DRUGS(NSAIDS) relieve inflammation and pain for
both traumatic and overuse injuries. Gentle
stretching and exercise such as walking help keep
the knee flexible and facilitate HEALING.
Mild to moderate ligament sprains often heal
without surgery in four to six weeks. Severe liga-
ment sprains and meniscal tears often require sur-
gery to repair. Orthopedic surgeons can perform
nearly all such operations arthroscopically, which
allows minimal recovery time. PHYSICAL THERAPY
facilitates rehabilitation after surgery and most
people able to return to regular activities in about
six months. Return to sports may require more
time, especially for activities of high vulnerability
for knee injury such as football, soccer, downhill
skiing, and basketball.
Risk Factors and Preventive MeasuresContact sports (such as football) and other sports
that involve running, twisting, and jumping (such
as soccer, basketball, and tennis) expose the knee
to direct blows with great risk for injury. Any
sport that uses cleats to improve traction (such as
track, soccer, and football) has increased risk for
knee injury resulting from excessive torsion
(twisting under pressure). Sports and athletic
activities account for the majority of knee injuries
in people under age 25. By midlife, repetitive
trauma (such as results from running) begins to
take its toll and overuse injuries become more
common. Excessive body weight further stresses
the knees.
Strong thigh muscles—the quadriceps in the
front and the hamstrings in the back—improve
stability of the knee. Weight-lifting or RESISTANCE
EXERCISE can strengthen these muscles. YOGA is
excellent for improving FLEXIBILITYas well as stabil-
ity of the knees. Knee supports, braces, and pro-
tective pads reduce the risk of knee injury in some
sports. Proper technique and adequate physical
conditioning are crucial elements of injury pre-
vention for any athletic activity. Other preventive
measures include stretching and WARM-UPbefore
and after participating in vigorous exercise or
sports events.
See also ANKLE INJURIES; ATHLETIC INJURIES;
OSGOOD-SCHLATTER DISEASE; STRENGTH; WALKING FOR
FITNESS.kyphosis A deformity of the upper spine that
gives the appearance of a hump in the upper back.
Kyphosis may represent a CONGENITAL ANOMALYin
the structure of the spine or may develop later in
life as a consequence of damage to the CARTILAGE
disks between the vertebrae that allow the verte-
brae to slide out of position. Mild kyphosis gener-
ally does not cause symptoms and may be
noticeable only with X-rays of the spine. Moderate
kyphosis can cause upper BACK PAIN, resulting from
distorted posture that strains the back muscles.
Treatment may include PHYSICAL THERAPYor CHIRO-
PRACTICcare to stretch the back, strengthen mus-
cles, and improve posture. Sometimes sleeping on
a very firm mattress with a low pillow allows the
spine to correct itself. The doctor may prescribe a
back brace for moderate kyphosis. Severe kyphosis
may require surgery to realign and support the
vertebrae.
See also ACHONDROPLASIA; LORDOSIS; OSTEOPORO-
SIS; SCOLIOSIS; X-RAY.332 The Musculoskeletal System
STAGE SCALE: LIGAMENT SPRAIN OR TEARGrade Extent of Injury or Damage Symptoms
grade 1 or first degree minor stretching of LIGAMENTfibers though mild PAINwith pressure to the knee
knee remains stable mild swelling
grade 2 or second degree moderate tear of the ligament with some moderate pain with pressure to the knee
instability of the knee moderate swelling
grade 3 or third degree complete tear of the ligament and its nerves; little if any pain with pressure to the knee
unstable knee pronounced pop felt and heard at time of
injury
inability to bear weight or use the knee