can be managed conservatively, whereas acute meniscal injuries may need more invasive treatment such as a knee scope.
Knee pain and instability can also be related to arthritis, which is a wearing down of the cartilage on the ends of the bones. Arthritis may be present for a while without knowing it and then may cause pain when a person becomes more active and exacerbates the inflammation in the knee. Often, arthritic pain can be treated with the proper use of anti-inflammatories, physical therapy exercises and the occasional injection of steroid or visco-supplementation. Visco-supplementation is a type of injection the mimics our own joint fluid and attempts to re-lubricate the knee and cut down on inflammation.
Rotator cuff injuries are also very common among people who suffer acute injuries such as slips or falls, but can also occur through mere overexertion of the shoulder and overuse. Your rotator cuff is made up of four muscles in your shoulder that connect your upper arm bone with your shoulder blade This injury can be prevalent among overhead athletes and laborers, but can happen to anyone and can be a degenerative issue as well, something that happens over many years of repetitive microtrauma. Like the knees, there are many conservative treatment options for the shoulder such as anti-inflammatories, physical therapy, and/or the occasional steroid injections if necessary. Shoulder pain when reaching overhead or when sleeping on the shoulder at night is often related to rotator cuff impingement.
So, when is a hospital or emergency room visit in order?
If you had a fall or specific injury, then you need get evaluated. If you have severe pain and swelling at the injury site or heard a popping noise at the time of the injury, you'll likely want to see a doctor. An ache or mild pain that occurs without a specific injury and does not limit function can often be observed for a short time before visiting your physician.
If you have only an aching pain, it could be a mild strain or arthritis and there are a variety of methods we can use to treat these injuries as mentioned above.
In addition, a common treatment for knee and ankle injuries involves R.I.C.E., which stands for Rest, Ice, Compression and Elevation:
- Rest the knee by staying off it or walking only with crutches.
-Ice to control swelling.
-Compressive elastic bandage applied firmly, but does not cause pain.
-Elevate the injury above the heart level.
In coming back from such an injury, you should take things slowly. Wear proper shoes. Exercise regularly, but don't overdo it. Your joints will thank you.


Dr. Kevin Witte is an orthopedic surgeon practicing at St. Mary's Medical Center. He can be reached at 816-220-8727.