Top 4 Preventable Orthopedic Injuries

1. ACL Tears

The anterior cruciate ligament, also called the ACL, is one of four major ligaments of the knee. Injuries to the ACL can be devastating, and may require surgery and a prolonged rehabilitation. Rates of ACL tears are especially high in women; about 8 times as frequent when compared to men. Why do women injure their ACL more frequently? Can these ACL tears be prevented?
ACL prevention has been the focus of many researchers in the past decade. Understanding how to prevent ACL tears requires an understanding of why some groups of people are more prone to sustaining ACL tears than others. Women have been shown to have a much higher risk of developing an ACL tear, and research has focused on answering the question as to why they have a high risk.

Why do women have a higher risk of ACL injury?

• Anatomic Differences
  There are many anatomic differences between men and women, including pelvis width, Q-angle, size of the ACL, and size of the intercondylar notch (where the ACL crosses the knee joint). Limited studies have shown a difference in these factors, but not an ability to predict individuals who will sustain an ACL tear.

• Hormonal Differences
  It is known that the ACL has hormone receptors for estrogen and progesterone, and it has been thought that hormone concentration could play a role in ACL injuries. Studies have shown some differences in rates of ACL injury during different phases of the menstrual cycle. However, there has been some conflicting data, and the effect of hormone concentration on ACL injury risk has yet to be defined.

• Biomechanic Differences
  Stability of the knee is dependent on different factors. The two most important are the static and the dynamic stabilizers of the knee. The static stabilizers are the major ligaments of the knee, including the ACL. The dynamic stabilizers of the knee are the muscles and tendons that surround the joint. Women have been found to have differences in biomechanic movements of the knee seen when pivoting, jumping, and landing -- activities that often lead to an ACL injury.

What can be done to prevent ACL injuries?

The best way found to reduce the risk of ACL injury is with the use of neuromuscular training programs. As stated above, the dynamic stabilizers of the knee are important in helping to control knee stability. Neuromuscular training is the process of teaching your body better biomechanic movements and improved control of these dynamic stabilizers. This is an unconscious process -- not something you can choose to do. However, there are ways to teach your body to have better unconscious neuromuscular control.

Neuromuscular programs have been designed to address deficits in dynamic stabilization of the knee. There are several neuromuscular programs that have been designed, most of which involve stretching, plyometrics, and strengthening. These programs "teach" the athlete how to land from a jumping position, pivot side-to-side, and move the knee without placing as much force on the ACL.

2. Back strains

1. Plan ahead before lifting.
   Knowing what you're doing and where you're going will prevent you from making awkward movements while holding something heavy. Clear a path, and if lifting something with another person, make sure both of you agree on the plan.
2. Lift close to your body.
   You will be a stronger, and more stable lifter if the object is held close to your body rather than at the end of your reach. Make sure you have a firm hold on the object you are lifting, and keep it balanced close to your body.
3. Feet shoulder width apart.
   A solid base of support is important while lifting. Holding your feet too close together will be unstable, too far apart will hinder movement. Keep the feet about shoulder width apart and take short steps.
4. Bend your knees and keep your back straight.
   Practice the lifting motion before you lift the object, and think about your motion before you lift. Focus on keeping you spine straight--raise and lower to the ground by bending your knees.
5. Tighten your stomach muscles.
   Tightening your abdominal muscles will hold your back in a good lifting position and will help prevent excessive force on the spine.
6. Lift with your legs.
   Your legs are many times stronger than your back muscles--let your strength work in your favor. Again, lower to the ground by bending your knees, not your back. Keeping your eyes focused upwards helps to keep your back straight.
7. If you're straining, get help.
   If an object is too heavy, or awkward in shape, make sure you have someone around who can help you lift.
8. Wear a belt or back support.
   If you are lifting in your job or often at home a back belt can help you maintain a better lifting posture. For ideas on inexpensive back supports that can help support the low back while lifting.

2. Hip fractures

1. Stay Active

Not keeping active is the biggest mistake I see older patients making. Many people believe that they should become less active as they age. They feel as though they cannot safely exercise, and become more sedentary.

Unfortunately, this is precisely the opposite of what needs to be done. Weight-bearing exercise has been shown to have beneficial effects on maintaining healthy bone. Furthermore, fit people have better balance and are less likely to fall or fracture a bone.

While maintaining fitness is crucial, it is important to exercise safely. Contact your local senior center or physical therapist to see if any classes are offered specifically for older adults.

2. Check Your Bone Density

A bone density test is a quick, painless way to measure your bone density and determine if you have osteoporosis. People who have osteoporosis, also called bone thinning, are at much higher risk for fracture.

Knowing your bone density can help you and your doctor determine what steps are necessary to help improve your bone health and prevent fracture. Patients with lower bone density may be placed on medications to limit bone loss and improve bone density.

3. Perform a Home Safety Check

Simple steps can be taken to ensure the home is a safe environment. Over 60% of falls causing a fracture in the elderly population occur at home. By taking a few simple steps, people can make the home a much safer environment.

A 1999 survey of homes by Yale University researchers found safety problems in the vast majority of houses. Almost 80% of houses of elderly people had loose objects on living room floors. including rugs, piles of books, or loose cords. Other areas of concern were stairways, kitchens, and bathrooms.

4. Stay on Top of Medications

Do you know what medications you are taking? Do you know what they are for? Everyone should be able to answer these two simple questions. Many medications have side effects that can include dizziness and lightheadedness.

By knowing your medications, and the signs of problems with these medications, you can take control of your health. Let your doctor know if you think a medication could be causing a side effect that may lead to unsteady walking, loss of balance, or a fall.

5. Check Your Vision

As we get older, we may face problems such as failing vision, cataracts, and glaucoma. These problems can be easily screened by an eye doctor, and all people should have their vision regularly checked.

Many older patients have poor vision and may wear corrective lenses. But unless they check regularly with their eye doctor, they may not know if their vision has been worsening. Treating poor vision is a crucial step to avoiding falls.

4. Wear & tear arthritis

1. Weight Control
   Obesity is one of the most significant factors contributing to the development and progression of arthritis. By losing even a small amount of weight, patients ofte n find dramatic relief of their arthritis. Unfortunately, exercising with painful joints can be difficult, but there are ways to lose weight while protecting joints.
2. Activity Modification
   Impact sports can accelerate the progression of arthritis. Patients with arthritis should perform low-impact exercise activities. The best low-impact exercise options include cycling, swimming, pilates, and yoga. Stair machines and walking can all be low-impact, but are not as good.
3. Physical Therapy
   Physical therapy can be used to strengthen the muscles around the knee joint. By strengthening the muscles, the damaged joint is better supported. Physical therapists can be very helpful at teaching patients ways to stay fit despite their joint problems.
4. Ambulatory Aids
   The most common ambulatory aids are a cane or walker. Another option for patients with knee arthritis is a special brace that can relieve pressure on the most damaged side of the joint. While not every patient can use this type of brace, it is worthwhile to ask your doctor if a so-called 'offloading brace' may be appropriate.
5. Joint Supplements
   Glucosamine and chondroitin are often sold as 'joint supplements.' The benefit of these medications has been the subject of controversy, but they are thought to be most effective in patients with early arthritis.
6. Anti-Inflammatory Medications
   Medications an be used to help control inflammation in the arthritic joint. These medications can help ease the symptoms of mild to moderate arthritis. Always use anti-inflammatory medications under the direction of your physician.