Anterior Cruciate Ligament (ACL) injury is one of the most common knee injuries. Athletes who play high strain sports like football, rugby and basketball are more at risk in developing this kind of injury.
The ACL is one of the four primary ligaments in your knee. The injury occurs when the ligament is overstretched.

Signs and Symptoms
ACL happens in steps:
a) First, you might hear or feel in your knee a 'pop' sound
b) Next, you might experience pain and an inability to move or continue with your activity
c) Then your knee will swell up
d) Lastly, hemarthrosis develops

Causes
The ACL injury can happen in various ways. Injury may occur if
1. You change directions quickly
2. You stop suddenly
3. You slow down while running
4. You jump and land incorrectly
5. You are tackled, like in football, through direct collision or contact

Diagnosis
The doctor will use the following tests to diagnose ACL injury:
1. Pivot-shift test: This test is done to check for instability
2. Anterior drawer test: This test is done to check for the suspected tear in the ACL
3. Lachman test: This test more or less resembles the anterior drawer test. It is considered far more superior in diagnosing ACL injury than the anterior drawer test.

Treatment
Treatment of ACL depends on the patient's age and lifestyle. A younger patient, who is involved in sports will need surgery to restore agility. An older patient can heal without surgery.
1. Conservative Management: This is recommended for people who are older and lead a quieter lifestyle. Also if the knee is overall stable, the doctor might opt for this treatment. Bracing and physical therapy is enough in this case. To protect the knee stability, braces are given. Crutches are also used to keep from exerting weight on the injured leg. When the swelling subsides, some exercises are performed. This is part of the rehabilitation program. Exercises will strengthen leg muscles that surround the knee.
2. Surgery: If the patient is young and has a very active lifestyle, surgery is very much needed. There are three surgical methods:
a. Primary repair- this method is not recommended barring bony avulsions, which are typically seen in adolescents
b. Extra-articular repair- generally includes a tenodesis of the iliotibial tract
c. Intra-articular reconstruction- this is the standard treatment for ACL injuries.

All About Anterior Cruciate Ligament Injury

Knee replacement can be extremely painful. Previously, opioids or narcotics were administered for pain relief. But excessive addition of opioids is not exactly effective for controlling pain. 

Multimodal pain management has become an important part of the perioperative care of patients undergoing total joint replacement. The principle of multimodal therapy is to use interventions that target several different steps of the pain pathway, allowing more effective pain control with fewer side effects. Many different protocols have shown clinical benefit. The goal of this review is to provide a concise overview of the principles and results of multimodal pain management regimens as a practical guide for the management of joint arthroplasty patients.

Multimodal denotes administering two or more than two types of medications that work with different mechanisms. The following are the techniques used:

Pre-operative Femoral Nerve Block: Prior to the surgery, a catheter is placed beside the femoral nerve for blocking it. This nerve is located in the upper thigh. Medication is delivered through the catheter for the nerve to be numbed for 24 hours. Thus, pain signals to the brain are blocked. This method reduces the use of narcotics and the consequent side effects.

Patient Controlled Analgesia (PCA): This method is also known as  Pain Pump . An intravenous pump is used to administer pain relief medications, such as oxymorphone or morphine, after the surgery. The control button of the machine could be pressed, by the patient for 6 to 10 times per hour. The machine is used for two post-operative days.

Oral Medications: The oral medications include Non-Steroidal Anti-Inflammatory drugs or NSAID; such as Celebrex which is similar to aspirin, structurally. Alternatively, acetaminophen, such as Tylenol or its equivalent composition, can also be used.

Acetaminophen: It acts on the Central Prostaglandin Synthesis and relieves the patient of pain through multiple mechanisms.

Epidural Analgesia: It produces lower pain scores and involves less time for achieving physical therapy goals. However, this is subject to side effects such as dizziness, urinary retention and itchiness.

Gabapentinoids: These medications include membrane stabilizers such as Gabapentin and Pregabalin.

The objective of multimodal treatments is to provide quick relief to the patient and immediately so. Earlier the rehabilitation, more successful will be the knee replacement surgery.

Multimodal Pain Relief After Total Knee Replacement

Osteoarthritis (oa) is a degenerative disease that affects the various bone joints, leading to painful movement and thereby limiting the patient's mobility. Knees, hips, joints of hands and legs are affected.

Symptoms of oa

The symptoms revolve around the bones and joints including:

 Pain and stiffness of the joints
 Swelling of the joints
 Inability to form a clench
 Difficulty holding things 
 Stooped posture 
 Weakness of legs and hands
 Reduced height over time

Treatment options in allopathy are limited to nonsteroidal analgesics to control pain and in severe cases, surgical correction, in case of oa. However, homeopathy takes into account the triggering symptoms, the associated symptoms, and the status of the immune system before deciding on a treatment regimen.

With this holistic approach, homeopathy achieve the following:

 Reduce the pain, swelling and stiffness
 Slows the pace of further degeneration
 Improves mobility of the affected joint (s)
 Improves the body's overall immune system, thereby allow the body to promote healing on its own
 Homeopathic intervention in the early phases is particularly helpful, as it will arrest disease progression
 It also enable better absorption of minerals and nutrients essential for bone health. This allows healing of existing bone fractures and avoids further bone damage by strengthening the bones
 Homeopathic treatment also enables the body's chemical state to withstand stress and illnesses better
 It vitalizes the body's natural healing and ability to repair itself, to create a better state of health and well-being

Some of the popular homeopathic medications based on areas and associated symptoms are listed below:

Knee joints:

 Bryonia alba: pain worsened with movement, relieved with rest; associated with swelling and stiffness of the joints; difficulty in climbing stairs.
 Calcarea carbonica: swelling and pain that is worsened when getting up from a seated position. The joints feel cold and painful.
 Sulphur: worse with climbing stairs, prolonged standing, feeling of warmth in the knees. 

Hip joints:

 Colcynthis: cramping pain improved by pressure.
 Rhus toxicodendron: pain when getting up from a seated position.
 Pulsatilla nigricans: associated with muscle stiffness and cramping.

Finger joints:

 Antimonium crudum: the pain pain gets worse in cold weather, improved by applying something warm) 
 Benzoic acid: there is an associated crackling sound when the fingers are moved or if there are nodes in the area of joints. The urine is highly offensive in these people. 
 Calcara fluorica: there are stony hard nodes formed in the joint area, greatly reducing the mobility.

These medications are safe, completely natural, do not induce habit formation, and are approved by fda. They don't just treat the symptoms but help manage the patient as a whole. This justifies why homeopathy is definitely a good option in treating osteoarthritis.

Homeopathy for Osteoarthritis: Why is it a Good Option?

Yoga is recommended for people with joint inflammation or arthritis. In the case of certain individuals with different sorts of arthritis, studies have shown that consistent yoga practice can lessen joint pain, improve flexibility of the joint and release the stress and strain to provide better rest. Yoga comes with a wide range of practices; however, for the most part, it includes adopting specific bodily postures. It also includes breathing and meditation exercises. 

Some of the yoga postures to cure arthritis are as follows:

Sun salutations: They are the perfect way to begin a day. They can be reflective and calming as you develop the strength to breathe fresh air. Stand with both feet touching, and afterwards, join your hands, palm-to-palm, and place them on your chest. Breathe out and raise your arms upward. Gradually twist backwards and extend your arms over the head. Unwind your neck and breathe in. You must keep in mind that it is one breath for every movement.
Kid's pose and child's pose plus: This is a truly gentle and simple approach to stretch the lower back. Get into the stance by dropping down onto your knees, spread your knees wide and join your toes. Place your hips back onto your feet or heels and stretch your arms forward onto the ground.
Bovine pose (cow pose): Get on all fours with your hands; keep your wrists directly under the shoulders, and spread your fingers wide. Your knees need to be at the hips' width and directly under your hips. Point your abdomen upwards, as your shoulder bones push down towards your abdomen, and tilt your pelvis up and back so that you are sitting.
Furious cat: Turn around the cow pose to do the furious cat pose. From all fours, pull your belliy in and your back arches into a back bend. Point your hips back toward your lower legs to build the space between every vertebra.
Prostrate twisting: Bending should be very useful, but if the bending or twisting brings on any pain, leave it quickly. Lie on your back, draw your knees toward your abdomen, and wrap your arms around your legs, giving yourself a little hug. Shake yourself from side-to-side or forward and backward.
Bridge pose: Lie in a straight position on the floor, twist your knees, and set your feet on the floor. Breathe out and press the inner parts of your feet and your arms into the floor. Push your tailbone up, tighten your hips, and lift them off the floor until your thighs are parallel to the floor. Keep your knees right above your heels and lift the upper part of your hips toward your stomach.

Arthritis - 6 Yoga Positions That Are Beneficial for You

Acupressure can prove to be extremely effective if you are looking for non-medicinal solutions to treat musculoskeletal problems, such as back pain, sports injuries, arthritis, etc. Acupressure is the application of putting firm pressure on the areas on the body which are swollen, agitated or tense by massaging the acupoints (specific points in the body). Acupressure believes that relieving these areas of pressure reduces the pain.

Here are some musculoskeletal problems that can be healed by acupressure:

    Arthritis: Those who seek acupressure as an alternative treatment for pain are mostly suffering from arthritis (a disease characterised by chronic joint inflammation and cartilage degeneration). Acupressure applies pressure on the inflamed joints.
    Back pain: Back pain is a common problem that can affect anyone irrespective of his or her age. Acupressure acts to relieve the points where the muscles are too tense and helps to tone or support the muscles which have become weak with disuse.
    Chronic pain: Unrelenting pain can stem from many causes. Acupressure focuses on the pain and the pain signals when treating chronic pain. The acupoint of the pain and the nerves are gently massaged to relieve the pain.
    Fibromyalgia: Traumatic injury to the soft tissue, emotional trauma or severe illness can cause fibromyalgia. It is non-inflammatory in nature and often leads to Chronic Fatigue Syndrome (a troublesome disorder with symptoms of deep fatigue, sleeping problems, pain, etc.). Acupressure can greatly improve the fatigue and sleeplessness that fibromyalgia causes.
    Tendonitis: The tendon connects the tissue to the bone, and tendonitis is the condition when the tendon is inflamed. Acupressure helps in reducing the inflammation and easing mobility restrictions.
    Sciatica: The sciatic nerve is the longest nerve in the body, stretching from the lower spine to the back of the foot. So when this nerve is agitated, pain radiates from the lower back to the foot. This condition is called sciatica. The acupoints in sciatica are the lower back and the hip. Acupressure effectively loosens the muscles in these regions and reduces inflammation.
    Sports injuries: Strains and sprains are common sports injuries, which mostly affect athletes. Acupressure has anti-inflammatory benefits that can help heal severely injured tendons, ligaments or muscle. Acupressure also plays a huge role in restoring and retraining the body, especially if you are an athlete and play high-demand sports.
    Carpel Tunnel Syndrome: Carpal tunnel syndrome is a condition in which the pressure increases on the median nerve as it goes through the carpal tunnel, and this causes wrist pain. Acupressure involves the use of directed pressure to specific acupuncture points on the surface of the body.
    Insomnia: Insomnia is a sleep disorder. The Acupressure Points between your heel and anklebones (on both sides) have traditionally been used to relieve and prevent insomnia.
    Migraines: Acupuncture is used to effectively treat primary headaches, namely tension and migraine, which are the most common.

Acupressure: The Non Medicinal Solution to Musculoskeletal Problems

Our skeletal structure is truly a work of art however, when we are faced with bone related disorders, our lives is no less than a roller coaster ride. Arthritis is one such ailment which can really alter the quality of life of a person who suffers from it. Taking into account the impact, would it not be good to know the symptoms of early arthritis, so it can be detected before it gets too bad?

There are a few symptoms of the condition, but it is to be noted that the intensity of the symptoms even in the earlier stages of the issue do vary widely. As a matter of fact, the problem can be developing for months on end without a person even knowing that he or she has arthritis while on the other hand, there are quite a few cases in which a person is provided with an almost instant  notification  that arthritis has started having its degenerative impact on his or her joints.

What signs to watch out for?
There are three areas that need attention if trying to detect arthritis:

Knees: When a person is in the process of developing arthritis, the signs he or she should be aware of include his or her knees being shaped like an outward curve; if he or she is developing the condition in the knee. Apart from this, a limp can also be seen for a lot of people who develop arthritis which affects the joints which bear the weight of the body. The best example of this is a case of arthritis affecting the ankle or the knee.
Neck: If a person has a near constant pain in the lower back or also of the neck, he or she should be aware of the fact that there could be arthritis developing and it is important for a doctor to be consulted about the same.
Fingers: In some cases, the signs of arthritis may not even be the cause of pain to a person. This is true when a person begins to develop something such as Bouchard s node; which affects the fingers when arthritis begins to set in on the digits. These nodes are not painful, in most cases, but, it is to be kept in mind, that they have the ability to limit the motion of the fingers which are affected.
Arthritis is something that can and should be limited to as far an extent as possible, rather than being allowed to worsen a person s condition and not allow him or her to have the freedom he or she is used to having in life. When in doubt, a quick consultation with a doctor can really save the person a lot of pain later on!

If You Have These Symptoms Check For Arthritis!

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