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 pain is a common phenomenon that plagues most of the people irrespective of their age. It can be the outcome of a torn cartilage or a ruptured ligament. Medical complications, such as infections, gout or arthritis (painful inflammation and stiffness of the joints) can also give way to knee pain. Minor knee pain can be eased by self-care remedies such as physical therapy or by putting on knee braces. However, few complications might demand surgical repair. Pain can be managed by the pain management specialists.

Tips to manage knee pain

1. Medications such as naproxen, ibuprofen and acetaminophen can be administered to help remedy knee pain.
2. You can seek relief by massaging your knees with ointments constituting of a number of agents such as capsaicin or lidocaine.
3. Keep away from your usual chores to prevent repetitive strains on the knees, thus, allowing the injury to heal as well as to stay safe from further damage.
4. Applying an ice pack in a towel can ease the inflammation and pain. But do not extend its usage for more than 20 minutes because that might harm the skin and nerves.
5. Compression bandages can inhibit fluid accumulation in the damaged tissues aiding knee alignment stability. Ensure that it is tight enough to render support to your knees without actually obstructing blood circulation.
6. To pacify the swelling, try resting your sore leg on a pillow (the idea here is to keep the affected leg elevated to reduce further pain).
7. Shed off your extra pounds as being overweight increases chances of other disorders such as osteoarthritis.
8. Go for regular work outs to enhance and maintain the flexibility of your muscles as excessively weak or abnormally tight muscles can contribute to injuries. Be smart while choosing your method of exercise based on the condition you are suffering from.

Knee Pain - 8 Effective Ways to Manage it

Gout is a type of arthritis, which can affect your joints, though usually, it causes maximum harm to your big toe. Symptoms that you are having a bout of gout include having a stiffness and swelling of the joint in question. The pain is very sudden and also causes a burning sensation. Gout is basically a recurrent type of inflammatory arthritis. However, the pain associated with gout can be remedied by ayurveda. Here are some of the best ayurvedic remedies which can be used:

1. Panchatikta ghrita guggulu: panchatikta ghrita guggulu is the most common and most widely recommended treatment for gout. However, it needs to be taken on an empty stomach. It is also worth note that it works best when teaspoons of it are taken two times a day with warm milk.

2. Kaishore guggulu: kaishore guggulu is a type of medicine, which should be accompanying panchatikta ghrita guggulu. It is usually administered after some initial relief is felt from panchatikta ghrita guggulu. Its best to consume this medicine in tablet form thrice a day.

3. Shallaki: this ayurvedic remedy is great for decreasing the pain in the joints affected. It also decreases the swelling in those joints, which have been affected by the bout of gout. Shallaki is also crucial in making sure that cartilage forms and that the blood supply to the joint which is affected by gout is still stable.

4. Ashwagandha: ashwagandha is medically known as withania somnifera. In the west, ashwagandha is popularly known as winter cherry. Also, it has a lot of therapeutic properties, which include reducing joint pains and also inflammation of muscles. This herb can also work wonders on your blood circulation.

5. Pinda taila: this is a type of oil which needs to be applied externally. Pinda taila is a very rare class of medicines which treats gout externally. Pinda taila or guduchyadi taila is administered by rubbing it on the body part affected.

Ayurveda and Gout

Gout: a brief idea

In the simplest of words gout can be defined as the inflammation of joints due to continuous accretion of urate crystals. An excess of uric acid can make a person suffer from gout. There could be a higher percentage of uric acid in a person's blood due to two chief reasons; an inept excretory system that fails to rid your body of surplus acid and also greater production of the acid. Arthritis is of three kinds; gout is one of those three. Homeopathy is known for its efficacy in treating gout. 
   
Homeopathic remedies for gout:
1. Urtica urens can cure gout: This homeopathic medicine is prescribed by a professional practitioner if the person is susceptible to cold. Urtica urens can work on a patient if he or she is allergic to snow,  air, touch and water. Hive like eruptions on your ankles, wrists, and shoulders can be treated through regular consumption of this medication.
   
2. Ledum can relieve you of pain: A painful, swollen area that develops on the small joints such as the joints of your toe fingers can be cured with the use of Ledum. The sensation of shooting pain in your limbs or feet can also be dealt with Ledum. Apart from that swollen small joints can be given momentary respite by falling back upon the cold compression therapy. Patients are advised to take this medicine if they exhibit intolerance to external warmth. 
 
3. Lycopodium is effective on sore joints: Chalky deposits of urate can be found in a person's knees. This results in chronic gout. Chronic gout has symptoms like limited urination. The urine may or may not have red sediments. People have also been reported with symptoms like extreme backache. Lycopodium successfully cures cases of unceasing gout.
     
4. Try out benzoic acid for a big toe: If your gout is accompanied by stinking yellow urine you probably need Benzoic acid. Gout could be so severe that it might result in a stiff limb. In certain cases it makes a person limp. The thumb of your feet might get swollen making you have a big toe. A big toe usually kills you with tearing pain.
    
5. Arnica deals with bruises: Arnica is your go to solution in case of a throbbing, stinging pain in any part of the body. This medication is a cherished answer to aches in every household. When gout is tender and it hinders free movement, this medicine comes to your aid. The medicine also heals bruised eruptions.

Homeopathy and Gout

Cervical osteoarthritis is also known as cervical spondylosis. It is a medical condition which involves changes in the joints of neck, bones and discs. This is generally caused due to the deterioration of the muscles owing to old age. With age, the cervical spine breaks down and loses all its fluids. This leads to stiffness in the spine. It occurs usually in middle aged and old aged people. This causes stiffness and severe neck pain. Corrective surgery is helpful to cure Cervical Osteoarthritis.

Symptoms of Cervical Osteoarthritis:

Pain and stiffness in the neck.
Headache which usually emerges from the neck.
Severe pain in the arms and shoulder.
Not being able to turn the head or neck fully while driving.
Muscle spasm and abnormal reflexes.
Grinding sensation or noise caused while bending the neck.
Cervical Osteoarthritis can be cured by physiotherapy in the following ways:

Heat modalities- In this method the pain and stiffness is reduced by putting heat on the affected area. This type of therapy is called heat therapy.
Neck exercise- Regular stretching and bending exercises for the neck can reduce pain and stiffness
Manipulating therapy- This form of therapy is used by massage therapists. They massage and manipulate the joints so that the muscles can function smoothly.
Hydrotherapy- This therapy involves exercising in a pool. Hydrotherapy is extremely beneficial for people having severe joint pain and stiffness.
Cervical traction- This is a common non-surgical treatment which cures pain in the neck by opening the cervical foramen (hole or passage).
Physiotherapy is the most natural and safe way of curing cervical osteoarthritis. If you are diagnosed with cervical spondylosis, you should start physiotherapy as soon as possible.

Cervical Osteoarthritis - Physiotherapy Treatment For It!!

Myths about Total Knee Replacement

Myth#1 - Knee replacement is a surgery for old people. “I’m too young for a knee replacement.”
Fact - Candidacy for a knee replacement is not based on age, but on the person’s level of pain and immobility. Living with a painful joint that prohibits you from working or participating in normal life activities is an outdated way of thinking. Age is not necessarily a limiting factor. Often times, a patient is actually fearful about the uncertainty of surgery. Once they are able to resume many of the activities they enjoyed before the surgery, with increased mobility and with less pain, they are very happy they had the surgery. The quality of life one achieves by living without knee pain is priceless.

Myth#2 - “I should wait as long as possible to undergo knee replacement surgery” 
Fact - You don't need to suffer by waiting until the pain is intolerable. The longer life of joint replacements enables people to consider surgery earlier and at a younger age. Osteoarthritis is a degenerative disease that continues to damage the joint and delaying surgery makes both surgery and return to activity more difficult. Delaying surgery lowers a patients’ quality of life not only before the operation, but even for up to two years following surgery.

Myth#3 - “I should continue with medications as long as possible”
Fact - Medicines including painkillers just give symptomatic relief for a temporary duration and prolonged usage is riddled with serious side effects such as renal failure, peptic ulceration  etc. All these medicines are NOT curable.

Myth#4 - Alternative therapies such as acupressure, ozone treatment, massage beds, oils, laser therapy, magnetic therapy; braces will cure my advanced arthritis and knee pain.
Fact - Till date there is NO cure for advanced knee arthritis and these alternate therapies are not backed by established scientific data. All these modalities give temporary pain relief in early to moderate arthritis for some duration only and are NOT curative. Often times, a patient who is actually fearful about the uncertainty of surgery lands up trying these in order to avoid surgery. 

Myth#5 - After a knee replacement, it takes months to recover.
Fact - Depending on the activity, most patients who undergo knee replacement are able to perform routine tasks within a few weeks. A return to rigorous activity takes only a few months. One becomes independent for himself before discharge from hospital. There’s no prolonged best rest required after the surgery.


Myth#6 - After knee replacement, I’ll have to give up some activities and sports.
Fact - You have a high probability of getting back to activities like brisk walking or cycling in 6 to 12 weeks. It will take a bit longer to return to more rigorous activities and contact sports. Squatting and sitting cross legged though possible but at best should be kept to minimal.

Myth#7 - Knee replacement surgery leaves a large scar that is noticeable.
Fact - Scarring is minimal compared to traditional surgery. In fact, the scar is typically only 3 to 5 inches long. As time passes, the scar will fade and become less noticeable.

Myth#8 - Knee replacement is a very painful surgery. There is lots of pain in post operative period.
Fact - With modern day pain management such as in a multimodal approach, ensures that the patient does not feel any pain in post op period and has a smooth recovery.

Myth#9 - Knee replacement is done one at a time.
Fact - Both the knees can be operated at the same time if the patient does not have significant co morbidities and is deemed fit to undergo the procedure by the doctor.

Myth#10 - The new knee lasts for 5-6 yrs. only.
Fact - With modern day precision including computer assisted knee replacement and advancement in biomaterials, the survivorship has increased considerably. Today's joint replacements last 25 years or longer and, for most people, will last a lifetime.

Myth#11 - Knee replacement cannot be done a second time.
Fact - Knee replacement can be done multiple times what is called as a revision joint replacement surgery with good survivorship.

Myth#12 - “I am obese, I cannot undergo Knee replacement surgery.”
Fact - Knee replacement can be successfully done in an obese patient though the recovery is somewhat prolonged and might require additional implants. However, patients who are morbidly obese and have restricted mobility primarily due to obesity are better off after a bariatric procedure.

Myth#13 “I have diabetes or hypertension or heart ailment, so  I cannot undergo Knee replacement surgery.”
Fact  - diabetes hypertension or heart.



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 13 Myths About Total Knee Replacement (TKR), Busted!

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