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Knee Arthritis: Symptoms, Prevention & the Latest Treatment Options

Thu, 26 Mar 2026 14:22:28 GMT

Arthritis of the knee currently affects approximately 8.5 million people in the UK, with one in five adults over 45 years old having symptoms that affect their daily life. These symptoms can range from intermittent discomfort and occasional knee swelling at lower intensities to constant pain with marked joint deformity, stiffness, instability, and resultant falls at higher intensities. So how does one know if the early symptoms of possible knee arthritis need treatment? Is there anything that can be done to prevent or slow down progression of knee arthritis? What are the latest treatment developments?

Owen Wall is a nationally recognised consultant knee surgeon with 25 years’ experience. His NHS practice is in Leeds, and he also offers private services locally and nationally. He offers complete solutions for arthritis of the knee such as total and partial knee replacement and has excellent long-term results with many happy, satisfied patients. His NHS practice allows him to be part of ground-breaking clinical research with cutting-edge technology which studies the results of stem-cell manipulation via keyhole surgery in treating early arthritis of the knee. He specialises in treating patients with both simple and more complex knee problems. His focus is to provide each patient with an accurate diagnosis and a tailored, individualised treatment plan centred around their goals and expectations.

Owen has a positive outlook regarding the development of treatments available for knee arthritis: “Over the past 15 to 20 years, multi-million-pound investments from national charities and private companies have been made with the singular goal of trying to prevent or treat early arthritis in the hope of avoiding knee replacement surgery. However, the results of total knee replacement and partial knee replacement for established arthritis of the knee are excellent and the technology developed to replace the damaged compartments of the knee while preserving the undamaged compartments (along with the stabilising ligaments) leads to outcomes which allow patients to return to full and normal activities in a pain-free and trouble-free manner. I’m in no doubt that the next decade will see these techniques evolve to give even greater satisfaction for patients with arthritis of the knee, helping to bridge the gap to achieve 100% satisfaction for all patients. Every patient has unique and personal expectations, therefore it’s imperative for me to provide a complete consultation with access to cutting-edge diagnostics that can help formulate a bespoke solution.”

Owen is now able to offer clinic consultations, along with diagnostic imaging, at Living Care Thorpe Park, which complements his existing clinics at Spire Leeds and Nuffield Leeds.

Leedskneeclinic.com | 0113 388 2009 | 07943 938 811 | owenrwall@leedskneeclinic.com

On Instagram @theleedsknee | On X @kneedoc74

Interview With Bradford City's Andy Cook On His Return To Football Following Knee Surgery

Thu, 27 Nov 2025 16:06:50 GMT

Over the years, we have had the privilege of working with a number of local sportsmen and supporting them with various knee problems and injuries. Over the last year, we’ve been working closely with Bradford City and their star striker Andy Cook as he underwent knee surgery and gradually worked on getting himself back to fitness and then very quickly back amongst the goals!

Recently, I sat down with Andy and Bradford City head physio, Joe Gannon, to discuss the surgery and talk about the experience and difficulties he faced upon returning to the professional game and getting back to fitness after a major injury.

So Andy, tell me what happened to you when you injured your knee?

‘I just touched the ball and I think I've done a bad step, like I've stepped on my left and stepped again, and then I just felt my knee, like my knee just exploded basically.’

Andy came to see me on the advice of Joe Gannon from Bradford City. We've had a lot of contact through Bradford City Football Club over the last few years and treated a few players along the way. I've also worked with Andy before. So when I saw Andy in early January 2025, it was pretty clear from the story that he had torn his ACL. We'd already had a scan at that point (video below), which did actually confirm the injury spectrum .

So following examination and confirming that the knee was unstable, we elected to go ahead with an ACL reconstructive surgery after a short period of intense rehab because the core muscles had lost quite a lot of mass.

We eventually went ahead with the operation as planned on the 21st January 2025. We did a mid third patella tendon graft. There was a small repair need for the lateral meniscus at the same time. Then we started on the rehab route.

So Andy, tell me a little bit about your experiences for the first few weeks after the surgery.

‘It was tough for myself mentally and obviously I couldn't really do much. But I had the exercises to do, just trying to get movement in my knee again. But yeah, obviously that was tough.’

The first three to four weeks are pretty hard going, aren't they? The knee is quite sore and swollen and obviously you are frustrated, you don't see much progression.

‘Yeah. Obviously the pain I was in. So much pain after with my knee. And I couldn't do much beyond the bare minimum. Yeah. But obviously I just kept doing my exercise each day and slowly got better around.’

Joe, how was it guiding Andy through this process?

‘Interesting. Yeah. Very interesting. Yeah. We had a couple of calls on a Sunday, a few times over, whether he’d redone it by sleeping. Yeah. But yeah he's cracked on, yeah.’

These are all very genuine sort of worries though. In the first few weeks after surgery, anyone who has had an operation, they're so worried that the slightest thing might undo everything. Realistically you've gotta have another injury, a significant injury to sort of unpick what's been done but the worry is there cause you are obviously exploring all those possibilities of “well, what if I’ve got a re-injury?”

Andy : ‘I think after, I obviously had two experiences with the first two weeks. I think after that I was able to put that aside, thinking that it's not, it's basically impossible to do.’

Joe : ‘I think it helped that you weren't in a brace. In terms of just feeling as normal as you can be.’

Andy : ‘Absolutely yeah. Encouraged to walk on it. Yeah, of course.’

So when I saw Andy this first post-op, which is about four weeks post-op, I was really pleased with how things were going. The wound was healing nicely and he was obviously a little bit swollen, but he was otherwise fine and putting it through his paces with regards to movement and stuff.

And then of course that first three months is always quite a struggle. But when I saw him after three months, both Andy and Joe were quite pleased with progress at that point. We were looking at trajectories for possible return to play, should everything go well. And I said, we'd have a better idea at the six month mark.

So Andy, tell us about what happened at the six month mark when I saw you there.

‘I think that was when I got the word to start training, just before some training camp like to go ahead. Yeah. Obviously I was running and doing all the line work. For me, it was a massive one mentally.’

The quads were coming back. But still not a hundred percent at that point.

‘Yeah. But it was mentally, it was amazing, do you know what I mean? Because I was obviously picking up what I could do.’

Joe, tell us about the challenges you had?

‘I think it was more just reigning Andy in. He was relatively normal in terms of what we were doing on field and in the gym. Obviously, there's still another stage to go but he’d done everything at that point. You get to that six months and you can shift focus to this game. That game. Training at this point with the lads.’

So I was quite happy about the assessment to say, look, if he feels things are going in the right direction today, to get back to a potential return to play for about nine months. So that was the plan really.

And then, about 10 days, two weeks ago, Andy was due to see me for the sort of final sign off and I got the message from Joe saying ‘please, can we postpone the appointment? Because there's a plan, there's a plan to bring him on as a substitute for the game?’

And not surprisingly, Andy made a very successful return.

I think you came on for the last 25 minutes.

And how many goals do you score?

‘Two.’

So that sort of set the tone really and set the expectations of what's hopefully possible moving forwards.

On the most recent checkup with Andy, I was really pleased with his knees; quads are back to full strength. He's got full range of motion and now it's just a case of building on what's already been built on and hopefully progressing to the point of the next sort of four to six weeks where he gets increasing game time with a view to full return for play as and when Joe and the head boss feels you're there.

Moving forward, of course, if there are any sort of minor issues or problems that Andy experiences, he knows that he can come back and speak to me anytime and any sort of small issues, we'll just bounce through from Joe.

So yeah. Anything else to say?

Andy : No, just thank you.

It’s been an absolute pleasure to work with Andy and Joe and I look forward to seeing him take this forward and hopefully return to his regular starting position. Both for the team and also bringing back all of the kudos that everyone and all the fans of course enjoy; we're very pleased to see Andy return.

So just a final thank you to Bradford City, Joe Gannon and of course Andy Cook, it's been a pleasure. Also, a special thank you to Andy Cook for the signed shirt. That’ll be getting framed and hung in the office very shortly.

Running Into Problems : Common Knee Problems for Runners

Tue, 07 Oct 2025 15:22:13 GMT

As we enter Autumn, we enter what is commonly known as runner season. The nicer running conditions and the cooler temperatures make it an ideal time to brush off the running shoes and get back into the 5Ks. Combined with the numerous marathons that are all over the calendar this time of year, there’s going to be a load of new runners as well as people returning to the habit of running over the coming months.

This influx of new and old does mean that knee pain will also be an accompanying experience for many. Knee pain for runners is particularly common and it can be difficult for new runners to identify what is wrong. This article will aim to help you identify the pain you might be experiencing while running and what you should be doing about it.

Runner’s Knee

The most common knee pain for runners is known as ‘ runner’s knee ’ but what that actually means can be quite different. It’s basically a catch all phrase for pain around the knee that commonly occurs with running. In general, this often refers to patellofemoral pain syndrome (PFPS), which is pain towards the front and top of the knee where it meets with the thigh bone. This will commonly flare up during running but can also show during periods of rest. If you suspect that you might be suffering with PFPS, it’s always best to get a diagnosis as it can be confused with other similar knee injuries. For PFPS, the treatment is relatively simple; it’s just a case of resting it and taking the usual painkillers. If it is a recurring problem, stretches, orthotics and tape might help reduce the pain and limit the chance of it continually recurring.

ITB Syndrome

The other most common way ‘runner’s knee’ can present is Iliotibial Band (ITB) Syndrome, which is responsible for 12% of running injuries. The Iliotibial Band is a tendon that runs from the hip to the knee and the friction caused by overuse can cause this band to become inflamed. Similarly to PFPS, the pain will often be towards the top and front of the knee. ITB syndrome can also be caused by running up or down an incline, a lack of proper warm up or cooldown or poor running technique. Treatment again is mostly rest and painkillers but you can also make an impact by working on your posture and running technique which will reduce the pressure being put on the band.

Shin Splints

For new runners, shin splints are a common pain point. Returning to or starting high levels of exercise can cause uncomfortable pain in the shins while running as well as some tenderness towards the front of your lower leg. While not strictly linked to the knee, the two can often come hand in hand and cause some pain towards the lower end of the knee. Shin splints are common but relatively minor injuries. Ice packs, painkillers and rest are the best strategy but they are often a sign you need to be more gradual with upping your exercise.

Patellar Tendinitis

Commonly known as Jumper’s Knee , this injury is more common amongst jumping sports such as skiing or basketball but it can also occur in runners, particularly with runners that run on an incline. The injury comes from overuse and pressure on the tendon connecting the knee to the shinbone, causing pain towards the bottom of the knee. General rest and cooling will help here but something to be careful of is swelling or significant redness under the knee. This might suggest something more serious and is worth consulting a knee specialist about. You should consult your doctor if this is a recurring issue, especially if you aren’t exercising through ‘jump-related sports’.

Bursitis

Bursitis is the inflammation of the fluid-filled sacs (bursa) that cushion your joints. Most relevant to runners are the joints and tendons around the knee but bursitis can also present around the hip. The most common symptom is just general pain but you may also find swelling or a visible lump around the knee, typically underneath. The best remedy is again rest, ice and painkillers but keep active tabs on the pain and the lump. If it fails to go away after 2 weeks or you are having difficulty moving the joint, you should get in contact with your doctor immediately who will be able to run tests on it to ensure that it isn’t infected or covering up another injury such as a ligament tear.

ACL or Meniscus Tears

While hopefully not too common for new runners, ligament tears can occur while running and are one of the most common long-term injuries faced by runners. The most common ways of tearing your ligaments are through falls or sharp turns with the ligaments weakened by overuse. You may hear an immediate popping sound during a tear followed by considerable discomfort during movement as well as significant swelling.

It is recommended to immediately cease exercise until the swelling subsides and pain diminishes but if it isn’t getting any better after a few days, consult with your doctor who will be able to assess the condition of your knee and recommend next steps. Depending on the severity of the injury and your circumstances, it may just be a long case of rest and recovery but in more serious cases, you may need surgery to repair the ligament.

As you begin your return or your journey into running, be aware that some minor pain is likely but frequent and recurring pain is a sign that something is wrong. It might not be serious but even a niggle can be a sign of something serious so if you are concerned about your knees or the pain you are experiencing, please consult your doctor or a knee specialist.

We have bookings available for knee consultations and experience with sports injuries as well as working with professional athletes and guiding them back to full fitness. Even if it’s for some friendly advice, please don’t hesitate to get in touch with our team . We’ll do our best to give you the advice and reassurance you need to get back on the right track.

Cycling With Care : Protecting Your Knees After A Ride

Tue, 05 Aug 2025 12:02:46 GMT

When thinking of physical activities prone to knee injuries, high-impact sports like MMA and football often come to mind. Yet, cycling, despite being a low-impact sport, can also pose significant risks to the knees if not approached with care. The repetitive motion of pedalling, combined with improper technique or inadequate equipment, can lead to overuse injuries that affect the knee joint. Therefore, cyclists should also prioritise knee health to ensure long-term enjoyment of the sport.

Understanding Cycling-Related Knee Injuries

Cycling is generally considered a joint-friendly activity, making it popular among individuals with knee issues. However, the repetitive nature of pedalling can lead to specific injuries if the body is not properly conditioned or if the bike is not correctly fitted.

The most common knee injuries associated with cycling include:

Patellofemoral Pain Syndrome (PFPS): Also known as "cyclist's knee," PFPS is characterised by pain around the kneecap. It is often caused by overuse, poor bike fit, or muscle imbalances.
Iliotibial Band Syndrome (ITBS): The iliotibial band, a thick band of tissue running along the outside of the thigh from the hip to the shin, can become tight and inflamed, causing pain on the outside of the knee.
Tendinitis: Overuse of the knee joint can lead to inflammation of the tendons, particularly the patellar tendon, causing pain and discomfort.
Meniscus Tears: Although less common in cycling than in high-impact sports, meniscus tears can occur due to sudden twisting or overloading of the knee joint during intense cycling sessions.

Causes of Knee Injuries in Cycling

Improper Bike Fit: A poorly fitted bike can place undue stress on the knees. For example, if the saddle is too high or too low, it can alter the angle of the knee during pedalling, leading to strain and injury.
Overtraining: Increasing mileage or intensity too quickly without allowing the body to adapt can result in overuse injuries.
Muscle Imbalances: Weakness in certain muscle groups, such as the quadriceps or hamstrings, can lead to improper biomechanics and increased stress on the knees.
Poor Pedalling Technique: Incorrect pedalling technique, such as applying too much force or not maintaining a smooth pedal stroke, can exacerbate knee strain.

Strategies to Protect Your Knees While Cycling

1. Ensure Proper Bike Fit

One of the most crucial steps in preventing knee injuries is ensuring that your bike is properly fitted to your body. This includes:

Saddle Height: The saddle should be positioned at a height where your knee has a slight bend at the bottom of the pedal stroke. A saddle that is too high or too low can cause excessive strain on the knees.
Cleat Position: If you use clipless pedals, ensure that the cleats are positioned correctly to avoid misalignment of the knee during pedalling.
Handlebar Position: The handlebars should allow you to maintain a comfortable posture without straining your back or knees.

Consider visiting a professional bike fitter to get a comprehensive assessment of your bike setup.

2. Strengthen Supporting Muscles

Strong muscles around the knee can provide better support and stability, reducing the risk of injury. Focus on exercises that target:

Quadriceps: Strengthening the quads can help protect the knee joint by absorbing shock during pedalling. Exercises such as squats, lunges, and leg presses are effective.
Hamstrings: The hamstrings work in conjunction with the quads to stabilise the knee. Incorporate exercises like deadlifts and hamstring curls to build strength.
Hip Muscles: Strong hip muscles contribute to proper knee alignment during cycling. Include exercises such as hip bridges and clamshells in your routine.

3. Gradually Increase Training Intensity

To prevent overuse injuries, avoid sudden increases in cycling intensity or duration. Gradually build up your mileage and incorporate rest days into your training schedule to allow your body to recover.

4. Focus on Pedalling Technique

Proper pedalling technique is essential for minimising knee strain. Aim for a smooth, circular pedal stroke rather than pushing down too hard on the pedals. Additionally, consider using a higher cadence (pedal revolutions per minute) to reduce the load on your knees.

5. Stretch Regularly

Maintaining flexibility in the muscles around the knee can prevent tightness and reduce injury risk. Regularly stretch your quads, hamstrings, and hip flexors, paying special attention to any areas that feel tight after a ride.

6. Use Proper Gear

Invest in cycling shoes that fit well and provide adequate support. Proper footwear can enhance pedalling efficiency and reduce unnecessary strain on your knees. It also helps to reduce the chance of slipping on the pedals, which can help to reduce accidents.

Knee health is paramount for cyclists, just as it is for athletes in more high-impact sports. By taking proactive steps, cyclists can significantly reduce the risk of knee injuries. Regular stretching and gradual progression in training intensity further contribute to maintaining knee health.

Cycling is a lifelong sport that offers numerous health benefits, but protecting your knees is essential to enjoying those benefits for years to come. Prioritise knee care on every ride to keep cycling both safe and enjoyable.

Why Your Knees Hurt After Running and What to Do About It

Tue, 05 Aug 2025 11:43:53 GMT

As we head towards the peak of summer and marathon season, the uptick in people trying out running or getting back into the habit will be on the rise. Running is a widely popular form of exercise in the UK and one that can be immensely rewarding from a general fitness perspective. However, many runners, from beginners to seasoned athletes, often encounter a common impediment: knee pain. This discomfort can range from a nagging ache to a debilitating pain, hindering performance and overall enjoyment of the activity.

Understanding the underlying causes of knee pain when running is crucial not only for effective treatment but also for preventing potential long-term damage. Knee pain is unlikely to go away on its own and while runners are often known for ‘making do’, this isn’t a long term solution and can regularly do more harm than good. This article delves into some of the most common causes, offering insights for runners seeking solutions to this pervasive issue.

Runner's Knee

Runner's Knee, or patellofemoral pain syndrome, is a term often used to describe pain around the kneecap (patella) and the front of the knee. As you can guess from the name, it is particularly prevalent among runners. The condition is characterised by a dull, aching pain, which is typically exacerbated by activities such as running, squatting, and climbing stairs. The causes of Runner's Knee are multifactorial, often involving muscular imbalances, overuse, misalignment of the kneecap, or even flat feet. While it’s certainly not the case that every runner will deal with runner's knee, it is believed that the cases are as many as 30% of female runners and 25% of male runners (source : https://www.templehealth.org/about/blog/common-knee-injuries-running ).

Risk factors include excessive training, a sudden increase in running intensity or duration, and inadequate strength training. To prevent Runner's Knee, runners are advised to incorporate strength and flexibility exercises into their routines, gradually increase their running intensity, and ensure they are running with proper form. Treatment usually involves rest, ice, compression, and elevation (RICE), alongside physical therapy focusing on strengthening the quadriceps, hamstrings, and hip muscles. In some cases, orthotics may be recommended to correct underlying foot issues.

Poor Running Form

If you have been running for a while, you’ll no doubt be aware of ‘proper form’ designed to allow for running over long distances without incurring pain. While many believe that form is only an issue for beginners, it is not uncommon for experienced runners to fall foul of proper technique. In this regard, it’s actually more difficult for veterans to get out of their bad habits so the earlier you can adopt the proper form, the easier you are going to find running overall.

The reason this is so important is that poor running form is a significant contributor to knee pain. Common form errors include over striding, where the foot lands well ahead of the body's centre of gravity, and heel striking with excessive force. These mistakes can lead to increased stress on the knee joint. Additionally, weak core and hip muscles often result in an unstable pelvis, causing the knees to bear the brunt of the impact with each step.

Improving running form can significantly reduce the risk of knee pain. Runners should focus on maintaining a slight forward lean, landing with the foot beneath the body, and utilising a quicker cadence with shorter strides. Strengthening exercises targeting the core, hips, and glutes can also improve stability and reduce the risk of injury. Periodic evaluation of running form, either through self-assessment or professional guidance, can be beneficial in identifying and correcting these issues. Running with a buddy is a great way to spot things you might be doing wrong while also making the runs more enjoyable overall.

Inappropriate Footwear

The significance of selecting the right running shoes cannot be overstated. Each runner has unique biomechanics, and wearing the wrong type of shoes can lead to knee pain. Shoes that lack proper support or cushioning can lead to excessive pronation (inward rolling of the foot) or supination (outward rolling), putting additional stress on the knee joints. Additionally, running in worn-out shoes that have lost their cushioning and support can have a similar detrimental effect.

Runners should seek professional advice for shoe selection, considering factors such as foot arch type, gait pattern, and the type of running they do. It’s also important to replace running shoes regularly – typically every 300 to 500 miles, depending on running style and shoe quality. Properly fitting, well-cushioned, and supportive footwear can play a crucial role in preventing knee pain and enhancing overall running performance.

Tight Socks and Compression Gear

Compression socks and gear are a popular choice for most modern runners and have become a necessary addition to the typical running kit. The basic idea is they help to increase blood flow and reduce stress on the legs during exercise. Research into compression gear is ever prevalent and views do differ widely but some scientific articles do show a relationship between compression gear and a reduction in knee pain, which is a good thing. For full transparency, please see below a list of useful articles to read if you wish to find out more about the actual benefits of compression gear.

However, it must be noted that this is only the case when the socks or gear is properly fitted and sized appropriately. Compression gear designed to improve circulation and stability can, if too tight, restrict blood flow and contribute to discomfort and pain around the knees. Similarly, tight socks can lead to constriction at the calf, altering lower leg mechanics and inadvertently increasing stress on the knee joints.

To avoid these issues, runners should opt for compression gear and socks that provide adequate support without being excessively tight. It’s essential to choose the right size and to be aware of how the body responds to these accessories during running. Comfort and proper circulation are key indicators of well-fitting running apparel. You’ll also want to make note of how easy the socks are to put on (if you are actively struggling to put them on, it’s time to move up a size) or whether they leave a clear mark on the skin. Compression socks and gear are a useful tool for runners but if they are not sized appropriately, you are not going to see the benefits and they are likely to do more harm than good.

Arthritis and Running

Arthritis, particularly osteoarthritis, is another common cause of knee pain in runners, especially in the older population. Osteoarthritis involves the wearing down of cartilage, leading to pain and stiffness in the joints. Running does not necessarily cause arthritis, but for those already experiencing this condition, it can exacerbate the symptoms.

Runners with arthritis should pay extra attention to the intensity and duration of their runs, opting for softer surfaces and incorporating low-impact cross-training activities. Proper footwear, as discussed earlier, is also crucial in this context. It’s advisable for runners with arthritis to consult with healthcare professionals for personalised advice and potentially integrate strength training and flexibility exercises to support the joints.

Knee pain in runners is a multifaceted issue and unfortunately, it is one that many will face at some point in their journey. Understanding the contributing factors is essential in addressing and preventing knee pain and allowing for better performance. It's crucial for runners to listen to their bodies, make informed choices about their running gear and technique, and seek professional advice when necessary. By doing so, runners can enjoy the benefits of this invigorating activity while minimising the risk of knee pain.

A Guide To The Best Shoes for Knee Pain

Tue, 05 Aug 2025 11:18:25 GMT

If you suffer from knee pain, you’ll know how challenging it can be to find footwear that doesn’t aggravate the discomfort. Despite this, we all still want to look and feel our best when we’re out and about. Knee pain shouldn't be a barrier to enjoying your day or feeling confident. This article aims to give you the tools you need to choose the right shoes to support your knees as well as answer some common questions around knee pain and shoes.

Why the Right Footwear Is Important

Choosing the right footwear is crucial for managing knee pain and supporting your overall posture and movement. The right shoes can help reduce stress on the joints, promote proper alignment, and cushion your steps to ease daily activity. Good footwear supports the body's natural movement and distributes weight evenly, which is especially important if your knees are already sensitive or inflamed.

Can Bad Footwear Cause Knee Pain?

In many cases, yes. While knee pain can be caused by a variety of issues, such as arthritis, previous injury, or overuse, poor footwear can contribute significantly. Shoes that lack support or alter your gait (such as high heels or flat sandals with no arch support) can throw your body off balance, putting excess pressure on the knees. Over time, this can lead to strain or even injury. If you already experience knee pain or have conditions like flat feet or overpronation, wearing unsupportive shoes can make things worse.

Can Bad Footwear Make Knee Pain Worse?

Absolutely. Footwear that lacks cushioning, proper support, or arch alignment can exacerbate knee issues by increasing impact or misaligning the legs. High heels are a major culprit as they shift your weight forward, increasing the strain on your knees. Likewise, shoes with uneven wear, minimal shock absorption, or poor grip can throw off your body mechanics, leading to worsened pain or even additional joint problems in the hips and back. Choosing the right shoes can help relieve this pressure and protect your knees from further strain.

Tips on Adapting Existing Shoes for Knee Support

If you have shoes you love but they don’t offer much support, you may be able to make them more knee-friendly with a few tweaks. However, much like with other conditions, it's often better to invest in a quality supportive pair than rely solely on temporary fixes.

Orthotic Inserts : Adding orthotic insoles (whether custom-made or off-the-shelf) can provide arch support and help improve alignment, reducing the load on your knees.
Heel Cushions or Pads : These can absorb some of the impact as you walk, reducing jarring on the knee joint.
Arch Supports : For those with flat feet or overpronation, additional arch support can prevent the knees from rotating inward with each step, reducing long-term strain.
Avoid Shoe Modifications That Distort Fit : Stretching shoes may help with bunions or narrowness, but for knee issues, support and structure are more important than space. Avoid modifying shoes to the point where they lose their shape or integrity.

Picking Out the Right Footwear

While modifying your existing shoes might help, the best long-term solution is investing in shoes specifically designed to provide support and cushioning. Fortunately, more and more brands are focusing on joint-friendly footwear that doesn't sacrifice style.

Look for Shock Absorption : Shoes with a cushioned sole, especially under the heel and forefoot, can absorb impact and reduce pressure on the knees.
Choose Low Heels or Flats With Support : Avoid high heels, which shift your body’s alignment and put added stress on your knees. Aim for shoes with a slight heel or wedge (1–1.5 inches), which often offer better alignment than completely flat soles.
Opt for Arch Support : Whether built-in or added through insoles, proper arch support helps maintain leg alignment and prevent strain on the knees.
Flexible Yet Supportive Materials : Look for shoes made with soft, breathable materials that move with your foot but still offer the structure needed for stability. Avoid flimsy, unsupportive flats or rigid, unpadded soles.
Secure Fit : Shoes with adjustable laces, straps, or velcro allow you to customise the fit and keep your foot stable inside the shoe, preventing unnecessary movement that can stress the knee joint.
Orthopaedic Alternatives : As with most things nowadays, there are a variety of brands available that offer shoes specifically designed for knee pain. You can also find alternatives for high heels and other troubling shoes. These brands are worth considering as you can often find a good variety of styles but bear in mind that these brands typically cost a bit more.

Managing knee pain involves more than just choosing the right footwear, but it’s a foundational step in protecting your joints and improving your daily comfort. If you are recovering from knee surgery or a knee problem, the right shoes can be vital in your continued recovery.

If you’re dealing with knee pain or related mobility issues and would like some guidance on supportive footwear or orthotic options, please don’t hesitate to get in touch . We’re available across Leeds for new patients and can offer a full consultation to help you find lasting relief. We look forward to hearing from you.

Foods & Supplements to Help Soothe Knee Arthritis

Thu, 12 Jun 2025 12:34:15 GMT

Knee arthritis is a growing concern for many in the UK with over 10 million people suffering from some form of osteoarthritis. If you're one of the estimated 8.5 million people dealing with knee arthritis , you know how daily aches and stiffness can slow you down.

What you eat can play a big role in easing pain and keeping your knees moving more comfortably. We’ve compiled a simple guide to help you identify foods and vitamins that are beneficial for your diet and ones that you are better off avoiding or restricting to the best of your ability. A lot of this information is fairly common sense but there might be something you could get more of that would make a big difference.

1. Load Up on Anti-Inflammatory Foods

Inflammation is one of the main reasons knees become stiff, swollen, and painful. Certain foods are known to naturally fight inflammation and can be a helpful part of your everyday meals. Fatty fish like salmon or sardines are rich in omega-3 fatty acids, which may ease joint stiffness. Leafy greens such as spinach and kale are packed with antioxidants that help calm the body and are commonly rich in vitamin K, just like most green vegetables. Berries, especially blueberries and strawberries, are also full of helpful compounds that fight inflammation. And don’t forget olive oil; studies have found that extra virgin olive oil is great for supporting joint health and promoting better movement.

2. Consider Supplements

Some people find relief by adding joint-supporting supplements to their routine. Glucosamine and chondroitin are among the most talked-about; they may help protect cartilage and reduce joint discomfort. Turmeric, often found in capsule form, contains curcumin, a natural anti-inflammatory. This is highly recommended to be taken in supplement form as turmeric on its own is too low in curcumin to make a noticeable difference and synthetic turmeric has related health concerns with certain products being pulled from shelves.

Omega-3 supplements can be beneficial but are not generally recommended due to low levels of research done. It’s better to get it from your food intake so if you don’t like or can’t eat much fish, nuts and soya are good ways to increase omega-3 intake. Vitamin D may also help as it helps keep bones strong and supports the immune system. Before adding any supplement to your daily routine, be sure to speak with your doctor or pharmacist to make sure it's right for you and stop taking them if you notice any adverse side effects.

3. Eat to Strengthen Bones and Joints

Your joints need the right nutrients to stay strong and flexible. Calcium-rich foods like low-fat yogurt, cheese, or fortified plant-based milk help support bone strength. Nuts and seeds provide healthy fats and magnesium, both of which are good for your joints. Whole grains such as oatmeal and brown rice are also beneficial, giving your body long-lasting energy without causing inflammation. As always, aim to include a rainbow of fruits and vegetables in your meals to get a wide range of nutrients that support joint health.

4. Foods to Cut Back On

Just as some foods help reduce arthritis symptoms, others can make them worse. Sugary snacks, soda, and desserts can increase inflammation in the body. Fried foods and processed items like chips or packaged pastries also contribute to joint discomfort. Eating too much red meat has been linked to higher inflammation levels, so it's best to enjoy it in moderation. Try to replace these foods with healthier options when possible.

5. Food Alone Isn’t the Whole Picture

While healthy eating and the right supplements are important, they’re only part of the solution. Staying active, managing your weight, and moving your joints regularly can help reduce pain and stiffness. Gentle daily movement like walking, stretching, or water-based exercises can make a difference. When all these elements work together, you’re more likely to feel better and move with greater ease.

Ready to Feel Better? Let’s Take the Next Step

If you are struggling with knee arthritis, we have recently started offering Anthrosamid injections to treat knee arthritis. For more information about Arthrosamid, knee injections or treatment for osteoarthritis, please get in touch below!

Women & ACL Injuries - What's The Link?

Wed, 16 Apr 2025 11:27:30 GMT

Why are women more likely to get ACL injuries than men?

Anterior cruciate ligament (ACL) injuries have a devastating impact on physical and psychological disability. As we've seen in competitive sports, rates of ACL rupture are significantly greater in females than males during the same sports. Across major sports such as football, ACL injuries have caused large concern as women's sports continue to grow in stature around the world.

Hormonal mechanisms have been proposed but are complex and poorly understood. This systematic review evaluates the effects of menstrual cycle on: 1) lower-limb biomechanics, 2) neuromuscular control, and 3) ACL injury risk.

Read the full article

How To Prevent Jumper's Knee While Skiing

Tue, 11 Mar 2025 14:14:16 GMT

Skiing is an exhilarating sport that demands agility, strength, and endurance. However, for those suffering from Jumper's Knee, also known as patellar tendinopathy, skiing can present unique challenges. This condition, characterised by pain and inflammation in the patellar tendon, often affects athletes who engage in repetitive jumping and high-impact activities.

If not managed properly, Jumper's Knee can hinder performance and lead to long-term issues. Here’s how skiers can effectively deal with Jumper’s Knee while hitting the slopes.

Understanding Jumper’s Knee

Jumper’s Knee occurs due to overuse and repetitive stress on the patellar tendon, which connects the kneecap to the shinbone. This stress can cause micro tears, leading to pain, swelling, and reduced mobility. Skiing, with its constant knee flexion, sudden jumps, and landings, can exacerbate this condition, making it crucial to take preventive and management measures.

Prevention Strategies

Strength Training – Building strong quadriceps, hamstrings, and glutes can help reduce the strain on the patellar tendon. Exercises like squats, leg presses, and step-ups can provide support to the knee.
Proper Warm-up and Stretching – Before hitting the slopes, engage in dynamic stretching and warm-up exercises such as leg swings, lunges, and knee bends to increase blood flow and flexibility.
Using Proper Ski Gear – Investing in well-fitted ski boots and knee braces can provide additional support and reduce strain on the knees.
Maintaining Good Technique – Avoid excessive strain on the knees by keeping a proper skiing posture, with knees slightly bent and body weight evenly distributed.
Gradual Progression – If you are recovering from Jumper’s Knee, gradually increase your skiing intensity rather than jumping into aggressive slopes immediately.

If the pain persists despite taking preventive measures and modifying your skiing routine, seek support from a professional and stop skiing. Persistent or severe pain might indicate a more serious injury requiring advanced treatments such as physical therapy, injections, or, in rare cases, surgery.

Skiing with Jumper’s Knee is possible with proper management and precautions. By strengthening the surrounding muscles, using the right equipment, and listening to your body, you can continue to enjoy the slopes while minimising discomfort and preventing further injury.

While skiing with jumper's knee is possible under the right conditions, it's still not generally recommended and seeking support for knee pain is always the preferred route. If symptoms persist, professional medical advice is essential to ensure a safe and enjoyable skiing experience.

We are available for knee consultations if you feel you need to address your knee pain or concerns. It may be that a simple lifestyle change will make all the difference but you can't know if you keep it hidden. The longer the pain goes unchecked, the more serious it can become.

Olympic Gold Medallist Lindsey Vonn’s Remarkable Return to Skiing

Fri, 10 Jan 2025 14:36:40 GMT

A Testament to Advances in Knee Replacement Surgery

The world of sports is unfortunately no stranger to athletes retiring early due to knee injuries . From football to cycling, the physical demand of competing at the top level on a consistent basis can leave bodies broken and recent rises in ACL injuries in particular has seen many athletes struck down at their very best.

One such star was former Olympic gold medallist, Lindsey Vonn. The skiing superstar was forced to retire early from competitive skiing in 2019, due to long term struggles with consequences of knee injuries . These included multiple ACL tears in both her left and right knee. Despite reconstructive surgery for her multi-ligament injuries, the longer term secondary consequences of such high energy trauma eventually forced her retirement. However, she has now made a stunning return to the Ski World Cup for 2025.

This time, however, her comeback is marked not just by her undeniable talent but also by groundbreaking advancements in medical science. Vonn’s return to competitive skiing has been made possible by a partial knee replacement—a procedure that has revitalised her career and offers hope to countless individuals facing debilitating knee conditions.

A Revolutionary Procedure in the World of Sports

Lindsey Vonn’s partial knee replacement , completed in April of last year, is a landmark achievement in the realm of sports medicine. It is the first procedure of its kind to enable a World Cup skier to return to competitive slopes. The surgery, which replaced only the damaged portion of her knee, allowed for faster recovery, improved mobility, and reduced discomfort. The surgery was performed under robot assistance and using detailed scans to ensure precise placement. Just months after the operation, Vonn is back on the slopes, proving that with the right treatment, no goal is out of reach.

For professional athletes like Vonn, knee health is critical to their performance and longevity in the sport. This procedure demonstrates that advancements in knee replacement technology are not just restoring function but also enabling individuals to return to physically demanding activities at an elite level even after long periods of relative inactivity. Her story is an inspiring reminder of what is possible when cutting-edge medical techniques intersect with determination and passion.

The Broader Implications of Partial Knee Replacement Surgery

While Lindsey Vonn’s success story is extraordinary, the benefits of partial knee replacement surgery extend far beyond the world of professional sports. This innovative procedure is transforming lives for people from all walks of life. By replacing only the damaged part of the knee joint, it preserves healthy tissue and bone, resulting in a more natural feeling and improved function compared to a total knee replacement. Whether it’s returning to skiing, playing with grandchildren, or simply walking without discomfort, partial knee replacement offers a life-changing solution to those suffering from chronic knee pain.

What This Means for You

If knee pain is limiting your daily activities or keeping you from the things you love, it’s worth exploring your options. Advancements in knee replacement surgery , like the one Lindsey Vonn underwent, are making it possible for more people to reclaim their lives and pursue their passions.

Lindsey Vonn’s remarkable journey back to the slopes serves as a powerful example of how modern medical advancements can transform lives. If you’re struggling with knee pain, don’t wait to seek help. Contact our clinics in Leeds or Harrogate to schedule an appointment. Together, we can explore the best options for your knee health and help you get back to doing what you love.

Common Knee Injuries in Skiing and How To Reduce The Risk

Thu, 09 Jan 2025 15:14:25 GMT

When it comes to the slopes, risk is part of the fun. The speed and joy of skiing carries with it a fair chance of getting injured, even for the very best. Still, millions of people will be heading out into the mountains to ensure a bit of rest, relaxation and skiing. Skiing can be a lot of fun but as one of the most dangerous popular sports in the world, it’s also one that carries a certain level of danger.

In particular, knee injuries are among the most common in skiing with it being so reliant on the knees. Twists, tears or even just a bit of pain are all pretty common on ski courses and in terms of winter sports, it is one that commonly produces the most injuries, with knee injuries accounting for around 25% of all skiing injuries.

Common Knee Injuries in Skiing

Medial Collateral Ligament (MCL) Injury

The MCL is a ligament on the inner side of the knee that stabilises the joint against forces that push the knee inward. MCL injuries in skiing often occur during falls, especially when the ski twists or slides outward, placing stress on the inner knee. These injuries can range from mild sprains to complete tears.

Anterior Cruciate Ligament (ACL) Tear

The ACL is a crucial ligament that prevents excessive forward motion and rotation of the tibia (shinbone) relative to the femur (thighbone). ACL tears commonly occur in skiing when the skier loses balance and twists awkwardly or lands heavily after a jump. This injury is often severe and can require surgical intervention.

Meniscus Tear

The meniscus is cartilage that cushions the knee joint and provides stability. Tears often result from a combination of compression and twisting forces, such as during a sharp turn or when falling with a rotated knee. Meniscus injuries can be acute or develop over time due to wear and tear.

General Aches & Pains

Even if you manage to avoid a big hit on the slopes, it’s not uncommon to experience some level of knee pain, especially if you are not particularly active. If you do start to experience pain, it’s not necessarily cause for panic but you should definitely take note of it, it’s typically your body’s way of telling you you're at limit. Pushing through the pain or trying to overcorrect yourself can cause more damage so take a break and if you are just starting out, let your instructor know.

Risk Factors for Knee Injuries in Skiing

Skiing is a dangerous sport for a number of different factors but in all honesty, that danger is built into the nature of the sport. Even when taking all precautions, an injury can still end up happening from a rough fall, a slip or a build up over time. For instance, professional skiers struggle massively with injuries. That being said, there are still plenty of things that you can look out for that will help you prepare for potential risks on the ski slopes.

Improper Technique: Incorrect body positioning and poor control increase stress on the knees and make the chance of a slip or fall more likely.
Fatigue: Tired muscles can’t adequately support the knee joint, making injury more likely. Pain on longer descents is common and can act as a warning sign.
Ill-fitting Equipment: Ski boots and bindings that don’t fit properly can exacerbate the risk of falls and improper movements.
Overconfidence: Skiing on slopes beyond your skill level can lead to dangerous falls.

Reducing the Risk of Knee Injuries

1. Pre-Ski Conditioning

In order to reduce the chance of strains and tears, you’ll want to focus on building the quadriceps, hamstrings, and glutes to support knee stability. Make sure to include exercises like squats, lunges, and leg presses in your workout routines. This will also help you maintain control on your skis, making the overall experience more enjoyable. A strong core can also help with this, reducing stress on the knees. You should also consider activities like box jumps and lateral hops to improve explosive strength and agility, mimicking skiing movements.

2. Warm-Up and Stretch

It’s common sense and should always be done before activity but an effective warm up is especially important in such cold conditions. Not only does this help your muscles but it’ll also help you perform better and be less impacted by the cold. Always warm up with light cardio and dynamic stretches before hitting the slopes. Target the quads, hamstrings, calves, and hip flexors with movements like lunges with a twist and leg swings.

3. Practice Good Ski Technique

There are plenty of good guides out there and you should have most of the protocol drilled into you by an instructor or guide but for some essential tips :

Stay Balanced: Keep your weight forward over your skis to maintain control.
Avoid Over-Twisting: Turn using your whole body rather than just the legs to prevent undue stress on the knees.
Pace Yourself: Take breaks to avoid fatigue, especially late in the day when muscles are tired.
Choose Appropriate Slopes: Stay on runs that match your skill level to reduce the chance of falls. Most courses will let you know the required skill level of a particular descent and if you’re unsure, make sure to ask.
Watch Weather and Snow Conditions: Icy slopes and heavy powder require different techniques and increase the risk of injury. If it’s too rough, they likely won’t open the course but if you’re relatively inexperienced, even small changes in conditions can catch you off guard.
Fall Safely: If you feel yourself losing control, aim to fall sideways with your knees bent to dissipate the impact forces.

4. Use Proper Equipment

In most cases, ill-fitting gear can be a major contributing factor to injuries. You want gear that supports you without restricting movement too much as this can easily cause too much tension in the muscle and put you at risk of tears and pulls.

Boots: Ensure a snug fit to provide adequate ankle support and reduce the risk of knee strain.
Bindings: Have your bindings adjusted by a professional to release appropriately during falls.
Knee Braces: Some skiers, particularly those with prior knee injuries, may benefit from wearing knee braces for added support.

5. What to Do if You’re Injured

If you suspect a knee injury:

Stop skiing immediately to avoid worsening the damage.
Apply ice to reduce swelling and pain.
Use compression and elevation to minimise swelling.
Seek medical attention for proper diagnosis and treatment.

Skiing is an exhilarating sport, but the risk of skiing knee injuries is real. In order to have the best time on the slopes, you’ll need to take the necessary precautions and ensure that your body is ready for the challenges and pressures. The risk of injury is never going to be zero but by following the advice above and by seeking advice from tutors and instructors, you’ll stand a better chance of enjoying yourself without risk.

If you notice something isn’t right after your trip or if you want to make sure you’ll be safe on the slopes, perhaps due to a prior injury or age, please do get in touch and we’ll be happy to support you as much as we can.

Meniscal Injuries - Causes, Treatments & Symptoms

Tue, 01 Oct 2024 09:07:51 GMT

Meniscal Injury

The knee joint has 2 menisci - the medial (inside) and the lateral (outside). In their normal healthy state these structures help to contribute functions of stability, load bearing and sharing, and joint surface (cartilage) protection. They are resilient structures, made from tough type 1 collagen fibres, and are securely attached within the knee to both the tibial surface (front and back) and the knee joint capsule (the periphery of the knee joint). Their collagen structure means that there is a relatively low water content in the tissue, and this confers a low degree of deformation under load, which helps maintain their shape and ability to help resist deforming forces across the knee joint during joint motion. Until the age of approximately 35, the meniscal tissue has its lifetime highest percentage of water content (relative to other tissues) and injury risk remains low. Only extreme deforming forces have the possibility of causing injury, and when this happens it is usually a vertical tear at the attachment of the meniscus to the capsule of the knee, sometimes caused a “circumferential tear”. These injuries are uncommon, but can be associated with extreme hyperflexion/rotation forces across the knee joint.

Meniscal injury (tears) have many configurations, dependent on a number of factors. Younger patients with memorable trauma often have radial/oblique tears, especially of the lateral meniscus, whereas older patients (over 35) often have horizontal splits in the rear (posterior) aspect of the meniscus which can sometimes occur innocuously or without significant trauma. The relative “drying-out” of the menisci in older patients renders the tissue brittle, stiff and less compliant, thus making it susceptible to splitting under lighter loads, for example, whilst squatting or kneeling down. Surgical intervention for these meniscal injuries is arranged after a detailed discussion with the patient concerning the risks of re-tear, chances of requiring further surgery and the long-term prognosis of both operative vs non-operative treatments.

Meniscal Tear Treatment

Not all meniscal tears require or need surgery, and the presence of a tear is not always the reason why an individual may have knee pain, which is why it’s important to make a thorough clinical assessment and have a recent MRI scan. An experienced consultant knee surgeon will be able to advise the patient as to whether surgery will then help, or whether it would only make minimal difference.

Sports activities that can sometimes result in meniscal injury include all the popular sports enjoyed around the UK and the world, eg. Football, netball, rugby, hockey, running, gymnastics, winter sports, even golf. If you think you may be carrying, or have developed a meniscal injury, seek a professional assessment as soon as possible so that you can put your mind at ease with respect to any symptoms that you may have. Simply click on the link and complete the form , or email directly using owenrwall@leedskneeclinic.com

Understanding ACL Injuries | Treatment, Symptoms & Causes

Mon, 23 Sep 2024 10:08:33 GMT

ACL disruption & injury

The ACL (anterior cruciate ligament) is an important ligament within the knee joint which helps maintain rotational knee stability and provides feedback to the brain concerning relative position of the knee during activity. It is a strong ligament which has attachments near the front of the tibia and toward the rear of the femur, with a “ribbon” like appearance to the naked eye. Whilst it can withstand very high loads during flexion, extension and rotation, there are occasionally situations which overwhelm its elastic limits causing the fibres to stretch and tear. When this happens, there is a momentary subluxation of the femuro-tibial joint surfaces and the ligament can no longer function normally. It sustains injury and exhibits evidence of damage (bleeding) within its fibres. There are grades of injury, from minor “bruising” within the fibres to complete disruption of attachment at either the femur or tibia. At high grades of injury, there can also be associated damage to meniscal cartilage and/or chondral cartilage, and at extreme grades sometimes also impaction fracture to the surfaces of the joint. All grades of injury will exhibit altered feedback and a various symptoms.

ACL Injury Symptoms

Symptoms of an ACL injury can range from a feeling of discomfort and minor swelling associated with a decrease in proprioceptive feedback at lower grades to extreme swelling, inability to weight-bear and inability to move the joint at higher grades. Patients with such injuries are often involved in non-contact rotational injuries and describe hearing/feeling a pop (or snap), often followed by the knee giving-way and instant pain. Swelling often occurs quickly and play is usually not able to continue. High force contact rotational injuries can also cause ACL injuries and also have a increased association of additional ligament injuries (multi-ligament).

Sports which have a relatively high association with ACL injuries (for both male and female) in the UK are football, rugby and skiing . Netball has a high association of ACL injuries for female athletes, hockey (both sexes) has a slightly lower association.

ACL Treatment

Diagnosis can often be made by an experienced practitioner who is able to carefully take the details of the injury and then diligently undertake a complete examination. Imaging (X-Rays) are often undertaken to exclude an associated fracture and MRI scans are often requested to confirm the spectrum of injury. The MRI scan findings can also help the surgeon inform the patient of expected outcomes, whether the patient opts for non-operative or operative treatment. Treatment options are tailored to the patient’s injury spectrum and their individual expectations of return to sports and activities. Non-operative treatment of ACL injuries can be as effective as operative treatment dependent on a number of factors. There is excellent evidence to show that operative treatment of ACL disruption, coupled with a comprehensive rehabilitation programme, can enable individuals to return to their previous level of sport.

If you have had such an injury and have not sought an expert opinion, please click on the link to book an appointment with The Leeds Knee Clinic today. Start your road to recovery with confidence of an expert assessment, tailored treatment options, and 15 years of ACL expertise.

Osteoarthritis - 3 Activities To Reduce Pain

Wed, 17 Jul 2024 15:30:00 GMT

Osteoarthritis is the most common form of arthritis in the UK and one that is becoming increasingly common as life expectancy improves and health problems such as obesity are on the rise. Those that suffer from osteoarthritis are currently upwards of 10 million in the UK alone with around 5.4 million suffering from knee osteoarthritis in particular. As the name suggests, osteoarthritis is arthritis of the joints and leads to stiffness, swelling and all-around discomfort in the knees, hips and other joints.

Not all osteoarthritis is severe and not all cases are the same but osteoarthritis is a major cause of discomfort, particularly for those over the age of 60. It then comes as a form of relief that there is continued research put into finding exercises and sports that are both suitable for reducing the pain and stiffness caused by osteoarthritis but also may help to reduce the chance of osteoarthritis developing in the first place. Now it should be noted that the exact causes of osteoarthritis are not fully understood and therefore there is no guarantees that doing any of the following will stop the chance of osteoarthritis but active exercise and building your knee muscles is a great way to reduce general knee pain and improve overall fitness so these are worth considering either way.

General low-impact exercise is recommended for osteoarthritis because it helps increase blood circulation around your knees while also helping to keep the joint active. The below exercises and sports are commonly recommended and recent studies have shown that the following activities have a noticeable effect on knee strength as well as reducing knee pain.

Swimming

Swimming is a popular activity for aching bones and muscles and is one heavily recommended for people recovering from major injuries. Swimming is a low-impact sport and one that can be done at your own pace. Water walking is a popular technique and water aerobics classes are becoming commonplace at most swimming baths, allowing for a communal feel that many enjoy. Swimming helps to increase circulation, the water reduces impact on the joints and exercising in warm water allows for a smoothing and relaxing experience, especially if you have particularly stiff joints. Swimming has been found to both help reduce swelling and pain caused by osteoarthritis as well as reduce the chances of developing the disease in the first place so it’s a worthwhile exercise to pick up alongside the many health benefits that swimming also provides.

Cycling

Cycling is the most recent exercise to have research done showcasing its value as both a preventative and supportive measure for osteoarthritis . Cycling is a fun and incredibly popular activity for all ages and with a rich variety of bikes being developed to allow anyone to ride, it makes for an incredibly accessible sport for those suffering with joint stiffness. E-bikes and comfort bikes both allow for easier pedalling and there are a number of short, paved routes that make for easier, low impact exercise. Cycling is also an effective way to lose weight and this can help to reduce stress on your joints, reducing the chances of developing osteoarthritis.

Weight Training

Osteoarthritis is partly caused by weak muscles so strength classes are surprisingly effective at helping to reduce pain and stiffness caused by osteoarthritis. While these are best done with the support and guidance of a physical therapist or personal trainer as they can do more harm than good if not done in a safe and comfortable way, regular strength training can help to reduce the overall stiffness of the joints and can be a really effective preventative measure for older people looking to stay active at their own pace.

The above are three really useful exercises and activities that can help reduce the risk of osteoarthritis as well as helping those suffering reduce swelling and overall discomfort. Our knowledge of osteoarthritis is continually growing and the amount of recent research being done is a major positive in terms of helping to educate people on how best to take care of their knees and joints. Please consult the below links for useful information from arthritis awareness groups and charities for more information on anything discussed here.

If you are struggling with knee pain, are concerned you might be developing arthritis or looking for treatment to make life with osteoarthritis easier, then please do get in touch. We'll be happy to provide you with a friendly and professional consultation to discuss your concerns and recommend next steps. Book in today for appointments in Leeds!

Avoiding Shin Splints - A Guide to Pain-Free Exercise

Thu, 11 Jul 2024 14:40:12 GMT

Embarking on a new fitness journey can be both exciting and challenging. For beginners, navigating through the myriad of do's and don'ts to stay injury-free is crucial. Knee and muscle pain is common for runners and cyclists. One common hurdle that many face is coping with shin splint pain, a frequent issue among fitness novices.

In this blog post, we aim to guide you through the essentials of avoiding shin splints, offering practical advice for prevention and management. Whether you're taking your first steps into running , joining a dance class, or engaging in any new physical activity, understanding and preventing shin splint pain is key to a smooth and enjoyable fitness journey.

What Causes Shin Splints?

Shin splints, medically known as medial tibial stress syndrome, are characterised by discomfort along the inner edge of the shinbone. This condition is prevalent among fitness beginners due to several factors. New exercisers often push their bodies without adequate preparation, leading to overuse and strain on the shin muscles and tendons. Additionally, engaging in high-impact activities like running or jumping on hard surfaces can exacerbate the risk of developing shin splints. Understanding these factors is the first step in avoiding this common ailment.

How To Avoid Shin Splints

Proper Footwear

The right footwear is crucial in avoiding shin splints. Shoes that provide adequate support and cushioning can help absorb shock and reduce stress on your shins. For activities like running or walking, select shoes that match your foot type and gait. Beginners should consider getting professionally fitted at a specialty store to ensure the best choice for their activities.

Lifestyle Adjustments

As with most things when it comes to exercise, your general life habits and diet are going to play a big factor. A lack of vitamin D and calcium in your diet can lead to weaker bones and lead to pain in your shins. Staying hydrated and maintaining a balanced diet helps your body recover and strengthens your muscles. It can also help you make quicker recoveries, reducing the chance of overuse injuries and allowing you to step up your training more quickly. Though,

Gradual Training

When you start exercising, the most common way to hurt yourself is through overworking. This is why increasing your exercise intensity gradually is vital. Start with lower-impact activities and slowly build up the duration and intensity of your workouts. This gradual approach allows your muscles, including those around your shins, to adapt and strengthen, reducing the risk of injury.

Cross-Training

High intensity training is effective but also can be especially strenuous on muscles and bones. This is why a variety of low-impact exercises, such as swimming, cycling, or yoga, can help prevent overuse injuries like shin splints. These activities allow you to build fitness and endurance while giving your shins a break from high-impact stress.

Recovering from Shin Splints

Managing Rest

If you start experiencing shin pain, the first and most important step is to rest. Continuing to exercise on painful shins can worsen the condition. Allow adequate time for your body to recover before gradually resuming your activities.

Stretching and Strengthening

Regular stretching and strengthening exercises can be beneficial. Simple exercises, such as calf stretches and toe raises, can strengthen the muscles around your shins and improve flexibility, helping to prevent shin splints. For knee and calf stretches for exercise , check out our guide.

Ice and Compression

If all else fails, the old school ice pack can be an effective way of reducing your inflammation and generally reducing the pain. Also, techniques like compression and elevating your legs can aid in recovery. Please bear in mind that these are typically just short relief options though; the main route to recovery is going to be from rest.

Embarking on a fitness journey should be an exciting and enriching experience. By taking these precautionary measures, you can enjoy your activities while minimising the risk of shin splints. Most importantly, be patient with your progress and consistent in your efforts. Fitness is a journey, not a race, and taking care of your body is the key to a long and enjoyable journey in the world of exercise.

If you are struggling with shin splints and are looking for treatment or professional advice, we can provide expert advice to help you improve comfort in your exercise and reduce any impact shin splints are having on your daily life. Book a consultation today and let's talk about how we can help you.

MMA - Knee Health & Injuries

Mon, 27 Nov 2023 14:45:30 GMT

MMA has gained popularity over the past few years and has started to draw participants from across all backgrounds. The majority of participants are in the age range 16-35, but there are also many who are in the 35-50 age group and even older. MMA seems to provide its participants with a means of keeping fit whilst also acting as a means of venting the frustrations and tensions of daily life. However, it can also mean that knee injuries are sustained.

The actions and forces going through the knee joints during MMA are fairly unique owing to the combination of twists, kicks, drops and falls that are part of the discipline. It is common sense to expect twinges and bruises around the knee from just simple participation, but what about more serious injuries?

How do you optimise your knee health to avoid such injuries and what should be done if you get one?

Optimisation includes maximising the interaction between the quad muscles of the front of the thigh and the hamstring muscles at the back of the thigh as this will give balance around the knee joint. Dominance of either muscle group will contribute to risk of injury, so aim for a 50/50 strength and conditioning balance. Optimise the ability of the knees to absorb jumping or bounding impact by undertaking plyometric exercises as part of a strength and conditioning program. Tendon stretching as part of a warm-up/cool-down routine can also help protect the knee joints against tearing or rupture of the quadriceps or patella tendons during sudden accelerative or decelerative manoeuvres.

Active avoidance of injuries is of course difficult when participating in MMA, especially competitive bouts. The nature of the sport makes this almost impossible, but pre-optimisation of your knee health may lower the severity of any injuries that may occur.

Typical knee injuries that may occur for MMA participants are as follows:

Disruption of structures within the knee joint:

The twisting and flexing nature of forces through the knee put some internal structures at risk of injury. These forces can sometimes be very minimal or innocuous, and the symptoms can also be subtle. Structures at risk of such injury are tears or splits to the meniscal cartilage and/or delamination injury to the chondral cartilage (surface cartilage). Often, symptoms present with pain at time of injury and then subsequent subtle swelling within the knee joint. Discomfort can be felt whilst weight-bearing, and occasionally the knee can “lock” or “jam” during certain manoeuvres. Whilst these injuries are serious, they can easily be ignored so getting a prompt diagnosis is advisable.

More severe injuries to structures within the knee can include tears or disruption to the anterior (and rarely posterior) cruciate ligaments (ACL/PCL). These injuries usually involve major disruptive forces applied across the joint in a rotational manner with audible “pops” or “crunches”, the patient can often feel a “separation” of the joint which then instantly reduces, and the joint usually swells severely over a short period of time. Such injuries can also include tears to the meniscal cartilage structures, and very occasionally can also include disruption to ligaments outside of the joint such as the medial or lateral collateral ligaments (MCL/LCL) in extreme situations. These injuries are serious and warrant “urgent” treatment and diagnosis, so ignore them at your own peril.

MMA participants suffer from a higher incidence of injuries to the knee-cap (patella) than any other sport, and often these injuries consist of a partial or total dislocation of the patella. The majority of these reduce or “pop back” as soon as the knee is straightened but this injury can include detachment of articular chondral cartilage fragments and ongoing repetitive instability of the patella. These are also serious injuries and “urgent” diagnosis should be sought.

Disruption of structures outside of the knee joint:

Essentially, the majority of these injuries relate to the medial or lateral collateral ligaments (MCL/LCL). The extreme rotational forces that go through the standing leg during kicks, and the extreme linear forces through the knee when the foot of the kicking leg makes contact with the opponent makes MCL injuries very common. Patients will often experience a tearing sensation followed by an “opening” of the inside of the knee joint and subsequent instabilty. LCL injuries are less common, but should be suspected if there is pain/swelling at the outside aspect of the knee following such injury. Injury to either MCL or LCL is serious and warrants “urgent” diagnosis and a discussion about treatment options. Most MCL injuries in isolation will heal without surgery if braced for 6-8 weeks but LCL disruptions are not so forgiving.

The two major tendons of the knee known as the quadriceps and patella tendons, which connect together the quad muscles to the knee-cap (patella) and then patella to the shin-bone (tibia) are also commonly injured during MMA bouts. Disruption to either the quadricep tendon or patella tendon is a serious injury and will render the individual unable to stand or walk. Both need urgent attention and should undergo urgent repair .

So, If you participate in MMA and are unlucky enough to suffer any of the described injuries above, or if you just have niggles and twinges which concern you, please get in touch with an expert in knee injury diagnosis who can also discuss the relevant treatment options.

The Leeds Knee Clinic offers such services with access to cutting edge diagnostic scanners, as well as working with top-rated private hospitals in Leeds. Please make enquiries below.

Bee’s Knees

Tue, 10 Oct 2023 13:55:18 GMT

Owen Wall, Consultant Knee Surgeon at Leeds Knee Clinic, explains how getting treatment for niggly knee pain could change your life.

Arthritis of the knee currently affects approximately 8.5 million people in the UK, with one in five adults over 45 years old having symptoms that affect their daily life. These symptoms can range from intermittent discomfort and an occasional knee swelling at lower intensities, to constant pain with marked joint deformity, stiffness, instability, and resultant falls at higher intensities. So how does one know if the early symptoms of possible knee arthritis need treatment? Is there anything that can be done to prevent or slow down progression of knee arthritis? What are the latest treatment developments?

Many people will experience knee pain at some time of their lives, and whilst most will see things resolve without the need for a diagnosis, a significant number will develop longer term “niggles” that may become bothersome enough to stop activities such as walking, tennis, golf, skiing, and hiking. If you are one of these unfortunate souls who have been putting off seeing a specialist, either because of worry about what’s going on, or concern that your “niggle” just isn’t severe enough, or even if you’ve just not had the time to make the appointment, now is the time to get some answers and your knee diagnosis completed.

An expert assessment of your knee combined with some simple X-rays and scans can reveal in great detail the overall health of your knee joint and will also allow a personalised discussion about what treatments are suitable for your needs. Not all people with knee niggles require interventional or surgical treatment, but if they do, then a number of options can be discussed, from “keyhole” surgery for minor issues up to knee replacement for established arthritis . For individuals who only have arthritis affecting one of the three knee compartments, then most would be suitable for a partial knee replacement. Hospital stays are typically very short (usually one night) or even day case. The outcomes of partial knee replacement are excellent, patients often experience a quicker return to normal function and can also participate in most sports and activities when rehabilitation is complete.

If you wish to know more, or have your knee niggles diagnosed, please contact me via the link below or alternatively, email me via owenrwall@leedskneeclinic.com

Good Knee Stretches For Exercise and Fitness

Thu, 08 Jun 2023 15:24:38 GMT

Knee pain is one of the most common injuries out there and one most people will have to deal with at some point in their life, especially if they are regularly active in high impact sports like cycling, running or football.

The key to reducing knee pain is to strengthen the area and the muscles around it so that they are less likely to become fatigued due to overuse. The good news is there are several ways to treat knee pain, including stretching and strengthening exercises that you can do on your own.

In this article, we’ll walk you through some of the most effective exercises you can do to reduce knee pain. These stretches and exercises are designed to be accessible for as many people as possible but if you have a serious injury or knee problem, it’s worth consulting your GP or knee consultant first to make sure you won’t end up worsening the problem or hurting yourself. Likewise, some of these stretches will help with knee replacements but it always worth gaining a professional opinion before doing any exercises.

That’s not to say that if you are injured, you shouldn’t exercise your knee. In fact, it is recommended you do this to avoid your knee stiffening which can make the pain even worse and reduce the amount you can actually move your leg. They can also help to strengthen your muscles so that your knee is under less stress and it can help with movement.

General Stretching Advice

Before performing these stretches, warm up with 5 to 10 minutes of light, low-impact activity or you can stretch after a workout. Keep your stretches gentle and slow and if you start to feel pain, stop. Don't bounce during the stretches and make sure to maintain consistent breathing throughout your stretches.

Standing Calf Stretch

Stand placing hands on the wall for support. Place your feet pointing straight ahead, with the involved foot in back of the other. The back leg should have a straight knee and front leg a bent knee.
Shift forward, keeping the back leg heel on the ground, so that you feel a stretch in the calf muscle of the back leg.
Hold 45 seconds.
Switch legs and repeat. Do this 2-3 times per leg.

Quad stretch

NOTE : If you are doing these stretches with an injured knee, you can do the same process lying down.

Stand with your feet hip-width apart.
Grab your left ankle with your left hand and pull it toward your hip. You should feel the stretch in your left quad.
Hold for 30 to 60 seconds.
Switch sides and repeat.

Hamstring Stretch

NOTE : For this stretch and others lying down, an exercise mat can be used to add cushioning under your back.

Lie down on the floor and straighten both legs. Or, you can bend both knees with your feet flat on the floor if this is more comfortable for you.
Lift one leg off the floor.
Place your hands just below the knee, on your thigh, and gently pull your knee toward your chest until you feel a slight stretch.
Hold for 30 seconds. If you start to feel pain at any point, stop.
Lower and change legs.
Repeat 2 times on each side.

Standing Hamstring Stretch

NOTE : If the other hamstring stretch was too difficult or caused you pain, try this one. It’s easier and less likely to cause pain.

Stand on your right foot with your left foot in front of you, heel on the floor, toes up.
Hinge forward at your hips and bend your right knee as you sit back a bit.
As you bend your right leg, keep your left leg completely straight with your weight on the edge of your heel.
Hold for 30 to 60 seconds.
Switch sides and repeat.

Half Squat

Get into a standing squat position with your feet shoulder-width apart.
Place your hands on your hips or out in front of you for balance.
Look straight ahead and slowly squat down, about 10 inches. This is the halfway point to a full squat.
Pause for a few seconds, then stand up by pushing through your heels.
Do 3 sets of 10 repetitions.

Knee pain is one of the most common injuries out there and one most people will have to deal with at some point in their life, especially if they are a sports or exercise enthusiast. The key to reducing knee pain is to strengthen the area and the muscles so that they are less likely to become fatigued due to overuse. If you start to notice something that isn’t quite right or are experiencing knee pain even while not working out, contact us for a knee consultation . We have experience with sports knee injuries and can help provide necessary support and help you find out what is wrong before the worst should happen.

How to Strengthen Your Knees for MMA Training and Competition

Thu, 08 Jun 2023 09:58:32 GMT

Keeping your knees protected

When thinking of physical activity where sports knee injuries are common, MMA and combat sports often come to mind. MMA is a physically demanding sport that places significant stress on the joints, particularly the knees. Consistent kicks and strikes to the muscles as well as a lot of twisting movements can easily promote tears and strains.

Knee injuries are common among MMA fighters , and they can be debilitating and career-ending. Just this past week, Ketlen Souza suffered a gruesome knee injury at the hands of a kneebar from Karine Silva. In particular, the recent increase in popularity of Brazilian Jiu Jitsu training or BJJ (popularised in the UFC by fighters such as Royce Gracie and the Diaz brothers) has seen a rise in knee injuries with around a 30% distribution of knee injuries for those who compete in BJJ according to a recent study with particular focus being put on the MCL which was found to be the most common injury.

Therefore, it's crucial to prioritise knee health and take steps to strengthen this vital joint. Strengthening your knee joints is ideal for all forms of sport and fitness anyway as sport knee injuries are incredibly common and they can be difficult to recuperate from. In this article, we'll explore some effective ways to strengthen your knees for MMA training and competition.

Strengthen Your Quadriceps

The quadriceps muscles, located in the front of the thigh, are crucial for knee stability. Strong quads help support the knee joint and absorb shock during high-impact movements. To strengthen your quads, try exercises such as squats, lunges, leg extensions, and leg presses. Start with lighter weights and focus on proper form to avoid injury.

Build Strong Hamstrings

The hamstrings are a group of muscles located in the back of the thigh, and they play a vital role in knee stability and injury prevention. Weak hamstrings can lead to imbalances and place additional stress on the knee joint. To strengthen your hamstrings, try exercises such as deadlifts and hamstring curls. Again, focus on proper form and gradually increase the weight as you get stronger.

Incorporate Plyometrics

Plyometric exercises are explosive movements that can help improve strength, power, and agility. They are also effective for improving knee stability and reducing the risk of injury. Examples of plyometric exercises that can benefit your knees include box jumps, jump squats, and jumping lunges. However, it's crucial to start with lower-intensity plyometrics and progress gradually to avoid overloading the joints.

Stretch Regularly

Flexibility is essential for maintaining joint health, and it's particularly important for the knees. Tight muscles can place additional stress on the knee joint and increase the risk of injury. Therefore, it's important to stretch regularly to maintain good flexibility. Focus on stretching your hamstrings, quads, and hip flexors, as these muscles can become tight with MMA training.

Invest in Good Shoes

Finally, investing in good shoes can also help protect your knees during MMA training and competition. Look for shoes with good shock absorption and cushioning, as these features can help reduce the impact on your knees. Also, make sure your shoes fit well and provide good support for your feet and ankles.

In conclusion, knee health is crucial for MMA fighters , and taking steps to strengthen and protect your knees is essential for success in this sport. By incorporating exercises that target your quads, hamstrings, and plyometrics, along with regular stretching and investing in good shoes, you can help reduce the risk of knee injuries and improve your overall performance. Remember to always prioritise proper form and progress gradually to avoid overloading your joints.

Knees Up For Ski Season

Mon, 05 Dec 2022 13:26:41 GMT

Whether you are a keen skier or just enjoy the cold, crisp, clean outdoor air that winter resorts can provide and prefer to indulge in the après-ski activities, having optimal knee joint health will help you enjoy yourself to your full potential. You may also like to try other winter activities such as snowshoeing, hiking, and climbing. To minimise your risk of injury or the risk of exacerbating existing knee niggles it is helpful to consider the following advice before you embark…

Whatever activities you plan to do, try to undertake a six to eight-week plan of specific strengthening and conditioning work for the muscles of the legs before you go and develop your gluteus muscle power. This muscle group is the biggest and most powerful in the body and really helps co-ordination. Concentrate on quadricep/hamstring strength aiming for balance between each muscle group. Develop calf and lower leg muscle conditioning using wobble boards or balance balls and work on joint flexibility and tendon stretching for the hip, knee, and ankle joints. The complex arrangements of the four major knee ligaments provides significant signalling to the brain to maintain balance thus plyometric exercises can enhance this feedback and “strengthen” the ability of the individual to avoid knee problems. Many gyms now offer specific pre-ski exercise classes where these conditioning exercises are taught, supervised, and encouraged.

If you are a skiier, whether you are experienced or not, be honest with yourself about your ability. Everyone likes to tell and hear stories of daring-do and crazy skiing exploits – these stories become legend and pass from generation to generation – but unless you are honest about your true ability you may find yourself getting out of your depth extremely quickly, potentially resulting in serious problems for your knees. If you are hiring ski equipment, go to a five-star rated hire centre where the equipment will be new and well maintained.

The last few years has witnessed an increasing number of skiers suffering “double ligament” knee injuries because of incorrectly adjusted ski bindings not releasing the skier beyond the limit of their ability. These injuries require a significant amount of rehabilitation and often surgery to provide long term stability. If you enjoy skiing adventures, and love to explore off-piste, hire an off-piste guide. Not only will you be supporting the local economy, but you will also be minimising your risk of knee injury. Your guide will not only know where all the best conditions are, thus giving you a fantastic experience, but will probably also have great “lift chat” (I speak from personal experience).

If you are not a skier and want to instead explore the natural wildlife at a more sedentary pace via snowshoeing or hiking, ensure you have well-fitted equipment, sturdy boots with outdoor soles and most importantly, when on snow, have two hiking poles. These will help you traverse slippery surfaces and help you prevent innocuous twists to the knees.

If you are unfortunate enough to suffer a knee injury while undertaking activities, or suffer an exacerbation of an existing knee condition, remember to apply the basic principles of first aid. Extend the joint if you can, apply ice and compression bandaging, keep weight bearing to a minimum and seek an expert opinion. The important point to remember is to rest and upon your return seek expert clinical assessment and treatment so that you can return to an active lifestyle as soon as possible.

If you need expert assessment for your knee problems, please contact me today.

I will endeavour to offer you a prompt clinical assessment at either Nuffield or Spire Hospitals in Leeds. Please quote JLIFE10 for a 10% reduction of your initial appointment.

Leading UK surgeon helping to pioneer new techniques in knee cartilage regeneration

Mon, 22 Nov 2021 16:02:46 GMT

Background: Synovial fluid (SF) mesenchymal stem cells (MSCs) are derived from the synovial membrane and have cartilage repair potential. Their current use in clinical practice is largely exploratory. As their numbers tend to be small, therapeutic procedures using MSCs typically require culture expansion. Previous reports indicate that the stem cell–mobilizing device (STEM device) intraoperatively increases SF-MSCs.

Purpose: This study evaluated the chondrogenic potential of non–culture expanded synovium-mobilized MSCs and SF-microfragments obtained after enrichment using the STEM device and ascertained if device-mediated synovial membrane manipulation facilitated ongoing MSC release.

A Slippery Slope

Wed, 20 Oct 2021 14:19:21 GMT

As ski season approaches, leading consultant knee surgeon Mr Owen Wall from The Leeds Knee Clinic discusses how to stay injury free on the slopes and beyond.

With autumn now upon us and winter just around the corner, there may be many of you yearning to return to the fresh white peaks of the world’s ski centres for a week or two of healthy outdoor winter activities. Over the past 18 months, many of us have had our usual routines turned upside down and inevitably, for better or worse, this may well have had some impact on the amount and type of regular exercise that would have normally been undertaken.

The re-opening of gyms and leisure centres across the UK has allowed many of us to get back to our routines. Running and cycling have again seen a further resurgence. Both of these activities are great for your cardiovascular fitness, but trading either exclusively for specific gym and conditioning routines for the muscles around the knee joint can unfortunately unmask niggles and problems, more of which I will discuss later.

Whether you are a keen skier or just enjoy the cold, crisp outdoor air that winter resorts can provide, and prefer to indulge in the apres-ski activities, having optimal knee joint health will help you enjoy yourself to your full potential. You may also like to try other winter activities such as snow-shoeing, hiking and climbing. To minimise your risk of injury or the risk of exacerbating existing knee niggles it is helpful to consider the following advice before you embark.

Whatever activities you have planned, try to undertake a six to eight-week plan of specific strengthening and conditioning work for the muscles of the legs before you go. Develop your gluteus muscle power. This muscle group (all around your derriere) is the biggest and most powerful in the body and really helps co-ordination. Concentrate on quadricep and hamstring strength aiming for balance between each muscle group. Develop calf and lower leg muscle conditioning using wobble boards or balance balls. Work on joint flexibility and tendon stretching for the hip, knee and ankle joints. The complex arrangements of the four major knee ligaments provides significant signalling to the brain to maintain balance and whereabouts in space and thus plyometric exercises can enhance this feedback and strengthen the ability of the individual to avoid knee problems. Many gymnasiums and sports clubs now offer specific pre-ski exercise classes where these conditioning exercises are taught, supervised and encouraged. If you haven’t got access to a gym, then a quick google search will bring everything to your fingertips.

If you are a skier, whether you are experienced or not, be honest with yourself about your ability. Everyone likes to tell and hear stories of daring-do and crazy skiing exploits – these stories become legend and pass from generation to generation. But unless you are honest about your true ability, you may find yourself getting out of your depth extremely quickly, potentially resulting in serious problems for your knees. If you are hiring ski equipment, go to a five-star rated hire centre where the equipment will be new and well maintained. Being honest about your ability also means that your ski bindings will have been adjusted correctly and release when they should for your expertise level and bodyweight, thus minimising the risk of injury to your knees.

Ensure that your ski boots are fastened snugly and not loose – if they aren’t comfortable when fastened snugly then get them changed. Years ago, skis had a very straight cut. This meant even experts found it difficult to get the skis to turn on their edges. The modern development of skis to have increasingly shapely profiles has brought edge carving to within reach of nearly all skiers. While the sensation of turning as if upon rails simply cannot be beaten, there can sometimes be an unfortunate sting in the tail. The last few years has witnessed an increasing number of skiers suffering double ligament injuries to their knees because of incorrectly adjusted ski bindings not releasing the skier beyond the limit of their ability. These injuries require a significant amount of rehabilitation and often surgery to provide long term knee stability.

If you enjoy skiing adventure, and love to explore off-piste, hire an off-piste guide. Not only will you be supporting the local economy but you will also be minimising your risk of knee injury. Your guide will not only know where all the best conditions are, thus giving you a fantastic experience, but will probably also have great lift chat (I speak from personal experience!) If you are not a skier and want to instead explore the natural wildlife at a more sedentary pace via snow-shoeing or hiking, ensure you have well-fitted equipment, sturdy boots with outdoor soles and most importantly, when on snow, have two hiking poles. These will of course help you traverse slippery surfaces but more importantly help you prevent innocuous twists to the knees.

If you are unfortunate enough to suffer a knee injury while undertaking any of the above activities, or suffer an exacerbation of an existing condition, remember to apply the basic principles of first aid. Extend the joint if you can, apply ice and/or compression bandaging, keep weight bearing to a minimum and seek expert opinion. Most ski centres have dedicated injury clinics where the basics can be undertaken such as provision of a splint, perhaps an x-ray, some even have more sophisticated imaging such as MRI.

The important point to remember is to rest and upon your return seek expert clinical assessment and treatment so that you can get back to an active lifestyle as soon as possible. Should you wish to get any ongoing or indeed new problems with your knees sorted out before the commencement of the ski season, then just don’t hesitate to get in touch. Bon ski! Bon après-ski!!

To get in touch with The Leeds Knee Clinic, call 0113 388 2009, email elaine.ingham@nuffieldhealth.com, or visit Leedskneeclinic.com

A Summer of Sport

Tue, 15 Jun 2021 14:07:24 GMT

With the great British summer ahead of us, leading Yorkshire consultant knee surgeon Mr Owen Wall explores how to protect our joints when enjoying our favourite outdoor sports and advises us when to seek help.

After a long winter had turned to a wet spring, the hope for a classic British summer is on everyone’s mind. Who doesn’t yearn for long summer days filled with plenty of sunshine and dry weather? As we all know, a British summer is often used as a euphemism for a wash out, but without those showers we wouldn’t be able to enjoy such fantastic Yorkshire countryside. As the days grow longer and evenings lighter, there is once again the opportunity to re-engage with those quintessential summer pastimes that are so ever popular in our region.

The reassuring sound of leather on willow, the rhythm of baseline returns, the quiet hush before the thwack of club against ball. Cricket, tennis and golf are all popular summer sports and a healthy way of enjoying the great outdoors with friends and family. If you are keen to start playing, how can you maximise your enjoyment without incurring injury or problems to your knees?

Well, the classic advice of doing some gentle stretching and warm-up exercises pre-activity is always a good start. Stretch and activate those muscles which you’ll use most frequently in order to provide them with maximum protection. Stretching thighs and calves and doing some rotatory torso warmups to activate your core will ready your body for the challenges ahead. Tennis, golf and cricket all provide plenty of opportunity for rotation of bodyweight about the knee, so it’s important to anticipate these movements which will help minimise the risk of injury. Should you be unfortunate enough to develop problems with your knees, first apply the RICE principles (rest, ice, compression and elevation). Perhaps try a graduated, gentle reintroduction into your activities to gauge whether the issue has resolved, and if so, slowly increase your demand while keeping a careful eye on how your knee responds. If you find that after a short period of time this does not improve the situation, then you may of course need professional help.

Sports knee injuries are a particular specialist interest of my professional expertise. I help all patients from keen sporting enthusiasts through to elite world-class athletes. Providing you with an expert opinion and diagnosis can go a long way to helping you understand why you may have developed the issues and what methods you can undertake to correct the underlying causes and help treat the current problems.

Access to rapid diagnostic imaging, along with the help and assistance of expert physiotherapy teams, will give you options regarding such treatment. Working closely with the two leading independent sector hospitals in the Leeds area (Spire Leeds Hospital and Nuffield Health Leeds Hospital) will also give you fantastic access to surgical treatment facilities should you need.

To seek expert advice concerning your knees, visit Leedskneeclinic.com, or call Mr Wall’s secretary, Elaine Ingham on 0113 388 2009 where you can discuss your requirements for an outpatient appointment.

Attune total knee arthroplasty: is there evidence of early tibial component de-bonding? A prospective cohort study with a minimum two-year follow-up.

Mon, 26 Apr 2021 10:41:27 GMT

Abstract

New TKA are designed to optimize patient outcomes and improve implant longevity such as the Attune TKA. Concerns have been raised regarding a potentially high rate of early de-bonding at the implant–cement interface of the tibial component. Our study aimed to prospectively assess the clinical outcomes and radiographs of a consecutive series of patients undergoing either Attune TKA or another modern TKA for OA to establish failure rates and compare radiological abnormalities.

96 Attune TKA performed by three surgeons at our local center were matched to 96 control TKA (PFC/Vanguard) performed between 2015 and 2017. Day one, one year and two year post surgery radiographs were analyzed by two independent, blinded assessors. Clinical outcome was assessed using the Oxford Knee Score and survival of the implant recorded. Patients were contacted two years from surgery, 93 Attune and 92 control TKAs attended for clinical and radiological assessment by the same independent assessors.

No TKA in either group were revised. No significant radiolucencies (≥2 mm) at the cement-bone or implant-cement interfaces were encountered in either group. The incidence of radiolucencies (<2 mm) across both interfaces was similar between both groups and did not affect clinical outcome. There was no significant difference between the incidence, progression and extent of radiolucencies at two years follow-up in either of the groups as compared with one year. No clinically relevant adverse radiographic features were found in this prospective cohort study comparing a consecutive series of Attune TKA with a matched group of established, modern TKA designs.

COVID Gardening Heroes

Thu, 15 Apr 2021 13:55:26 GMT

As our gardens have bloomed over lockdown, leading Yorkshire consultant knee surgeon Mr Owen Wall explores how to protect our joints when tending our patch, and encourages those suffering painful conditions to seek medical solutions to enjoy our new-found freedoms to the full.

As I’m sure you would all agree, the past 12 months have been some of the most unusual we’ve experienced since the cessation of the Second World War. Who would have predicted that back in March 2020, we would all be subjected to restrictions at variable levels, on our personal freedoms because of the global health pandemic caused by the SARS-Cov-2 virus, commonly known as COVID-19? We are still not yet out of the woods by any means but there is now significant hope that ‘normality’ may slowly return as we progress through 2021 because of a very well planned and executed vaccine rollout.

‘What did you do during the great pandemic Grandad?’ This may be a typical question that is asked by our grandchildren in the years to come, and what will our answers be? Well, for many, especially those of us lucky enough to have gardens or allotments, we certainly did a lot of gardening. Throughout those first few months during the first lockdown, as the weather improved and the sun shone, lawnmowers, hedge trimmers and strimmers could be heard with regularity. Borders were turned, shrubs and flowers planted and lawns manicured. Allotments were busy with keen gardeners readying their plots with vegetables and fruit for the summer and autumn harvest. As a nation, we were probably busier with our gardens over the last 12 months than at any time before.

However, the increase in time spent in the garden can unfortunately lead to detrimental problems for your back and your joints, especially your knees. If you have pre-existing wear and tear problems, or you already have arthritis of your knees, the crouching, twisting and loading that comes with keeping your borders weed free can exacerbate symptoms of pain and stiffness so much that you may need a considerable period of rest before things settle down, and of course, they may not. How can you protect your knees whilst gardening? Knee pads or thick foam pads can certainly help relieve the pressure on the kneecaps (patellae) while kneeling, and taking care not to crouch and twist with full bodyweight loading can also help to prevent torn cartilage pads within the joint. If you have taken care but still have caused problems how do you recognise when to seek professional help?

If you have torn a cartilage or have exacerbated a pre-existing knee condition, then you may experience a general or localised pain in or around the knee. You may notice a swelling or a feeling of tightness and restriction when bending your knee. You may notice that you can’t fully straighten your knee or it gets stuck (locked). Some people may feel a clunking or clicking within the joint when moving the knee in a certain way. If these symptoms are recurring or seem to be getting worse over time rather than improving, then it would be advisable to seek expert help. A prompt diagnosis and tailored solution may help you significantly and get your knees ready for your summer gardening sooner than you think.

You may already have arthritis of your knee and have been previously advised that you may benefit from total or partial knee replacement but have been putting this off because of the pressures put on the health service secondary to the pandemic. Now that the winter pressures are all but over, this spring or summer would be the ideal time to get rid of those nagging arthritic pains and stiffness by having your knee treated. Do so while you are still able to enjoy the new-found freedom that a pain-free joint replacement can give you. Many patients have been forced to delay treatment for their arthritic joints over this past year and demand is ever growing, but the opportunity to seek a solution is available to you.

If either of the above scenarios are relevant to you, please make contact with my secretary, or directly with myself via my website, and book your consultation with me at Leeds Spire Hospital or Leeds Nuffield Hospital today.

Call Mr Wall’s secretary Elaine Ingham on 0113 3882009, email elaine.ingham@nuffieldhealth.com or visit Leedskneeclinic.com.

Kneed to Know

Wed, 10 Feb 2021 15:03:18 GMT

With the gradually lengthening days and spring just starting to ease into view, most of us will have a desire to achieve new fitness goals for 2021. Leading Yorkshire consultant knee surgeon Mr Owen Wall explores how you can make this happen safely.

The most recent lockdown restrictions, which have seen further closure of gyms and outdoor fitness clubs have once again turned people’s attention towards running and cycling. Running had already gained popularity over the summer, while the UK also saw the biggest rise in new bicycle purchases since 2014. As the weather improves through the spring, many will once again don their trainers and dust down their bikes to enjoy the great outdoors. If you are keen to either start or restart these activities, what are the best things to do in order to protect your knee health and prevent injuries?

Hit the Ground Running

A new pair of running shoes enables both young and old to easily consider the “couch to 5k” as an achievable goal. However, running can often be associated with knee problems. Those who already have advanced ‘wear and tear’ changes within their joints will have been advised not to run by their GP or specialist surgeon, and this advice holds true. For those of us with good joints however, running can increase the ability of the cartilage surfaces to withstand increasing loads and therefore become less susceptible to sustaining long term damage.

So, how does one maximise the benefits of running while avoiding injury? Most ‘injuries’ suffered by runners are in fact overuse injuries and relate to the tendons which connect the various muscles to the bones of the knee joint. For example, Runners Knee is inflammation of the thick band of stabilising tissue on the outside of the knee joint, the symptoms can be near the knee or also commonly near the outside of the hip. This and patella tendon inflammation are the two most common problems suffered by runners. There are less common problems that may also affect the internal structures of the joint – but these are rare.

To minimise the occurrence of these problems, ensure you always do the following:

Ensure you have a good pair of well-cushioned running shoes, fitted by an expert, who has studied your gait pattern.
Stretch and warm up prior to your run.
If you are a novice, always start slowly and build gradually - no more than 10% gain in intensity or distance per workout.
Stretch and cool down after your activity.
Maintain good muscle strength and balance to the core, hip and knee.
Try not to use a new pair of trainers for a big event, ensuring you break them in beforehand.
If you develop niggles around the knee, rest your running for a week to see if they resolve.
Should you develop problems with your knee joints, seek help from an expert.

In the Saddle

Cycling in the UK has witnessed a steady rise in popularity since Le Grand Depart and the next two stages of the Tour de France were hosted by Yorkshire in 2014. It is a great way of keeping healthy and active and also seeing the countryside. In Yorkshire we are blessed with having some of the best countryside, quiet roads and challenging terrain (if you choose to look for it) for cyclists in the UK.

Cycling is an easy sport to start – a roadworthy bike, a helmet and some hi-visibility clothing is enough to get pedalling. One of the big advantages of this particular exercise is that it affords protection for the knees and hips and this thankfully means that internal joint injuries are rare. However, even experienced cyclists can develop injuries. Most of these relate to overuse issues and effect the tendons which attach the muscles around the knee to the thigh and shin bone. There are occasionally issues within the knee joint too such as an exacerbation of wear and tear to the knee articular cartilage surfaces, which may cause swelling and pain. Obviously, if a cyclist were to experience such problems, they should rest and ice the joint, apply compression and seek expert opinion if the symptoms persist.

To minimise the likelihood of developing such issues, it’s important to remember the following:

Make sure your bike is roadworthy, has working brakes, correct tyre pressures and smoothly working gears.
If you are new to cycling, make sure your seat height is set correctly. Too low and your knees may suffer, too high and your hips and ankles will suffer.
If you are starting out (or restarting following a break), try not to overdo your distance – aim to ride steadily for 30 to 45 mins and build from there.
If you are using clip-in pedals, ensure these have been set correctly and allow your foot to attain its natural angle in the pedal.
Practice exiting clip-in pedals smoothly to avoid falls at traffic lights or junctions.
If you develop soreness, swelling or stiffness in the tendons or muscles around the knee or within the knee itself, take some time off to recover.
If these symptoms persist, seek expert help

Hopefully, as spring becomes summer, those of you who have chosen running and cycling as a way to keep active and healthy into 2021 will find that your efforts are rewarded with a new-found wellbeing that continues for the rest of this year.

If you do find that you are having persistent issues with your knees, make sure you seek help and guidance from an expert who can diagnose, treat and help you return to an active lifestyle as quickly as possible.

Call Owen’s secretary, Elaine, on 0113 3882009 or email elaine.ingham@nuffieldhealthcare.com to arrange a consultation at Nuffield Hospital Leeds or Spire Hospital Leeds or fill out our contact form using the button below.

Owen Wall's research while affiliated with The University of Leeds and the LMBRU

grant@blam.online (Blam Websites) — Wed, 03 Feb 2021 11:37:33 GMT

Owen Wall is a leading researcher into knee surgery and cartilage repair and helped publish a number of articles and documentation in this rapidly developing field in associated with the University of Leeds and the LMBRU.

RESEARCH DOCUMENTS:

FRI0389 TOWARDS ONE-STAGE ARTICULAR CARTILAGE REPAIR USING DEVICE BASED ARTHROSCOPIC MECHANICAL RELEASE OF SYNOVIAL MESENCHYMAL STEM CELLS WITH CHONDROGENESIS AUGMENTATION WITH AUTOLOGOUS PLATELET CONCENTRATE WITHOUT CELL CULTURE EXPANSION

AB0098 GENE EXPRESSION AND FUNCTIONAL COMPARISON BETWEEN MESENCHYMAL STEM CELLS FROM LATERAL AND MEDIAL CONDYLES OF KNEE OSTEOARTHRITIS PATIENTS

Effects of the menstrual cycle on lower-limb biomechanics, neuromuscular control, and anterior cruciate ligament injury risk: a systematic review

A Novel Arthroscopic Technique for Intraoperative Mobilization of Synovial Mesenchymal Stem Cells

Platelet lysate enhances synovial fluid multipotential stromal cells functions: Implications for therapeutic use

FRI0001 All stages of synovial mesenchymal stem cell activity including adhesion, proliferation, migration and chondrogenic differentiation are supported by human platelet lysate- implications for novel one stage joint regenerative procedures

Effects of the menstrual cycle on lower-limb biomechanics, neuromuscular control, and anterior cruciate ligament injury risk: a systematic review

Mobilisation of Joint-resident Mesenchymal Stromal Cells for Articular Cartilage Regeneration

A4.06 Mobilisation of joint-resident mesenchymal stromal cells for articular cartilage regeneration

Surgical techniques: Partial knee replacement

grant@blam.online (Blam Websites) — Wed, 03 Feb 2021 11:28:07 GMT

Abstract

The content of this DVD is well structured and progresses in a logical order. It addresses virtually all technical aspects of unicompartmental knee arthroplasty (UKA) – medial (fixed and mobile bearing), lateral, patellofemoral, and combined replacement. The content builds from a simple demonstration of how to do a UKA on a cadaver limb through live surgical demonstrations culminating in a brief but useful ‘pearls and pitfalls’ discussion. The authors of each section give clear and precise narrative, with explanation of why the specific surgical techniques are performed. The only notable omission was that of the increasingly-popular ‘spacer-block’ technique for fixed bearing UKA, a system being offered by most new-generation devices. Although freehand techniques are diminishing in popularity, the inclusion of the Repicci methods add some useful tips and not just an historical perspective.

Osteotomies around the knee

grant@blam.online (Blam Websites) — Wed, 03 Feb 2021 11:26:41 GMT

Abstract

The concept of osteotomy has been around for thousands of years. Whilst the principles have not changed, practice has definitely evolved. Osteotomies around the knee have traditionally been used to treat unicompartmental osteoarthritis but they are now playing an important role in managing joint instability and are also being utilized in combination with cartilage regenerative procedures. To understand how this is possible, this article will outline and summarize the required mechanical principles for the different types of osteotomy around the knee. It will also provide a précis of both standard and novel operative techniques which are facilitating the revival of this procedure, allowing for an increased repertoire of indications and ultimately better patient outcomes.

Revision ACL reconstruction using bone allograft - CT images showing graft incorporation

grant@blam.online (Blam Websites) — Tue, 08 Dec 2020 14:01:00 GMT

Abstract

The incidence of anterior cruciate ligament reconstruction (ACLR) is continuously increasing. As a result so has the need for revision ACLR, which unfortunately has worse functional outcomes and rate of return to sport. Revision ACLR can be performed as a single stage or in two stages. The latter is recommended in the presence of enlarged and/or mal-positioned tunnels. We describe our surgical technique, experience and outcome of our first 19 patients in whom we used allograft bone dowels in the first stage of revision ACLR.

Introduction

The incidence of anterior cruciate ligament (ACL) tears in the United States is over 250,000, of which around 65% proceeds to ACL reconstruction (ACLR). The recommended management for ACL tears in young active patients with functional instability following an ACL tear is ACLR. Patients with ACL tears who continue to play high-level pivoting and cutting sports are at high risk of developing osteoarthritis, especially of the lateral tibiofemoral and patellofemoral joints. Some patients despite an intact graft complain of functional instability following ACLR which limits their ability to return to sport. The increasing incidence of ACLR has resulted in an increasing number of revision ACLRs. Risk of ACL graft failure has been reported to be 2–6% at <5 years and 3–10% at 5–10 years, and peaks around 1–2 years postoperatively mostly due to sport injuries.

Current literature shows that approximately 1.7–7.7% of primary ACLR will be revised. Primary ACLR failure can be attributed to surgical technique error, graft failure, trauma and failure to address other ligamentous injury. The main determining factors are the position and size of the original tunnels and the presence of infection. Re-rupture rate following revision ACLR varies between 3.5% and 33%. Patients should be made aware that revision ACLR has inherently a worse outcome than primary ACLR in terms of functional scores, quality of life and return to high level sport.

Several techniques have been described for dealing with bony defects in staged revision ACLR, including autograft such as from the iliac crest and allograft chips, struts, as well as bone dowels. Although allograft bone dowels are easy to use and avoid donor site morbidity, several concerns have been raised for fragmentation and failure to effectively plug the defect due to the tunnel shape irregularity and the lack of malleability of the bone dowels.

The aim of the present study was to investigate the practicality and radiological integration of the allograft bone dowels used in the first stage of revision ACLR, which would then allow for a solid bony bed to place anatomical ACL tunnels, and to review the clinical outcomes using this two-stage technique in revision ACLR.