The knee joint is formed by the lower end of femur, upper end of tibia (leg bone) and patella (knee cap). The ligaments of the knee play a crucial role as they are the most important element in providing stability to the knee.

Ligaments of the Knee

The knee is stabilized by four main ligaments – two ligaments in the center of the joint (cruciate) and two ligaments on either side of the knee (collateral ligaments).The Anterior Cruciate Ligament (ACL) is in the front of the knee joint and it prevents the tibia from slipping forward. The Posterior Cruciate Ligament (PCL) is at the back of the knee and it prevents the tibia from slipping backwards.

The collateral ligaments prevent abnormal sideward movements of the tibia. The Medial Collateral Ligament (MCL) stabilizes the inner side of the knee and the Lateral Collateral Ligament (LCL) along with a few more ligaments stabilizes the outer aspect of the knee.

How ACL is damaged

Body contact sports, road traffic accidents and awkward fall are common causes of ACL injury.

How do I know

Many people can hear a “CRACK” or “POP” at the time of injury, followed by immediate swelling and pain. Players often have to be carried off the field. Later there will be pain, weakness and a peculiar looseness of knee- giving way- the most disabling problem.

What is the treatment

It depends on your disability and your activities. In brief, if you are engaged in lots of outdoor activities and heavy work and not willing to restrict your activities then you need an operation to make a new ligament. This applies to most young and active people.

What is the operation

Operation is done in general or spinal anesthesia. At first inside of knee is examined by a telescope, which is introduced through small puncture (arthroscopy). Next a new ligament is prepared by taking few fibers from the tendons around knee. Generally the hamstring or patellar tendon is used.

This newly fashioned ligament is then placed inside the knee which grows and matures to take the function of original ligament.

What if I do not get operated

Other then the disabilities like giving way, pain, swelling etc. it is said to be the “Beginning of The End of Knee.” The knee suffers repeated injuries because of its undue laxity and early arthritis sets in.

ACL Injury Tear Surgery Recovery

ACL Surgery Guideline For patients

Preparation before the operation:

1. Arrange for a leave about one month from your work.

2. DO NOT eat or drink anything after Midnight. (NBM)

3. Report to hospital 8 a.m. – Please bring your all X ray and reports with you.

4. The hospital stay is usually 2-3 days – bring your clothes accordingly.

After operation

1. Exercise: Start the static quads exercise the same day. From next day a qualified physiotherapist will take you through a detailed exercise schedule.

2 .Walking:  You can stand up next morning and start walking. You will need the help of a stick or a pair of crutches for the first few weeks. However, walk minimally for first two weeks after operation.  This reduces pain, swelling and helps healing.

3. ICE: Compress: Put some crushed ice in a plastic bag, cover it with dry towel and place it on the knee for 15-30 minutes. Do it four times daily.

4. Dressing: Will be changed in the hospital the after the operation. No further dressing is usually necessary. Keep it dry until stitches are removed.

5. Stitch removal:  Usually done 12-14 day after operation.

6. Shower: Allowed only after 2 weeks, when stitches are removed.

7. Toilet: You should use commode for 2-3 months after operation (If you do not have commode at home arrange for a chair commode)

8. Driving:  You can drive a car after two months and a two wheeler after three months, provided you have good power and control of leg.

9. Activities: During first two weeks you should mostly rest in bed with leg elevated on a pillow, and do exercise as advised. Subsequent movements depend on your muscle strength and type of operation.

Generally, after 4 weeks one can join light office duties.

After 8 weeks one can join gym, ride a bicycle or drive a car.

After 4 months light on field activities are allowed.

After 6 to 9 months games can be played provided good muscle power is achieved.

Also read:- ACL reconstruction surgery कब तक करवानी चाहिए ?

The post ACL TEAR RECONSTRUCTION SURGERY first appeared on My Shoulder & Knee Expert Blog.

1. Reduces stress and improves Mental Health

Cycling can ease out feelings of stress, depression, or anxiety. Focusing on the road while cycling helps develop concentration and awareness of the present moment. This may help take your focus away from the mental chatter of your day.

If you are feeling lethargic, get yourself on your bicycle for at least 10 minutes. Exercise releases endorphins in brain, which in turn help you feel better while lowering emotional stress.

2. Cardiovascular health and Blood Pressure

High blood pressure is a risk factor for cardiovascular disease in some people. Physical activity such as cycling controls your blood pressure and reduces risk of heart diseases. Use of cycling for going to office reduces the rate of heart attacks by 15 percent than with no physical activity.

3. Weight loss

Cycling is low impact exercise and can be done at moderate intensity for extended periods, it is among best exercise for anyone looking for weight loss. While diet is generally an important part of any weight loss plan, studies have shown that even without diet restrictions, individuals who were obese and cycled daily for six months lost 12% of body fat, and cycling was a more effective activity than the walking and swimming groups in the same study.

4 Low impact exercise

It is low impact form of exercise which makes it safe for older adults and people with weak or damaged joints.

Orthopedic surgeons may recommend cycling on level surfaces or indoors after surgeries such as total hip and knee replacement patients. This low impact nature of the exercise can accommodate a variety of injuries and disabilities while still allowing a person to be active.

5. Improves balance, posture, and coordination

While cycling when you try to stabilize your body and keep your bike upright, it improves your overall balance and coordination. Balance tends to decline with age and inactivity, which can be improved with cycling.

Improved balance is beneficial in the prevention of falls and fractures, which can leave you on the sidelines while you take time off from exercise to recover.

6. Boost  your immune system ?

This one is particularly important during the global corona pandemic. There is question mark in the statement. Studies suggest that immediately after intense exercise, such as an interval training session, your immune system is lowered but after adequate recovery such as eating and sleeping well it boosts your immunity.

7. Environmentally friendly

Reduce your carbon emission footprint by riding your cycle whenever possible. Cycling is a great replacement for transport options especially useful when you are going to places that are a bit too far to walk, but you still don’t want to take a car. And you don’t need to fight for a parking space in crowded areas.

Know more about sports injury in Hindi

Author is senior orthopaedic surgeon and sports injury expert at Jaipur, India

Sports Injury doctor in Jaipur

The post Seven benefits to start Cycling in Corona Pandemic first appeared on My Shoulder & Knee Expert Blog.