Meniscal Tears in Athletes

By W. Christopher Patton, MD

Alabama Orthopaedic Clinic, P.C.

251-401-3600 or www.alortho.com

Specialties: Sports Medicine, Shoulder Surgery, Knee Surgery

     One common injury seen in sports is tearing the C-shaped cartilage located between the tibia and femur called the meniscus.  Acute tears of the meniscus have been reported to be up to 61 cases for 100,000 persons.  The medial meniscus is less mobile and bigger than the lateral meniscus.  This reduced mobility of the medial meniscus is felt to one of the reasons that medial meniscal tears are more common than lateral tears.

     Symptoms of a meniscus tear include pain, swelling, locking, and loss of motion.  Localized tenderness along the joint line is one of the most important physical findings.  Additional findings of a positive McMurray test which involves compression of the involved meniscus with the hip and knee flexed 90 degrees. This compression is combined with a twisting motion to see if the torn meniscus pops as it becomes trapped. 

     MRI greatly improves the diagnosis of meniscal tears as the morphology of the tear can be determined without exposure to radiation.  Combining clinical findings with MRI findings improves the diagnosis accuracy of tears of the meniscus.

     Treatment of acute meniscal tears in athletes generally involves arthroscopic surgery.  The meniscus is either debrided or repaired depending on the tears size and morphology.  Bucket handle tears of the meniscus in the vascular outer zone are often repaired.  Patients younger than 40 tend to have higher healing rates in meniscal repairs than older patients although there are no absolute limits to repair.

     One third of all acute meniscal tears in athletes are associated with anterior cruciate ligament tears.  In patients with acute ACL tears, lateral meniscal tears occur more frequently than medial meniscal tears (83% to 17%).  Medial meniscal tears are more common in chronic ACL-deficient knees.  One rational to reconstructing the ACL is to prevent damage to the menisci and, hopefully, protect the joint cartilage from traumatic damage. 

Beat the Heat

Clayton G. Lane, MD

Alabama Orthopaedic Clinic, P. C.

251-410-3600 or www.alortho.com

Specializing in Sports Medicine, Shoulder Surgery, Shoulder Replacement, Knee Surgery, Knee Replacement, and General Orthopaedic Surgery

     Here in South Alabama athletes have the advantage of being able to train outdoors year-round thanks to our subtropical climate. The downside of that is that in mid to late summer the heat and humidity can combine to put athletes at risk of heat-stroke, a deadly condition responsible for the deaths of 37 football players between the years of 1980 and 2001. While a sports medicine orthopedist’s primary job is to evaluate and treat orthopedic injuries, one of the most common issues I run into on the sideline is heat-illness.

     There are three categories of heat-illness in order of increasing severity: heat cramps, heat exhaustion, and heat stroke. Heat cramps presents as cramps in the arms and legs during exertion. The athlete’s skin will be pale and wet with sweat. The athlete should be moved to the shade and hydration with cold sports drinks initiated.

     Heat exhaustion, the next step on the ladder, is characterized by headaches, weakness, and “feeling faint”. The skin is still pale, but sweat volume decreases. The skin can be described as “cold and clammy” (moist to the touch). Again the athlete should be moved to the shade, but more aggressive cooling should begin such as ice bags in the armpits and groin. The athlete should lie down and remove their clothes (particularly heavy gear such as football pads).

     The first sign of heat- stroke, the final stage of heat-illness, is confusion. This may be accompanied by nausea and vomiting. The skin will be red and hot. The athlete may still be sweating, but as the severity increases, sweating may stop. The core body temperature will rise to greater than 104ￚF. This is an emergency. IV fluid hydration must be begun urgently and the athlete transported to the nearest hospital. During transport, the cooling methods mentioned above such as ice bags and ice water immersion should be performed if possible.

     Heat illness, once it begins, is hard to reverse without discontinuing play. Therefore, coaches, trainers and athletes should place adequate emphasis on prevention to avoid not only the risks of heat-illness but also the inconvenience of having to stop a workout or withdraw from competition. Regarding weather, the temperature and the humidity are important. For example, while it may be safe to compete in 90ￚ weather when the humidity is 40%, it is recommended by sports medicine organizations that play or practice be cancelled if the temperature is 90ￚ and the humidity 80%. Now this is not always realistic here in South Alabama as we probably could not get through a season if that guideline was followed strictly. However, measures can be taken such as scheduling work-outs and games in early morning or late evening in the hottest months and moving to the air-conditioned weight-room or gymnasium to work-out when exceedingly hot and humid. A single layer of light-colored clothing is preferred when heat is an issue to promote evaporation of sweat and protect from UV rays. Also changing out of a sweat-soaked garment during exertion is helpful when possible.

     Another means of prevention is paying close attention to athlete hydration. While body types and metabolism will vary the required amounts of fluid, a good rule of thumb is to drink 20 ounces 2 hours before exercise. Drink another 10 ounces 20 minutes before exercise and then 10 ounces every 20 minutes during exercise. Sports drinks are superior to water if exercise lasts greater than 1 hour. A good way of monitoring this is pre- and post-practice weigh-ins. If the athlete loses greater 3% body weight during exercise, they are not adequately hydrating.

     Taking these precautions will help prevent heat-illness will likely improve performance.

Mattress World has the Mattress for you. 

“Are you tired of sleeping in a hole?

Andy and Jay Lee can help you find the right mattress for you.  Call 251-633-0733 or 251-479-2575 for more information.

Why is a mattress so important for a person to get quality rest for their body?
It is important for you to get quality rest because without it, you cannot use your mind or body to its full potential.  

Explain why it should be a priority for an athlete to understand the real benefits of the right mattress when they may not realize the importance of finding the right mattress for their posture?  If you do not sleep on a mattress that provides good sleeping posture, you will wake up achy and sore.  Also, if you sleep on a mattress padded with polyfoam, your mattress will put you in a hole.

What are some of the problems that happen to the body after resting on the wrong mattress?
A bad mattress can cause back problems or it can exacerbate an already injured area.

Share some of the feelings people have after quality rest on the right mattress?
If you are sleeping on a good mattress, you will wake up feeling refreshed.  You will have more energy and mentally, you will be revived and ready to take on the day.

Can Mattress World put a person in the right mattress by hearing about symptoms that have previously caused painful rest?
At Mattress World, we can provide you with the best mattress to fit your needs.  A mattress cannot cure a medical problem, but it can help prevent further injury.

Can you help athletes find the better mattress according to specific workout programs that they are accustomed and dedicated to?
If their workout program causes pain to a specific area, we can help them find the bed that will help relieve pressure in that area.

Do you have a variety of mattresses that cater to the needs of everyone?
We do have a variety of nineteen different mattresses to choose from.  Some are designed specifically for back, neck, or hip pain.  They vary from soft to firm.

What is the best advice you can offer to someone that just can’t seem to find the right mattress?
Your mattress needs to be built with the highest quality materials, and we do that here at Mattress World.  The best bedding product you can use is latex rubber, so come see us.

What are some of the most popular types of mattresses you offer at Mattress World?
The Body Print is very popular.  It comes with a lifetime service policy and is cushioned with real latex rubber.  Also, it is a softer bed designed for neck, hip, and back comfort.  Another popular bed is the Paragon I.  It comes with a lifetime service policy and is also cushioned with real latex rubber.  It is a firmer bed specifically designed for back comfort.

Does Mattress World guarantee its products and services?
Yes, our beds come with service policies starting at five years all the way up to lifetime policies.  We stand behind our mattresses.

How long has Mattress World been in business?  Tell about the history?
We have been in business since 1982.  This company was founded by my father, Jay Lee.  His intention was to build the best mattress for an affordable price.  Jay brought his two sons into the business a few years later.  We believe in using only the highest quality material, a product that will last.

Andy, most sports enthusiasts have heard your father, Jay Lee, talk about Mattress World on the radio.  Tell about the commercial and how important it is for people to stop “sleeping in a hole.”  What is it like being in a business with your father?   
We try to educate people to watch out for mattresses that feel great in the store, but are made with cheap materials.  That mattress within a few weeks will leave you sleeping in a hole.  We quarantee our beds to be durable and not to put you in a hole.   My father is all about being honest and
wanting the customer to get the best mattress to fit their budget.  He teaches us to always be honest and always do things right the first time, to give 100 percent.

Are too many people taking it for granted when they are hurting because of sleeping on the wrong mattress?
Yes, sleeping on an uncomfortable mattress changes your quality of life.  If you are hurting or tired when you wake up you cannot function properly all day.  If you want the rest of the world, come see us at Mattress World.
 
How does someone shop for a good mattress at Mattress World?
When you shop Mattress World, it's your job to find a mattress that feels good to you. It's Mattress World's job to build a mattress that is durable and lasts you a long time. Always buy the best mattress that fits your budget and then you've done as good as you can do.
 
What sets Mattress World apart from furniture stores and sleep shops?
Their interest is to buy from a factory the biggest, thickest, prettiest, cheapest mattress they can buy. Mattress World wants to sell you the best mattress that fits your budget.
 
What are the disadvantages of choosing a mattress with egg crate foam?
Egg crate foam, or convoluted foam, is widely used foam in many mattresses. However, convoluted foam is not as dense or durable as latex or memory foam and will compress over time resulting in a less comfortable mattress.
 
What is the difference between latex rubber and regular foam?
Latex rubber is superior to foam as much as a paved road is to a dirt road. The resiliency of latex rubber pro vides a longer lasting mattress.
 
Why are some mattresses flippable and some no flip?
If it is cushioned polyfoam, it must be turned from time to time. Latex rubber does not need to be turned to keep its shape.
 
Why does Mattress World competitors leave people sleeping in a hole?
They use memory foam and eggcrate polyfoam. Both of these items will break down and loose resiliency. Mattress World uses superior cushioning like latex rubber which does not lose resiliency and when we do use polyfoam, it is not eggcrate or convoluted foam. It is solid foam.

Does Mattress World deliver?
Yes, we deliver free of charge in metro Mobile and Baldwin counties.

Where are the locations of Mattress World?
7335 Airport Blvd Suite B, Mobile, AL 36608 -251-633-0733
1980 Halls Mill Rd Mobile, AL 36606 – 251-479-2575