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  • Sports Injury QandA

  • Paul Fadale, MDWhether you're a professional football player or a backyard badminton enthusiast, Paul D. Fadale, MD, chief of sports medicine and an orthopedic surgeon at Rhode Island Hospital, and an associate clinical professor at Brown University Medical School, has answers to your questions about sports and injury.

    What are the most common injuries you treat?

    Knee injuries, particularly anterior cruciate ligament injuries and cartilage tears, are particularly common.

    What causes cartilage or ligament injuries?

    Any twisting or turning event can cause an injury. Commonly, sports activities and other accidents are to blame.

    Which joints tend to be the most susceptible to injury?

    I think most physicians would agree that the knee is most susceptible to injury because it sustains most of the pivoting and jerking motions associated with sports activities. Amazingly, as more women become involved in sports we're finding that women are at a significantly higher risk-more than 5 times greater risk than men, according to some studies-for ligament tears, especially ACL injuries.

    When is surgery necessary?

    For ligament tears, I recommend surgery if the patient has done further damage to the joint because the knee feels "sloppy" or is unstable. For cartilage repairs, surgery is necessary when the patient is in constant pain. Of the 4,000 knee injuries I evaluate each year, several hundred require surgery.

    What is the recovery time after surgery and what does it entail?

    The average recovery time after cartilage surgery is two to four weeks. Ligament surgery typically requires a much longer recovery time, usually four to six months.

    Are the treatments for children any different than those for adults?

    Cartilage and ligament injuries in children are rare, but they do happen. Children require different treatment because their bones are still growing, and adult surgical procedures would affect the bone's growth plate. Surgically sewing in cartilage can repair cartilage injuries in children, but ligament surgery must wait until the child is a teenager, so we usually brace the leg and wait until surgery is possible.

    What are some precautions people can take to avoid ligament and cartilage injuries?

    There is no gadget or gizmo you can attach to your body to prevent a cartilage or ligament injury. Even braces have not been shown to effectively prevent injury. Early studies on training programs that teach athletes safer ways to jump and land are promising. There is also some evidence that strengthening muscles and stretching before physical activity can help prevent injury. The best advice I can give an athlete is to stay within their "zone." For example, it's tempting if you're a skier to try to tackle a black diamond, but if you haven't worked up to that skill level, it's an accident waiting to happen. Getting in over your head can cause strain and excess fatigue that may lead to injury.