Tennis is a lifelong sport that can be played at any age. The sport keeps your body moving and is great for both physical fitness and overall wellness. By playing tennis all through your life you are doing something good for yourself but aches and pain can creep up on you – especially in the knees. Just as you are keeping your body healthy with tennis it is important to have healthy knees too so you can stay in the game. 

The following article is from our friends at Atlantic Orthopaedic Specialist (AOS). AOS is a partner of USTA Mid-Atlantic and provides athletic training services at many of our Regional and Sectional tennis events. In this article, AOS physician Dr. Bradley Butkovich outlines his approach to treating knee pain in tennis players and offers tips for evaluating options for improving knee health.

Is knee arthritis affecting your tennis game? I’m Dr. Bradley Butkovich at Atlantic Orthopaedic Specialists in Virginia Beach. My goal as a Sports Medicine Specialist is to keep you active and doing the things that you want to do on the court. I see many patients throughout the day who have been struggling with the aches and pains of knee arthritis. In fact the Center for Disease Control estimates that the prevalence of symptomatic knee osteoarthritis may reach 50 percent by age 85¹.

There are many risk factors that can contribute to the degeneration of the articular cartilage in your knee including: age, prior injury, and repetitive use². An analogy that I like to use with my patients is comparing the articular cartilage with the tread of a tire. Over time and miles that tread wears thin in one area or another and eventually that tire may need to be replaced. However, there are many steps in the treatment flow chart that we go through prior to jumping to a knee replacement.

So, as a patient, what are my treatment options?

Well typically my first recommendation to a patient who has just began to feel the symptoms of arthritis is to begin a regiment of NSAIDs (Nonsteroidal Anti-inflammatory Drugs)for a short period of time and see if that can take care of it. If taking an NSAID before you play tennis allows you to play without pain then that is a relatively easy treatment option to begin with. If NSAIDs are not working then the next step on the flow chart is to consider a cortisone injection. This puts a strong anti-inflammatory directly to the source and typically gives patients adequate relief for a more extended period of time. In some cases, when working with patients who have more advanced knee arthritis, cortisone injections may become ineffective or only effective for a few days to weeks.

Often times, depending on the severity of the arthritis, we may consider Hyaluronic Acid injections as a treatment option. These are best described as a lubricating shot for the knee. The material lines and coats the degenerative joint and helps the knee to glide better across the articular cartilage. This has also been shown to be an effective treatment option that can provide some patients with 6 months or greater of adequate pain relief³.

Other treatment options to consider can be bracing methods such as unloader braces. This can be effective in patients with valgus (knock knee’s) or varus (bowlegged) knee deformities secondary to advanced osteoarthritis. The brace shifts the weight in your knee off of the arthritic area and onto the area of good cartilage. This is not something that necessarily needs to be worn all the time, but may be an option for helping with arthritic pain while on the tennis court or other exercise.

So how do I know when I need a knee replacement?

I always tell my patients that you will tell me when you are ready for surgery. Reasons to move forward with a Total Knee Arthroplasty include:

1.) Nothing is working to control your pain

2.) It is causing you to stumble, trip, or fall

3.) You are unable to do the things in every day life that you want to do

If you are meeting this criteria then the Total Knee Arthroplasty is the definitive treatment option for your knee arthritis. Many patients do very well with this procedure, as it will decrease pain and improve function by replacing the degenerative joint with new metal and plastic implants to restore the alignment of the knee.

I hope that you may find this information helpful in evaluating your knee health as you move forward with your tennis career. If you are interested in scheduling an appointment with me at either our Norfolk (DePaul) or Virginia Beach (Kempsville) locations, please call our office at 757-321-3311.

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At Atlantic Orthopaedic Specialists, Dr. Bradley Butkovich is board certified in Orthopaedic Sports Medicine and Arthroscopy, as well as general orthopaedics. Dr. Butkovich is one of a few surgeons in Hampton Roads to have completed an accredited Sports Medicine Fellowship and to have received separate Board Certification in Sports Medicine through the American Board of Orthopaedic Surgeons.

AOS is a partner of USTA Mid-Atlantic and provides Athletic Trainers for several USTA Mid-Atlantic Regional, Sectional and other tennis events.

References

1. Murphy L, Schwartz TA, Helmick CG, Renner JB, Tudor G, Koch G, Dragomir A, Kalsbeek WD, Luta G, Jordan JM. Lifetime risk of symptomatic knee osteoarthritis. Arthritis Rheum. 2008;59(9):1207–13.
2. Losina E, Weinstein AM, Reichmann WM, Burbine SA, Solomon DH, Daigle ME, Rome BN, Chen SP, Hunter DJ, Suter LG. Lifetime risk and age at diagnosis of symptomatic knee osteoarthritis in the US. Arthritis Care Res. 2013;65(5):703–11.
3. Newberry SJ, Fitzgerald JD, Maglione MA, O’Hanlon CE, Booth M, Motala A, Timmer M, Shanman R, Shekelle PG. Systematic Review for Effectiveness of Hyaluronic Acid in the Treatment of Sever Degenerative Joint Disease (DJD) of the Knee.