Your Health: Understanding Trick Knee Syndrome

An essential stabilizing part of the knee, the anterior cruciate ligament (ACL) can sometimes become stretched, weakened or torn. This results in a condition that's commonly known as a subluxation or Trick Knee Syndrome. Trick knees are extremely painful and difficult to treat, often requiring numerous surgeries in order to restabalize the knee and to keep the joint from "going out." Fortunately, there are several things that you can do to help prevent this painful condition before it starts.

Understanding Your Knee

Did you know that your knee is the largest joint in your body? It's also a weight-bearing joint that helps to support the weight of the entire body. Needless to say, knee pain is common, particularly in growing children, elderly people and those who are overweight. Knees are under a great deal of daily strain. As we bend, twist and pivot, we are constantly using our knees.

The knee works much like a hinged door, with two ligaments that help to stabilize the joint. These two ribbon-like ligaments, known as the anterior and posterior cruciates, connect the two main bones of your knee - the femur and tibia - holding them together as your knee bends and twists. It's the anterior cruciate ligament that we're focusing on, as this is the one that keeps the tibia (also known as your shin bone) from moving forward and slipping out from underneath the lower end of the femur (the thigh bone) when the front thigh muscles tighten, or when the body performs various knee-twisting movements during normal activities. Injuring this important ligament can cause excruciating pain, as well as severely hampering movement.

How Trick Knees Occur

Trick Knee Syndrome occurs when the anterior cruciate ligament becomes stretched out of shape or, in the case of injury, is suddenly torn. This causes the knee to feel as if it is giving out, or buckling, when the tibia slips forward during any weight-bearing activity. This can happen during a sudden pivot and change of direction, or can even occur with a simple misstep when walking. Some people describe it as the knee suddenly "going out" on them or they may say that it felt as if it went out, but popped right back in.

Falling victim to a trick knee can be either very painful or can even create a grating feeling that makes one nauseated. The injury can also be further complicated if it irritates or damages the bursa - a small sack that helps to lubricate the knee joint - or strains surrounding muscles. Frequent slippage can often herald the onset of other conditions, such as arthritis, and can commonly cause cartilage damage and/or loss. Any injury of the knee should be checked out by your doctor.

Repairing the Trick Knee

I remember when I first began complaining of knee pains, my parents were told that they were simple growing pains and that I would outgrow them before long. As the pain persisted and the problems with my knee continued to worsen, that diagnosis would be changed to a case of bursitis, or an inflammation of the small sack that lubricates the knee. It wasn't until years later, that I was finally diagnosed as having a loose anterior cruciate ligament in my left knee and a torn one in my right. This wasn't a misdiagnosis by our doctors, however - it was common for trick knees to be blamed on various knee and cartilage problems. It's only been within the last 30 years that doctors have discovered the purpose of the anterior cruciate ligament - for many years, it was believed to have no real purpose!

For years, we had declined the suggestion that I have Cortisone injections into my knees, due to the controversy surrounding Cortisone and the risk of it damaging weight-bearing joints. For many years, I was put on various pain relievers and anti-inflammatory medications, as well as wearing a variety of braces. Some were unobtrusive sleeve-like devices that I just pulled up over my knee. Others were nightmarish things that immobilized my entire leg and made me walk like I was trying to do a bad "Revenge of the Mummy" impersonation. Some of my more expensive braces involved lots of foam, Velcro and hinges. It was still awkward, but it allowed me to walk with a degree of confidence.

I was in my 20's when I stepped wrong and fell, severely injuring the ACL in my left knee. For any that have ever torn their ACL, it's something you never forget - the wrenching pain and loud, audible snap, followed by the sensation that your leg won't support any weight. This was when I learned about shock therapy and how it helped with healing. My doctor sent me to a specialized sports doctor and I got to sit and watch my muscles twitch for several minutes per session. The results didn't -feel- quick but, ultimately, I do believe that I healed much faster than I would have, were I to go with the old standby of just staying off of it.

The last healing option is the only real one that truly eliminates the problem - surgery. While it was originally a major deal with the knee, ACL repair and reconstruction is now performed on an outpatient basis, usually only taking a couple of hours to perform. Recovery, however, often takes several weeks and will generally require physical therapy to regain the use of the knee again. This is generally an option for those who wish to return to sports or those who have a very active lifestyle. Chicken that I am, I've opted to simply adjust my lifestyle and be more careful, for as long as this option works for me. While I won't run any marathons anytime soon, I can generally make it safely from point A to point B.

Tips for Preventing Torn Ligaments

Your ACL can be injured in numerous different ways - The best ways to avoid injury is to not engage in sports that require you to put a lot of strain on your knees or, if you must engage in these activities, try doing some knee-strengthening exercises BEFORE you get hurt. Controlled zigzag running will help to strengthen your ligaments, as well as 'high stepping.' Standing on a bench that's roughly knee high, stretch your heel downward as you slowly step down off the bench. Step back up and repeat with the opposite foot - taking it slow and gradual is the key to success.

Trick Knee Syndrome is a painful condition, but it can be managed. Rather than having to treat the problem, engage in regular strength training and always use caution when playing on a dangerous field. These will help to prevent you from suffering a stretched or torn ACL. Tread carefully and your ACL will cause you far less problems.

Sources:

Experience with stretched and torn ACLs

http://www.pponline.co.uk/ - Exercise ideas for strengthening the knees