Wisconsin Golfer - September/October 2011

Meniscus tears common in golf

The cartilage acts as a shock absorber in the knee

he knee joint is made up of the femur (thigh bone)
above and the tibia and fibula (leg bones) below. In
between the femur and tibia are two discs of cartilage
called the medial meniscus and lateral meniscus.

The function of the meniscus is to protect the smooth, almost frictionless cartilage at the end of the femur and the upper part of the tibia. The meniscus acts as a shock absorber and spreads force throughout the whole knee and supports the ligaments of the knee for stability. Meniscus tears are some of the most common injuries in sports.

Meniscal tears can occur from many causes. The most common is a twisting injury with the foot planted which frequently occurs during the golf backswing. Poor golf mechanics can lead to more tears because of poor foot positioning.

In contact sports, a blow to the side of the knee can cause a ligament tear as well as a meniscal tear. In arthritic knees, degenerative tears can occur, as the meniscal tissue and cartilage of the joint are not as pliable and soft.

The symptoms of a meniscus tear include pain along the joint line, swelling of the knee, pain in the back of the knee, catching and locking or popping when attempting to bend and straighten the knee. Some people will experience an inability to fully straighten the knee or feel pain going down the lower leg.

If a tear has been present for a long time, some of the symptoms will periodically appear and disappear de-

T

pending on activities. Sometimes the muscles of the thigh will atrophy over time due to less use of the affected leg.

Diagnosis of a meniscal tear is made by a clinical visit with a physician where a history of events, physical exam of the affected knee, X-rays and commonly an MRI are ordered. Once the diagnosis is made, there are treatment options. If the tear is small and not significantly affecting quality of life, then ice and anti-inflammatory medications such as ibuprofen can be effective. Physical therapy to restore range of motion and strengthen the quadriceps and hamstring muscles can alleviate the symptoms of a meniscus tear. Cortisone shots may act as a quick treatment to diminish pain in the knee. However, a cortisone shot only acts to mask the pain from a meniscus tear rather than facilitating healing, and they are not recommended in the younger population.

Unfortunately, the majority of meniscus tears do not heal on their own. If symptoms persist, arthroscopic surgery to remove the torn part of the meniscus is recommended. The goal of this procedure is to remove the smallest portion of meniscus possible so that the painful symptoms will not return, but still keep as much function-ing meniscus intact to protect the knee. On average, most golfers can return to normal activities in two to six weeks after an arthroscopic procedure on the meniscus.

Prevention is important to any athlete. To help a golfer prevent a meniscus tear, proper swing and stance should

be sought. Strengthening the quadriceps and hamstrings will aid in protecting the knee and flexibility of the joint will also prevent undue force on the meniscus during a golf swing.