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Instep Dance Magazine Articles

Reprints of monthly column as first appearing in Instep Dance Magazine.

April 1998

Knee Injuries - Part 2b - Real Life Trauma

By Rick Allen, DC

"Better health leads to better dancing."

I'm spending more time reviewing injuries to the knee because it is one of the joints dancers most commonly injure. In fact, I interviewed a few of our well-known ballroom dancers who injured their knees within the past few years. With their permission, I'll share the mishaps and recovery of Rick Pride and Gail Lund. First, though, let me give you some background on meniscal injuries of the knee.

[ Diagram of knee / cross scetion of meniscus ]

The knee has two types of cartilage: articular and meniscal. The articular cartilage is the smooth glistening surface that allows the joint to move freely. It has the appearance of white marble and the consistency of semi-rigid plastic. The meniscal cartilage, on the other hand, is much softer. It is formed in two C-shapes that lie between the femur and the tibia. They create shallow cups that stabilize and cushion the knee.

[ Diagram of knee / meniscus cartilage ]

The menisci are usually injured with a sudden twisting and compression of the knee. It commonly happens to a basketball, football or soccer player who plants his foot and then suddenly twists his knee, perhaps when he changes direction suddenly or collides with another player. (The same thing can happen to a dancer, as we'll see later in this article.) Often the athlete can feel or even hear a "pop", followed by severe pain in the front or side of the knee. In a severe injury, the ligaments of the knee may be torn as well.

Many meniscal injuries are small, and the athlete does not seek medical attention. A common complaint is that the leg swells after exercise. The knee joint may lock or give way without warning. This is sometimes called a "trick knee". Tears may be visible on a magnetic resonance image (MRI) or arthrogram.

Treatment for a torn meniscus varies. Sometimes, resting the knee with a splint for a few days relieves the symptoms and there can be a return to routine activities in a few weeks, with no further problems. However, this is not always the case. The cartilaginous menisci heal slowly because they have direct blood supply only to their outer, peripheral rims. Tears or folds in the portion of the menisci without good blood supply may never heal. If they continue giving the athlete trouble, the injured portion may have to be removed with athroscopic or even open surgery.

Let's take a look at the knee injuries suffered by two local high-level ballroom dancers and their recovery. Because each individual and their injury is unique, I won't give exact dosages of supplements or exercise protocols here. If you are injured, I suggest first having a thorough examination with a conservative, sports-minded doctor of chiropractic, naturopathy, osteopathy, or medicine. Use this article to educate yourself in both the medical and alternative or complementary treatments. Then discus you individual case with your doctor.

Rick Pride has a zest for life. He'll try crowd-pleasing lifts and drops. He has "crashed and burned" a number of times. Yet it wasn't a really fancy move that did him in a year and a half ago. It was wearing tennis shoes while teaching dance lessons back in July of 1996. He twisted his knee badly enough to prevent dancing for a month. While a MRI of his left knee did not show the tear, physical examination and the symptoms of continued knee pain indicated a torn medial meniscus. He has taken the conservative route to near-complete healing. First, he taught on the flat and avoided movements that might re-injure the knee. Second, he increased nutrients that the body uses to heal damaged joints: complementary supplements glucosamine and chondroiton sulfate; minerals calcium, potassium and magnesium; and even shark cartilage. Third, he strengthened his quadriceps muscles with leg extension exercises. Lastly, he stopped teaching dance in tennis shoes!

Gail Lund dislocated her patella laterally eleven months ago during a fast turn with weight and twisting on the left knee on sticky dance floor. Her description of the accident sounds just like that found in the textbooks. She was initially surprised at the sight of her kneecap off to the side of the normal groove. Then the pain started. Ouch! She really couldn't move, so she was taken by ambulance to the hospital, where the emergency room physician replaced the patella without anesthesia. Ouch, again! She was advised to avoid walking, take Advil for two days and ice the knee daily. She was started physical therapy exercises to strengthen the medial portion of the quadriceps muscle, the vastus medialis. These included both closed-chain exercises, such as partial knee bends with the foot planted on the floor, and open-chain exercises, such as leg extensions. For three months she had the knee taped to help hold the patella in place whenever she did the exercises. Unfortunately, she started jive too soon, which has set back her healing. Her tibial tuberosity (the bump on the front of the leg bone below the kneecap where the quadriceps attaches) and collateral ligaments (the ligaments on the sides of the knee that stabilize the joint) are still sore. She has been using a Nikken magnet on the tendons and ligaments of her knee, which seems to reduce swelling and pain a bit. I suggested she continue an increased dosage of vitamin C and joint-healing supplement containing glucosamine, have a professional do cross-fiber friction on the ligaments, and continue icing the knee after treatment or dancing. As Gail says, "Ice is my friend."

Remember that prevention is best. Avoid tennis shoes and sticky floors. Drink lots of water. Have a coach watch your moves, especially lifts and drops. And keep on dancing!

Next article: Oops, again! I'm out of space, so let's wrap up next month with a review of sprain or tearing of the cruciate ligaments, the "Terrible Triad", a few more case histories, and a review of suggestions to prevent knee injuries.

I'm still looking for two more individuals who have injured their knees. If you have had a knee injury and are willing to share your experience, please give me a call or an e-mail. It is always helpful for others to read about your personal experience.

Future article: I still want to do an article on foot supports, technically called "orthotics". If you have had experience with orthotics (good, bad or indifferent), I would appreciate hearing from you.

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