Monthly Archives: September 2015

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Muscle Fatigue

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Muscle fatigue is a condition where your muscles lose ability to generate force. It can be a sign that your body needs a break, or a symptom of serious illness. It’s important to be able to recognize muscle fatigue, and to be able to differentiate it from the regular “burn” associated with working out. Doing so will allow you to spot early warning signs of underlying medical issues, understand how to challenge yourself physically without going too far, and avoid injury.

Signs and Symptoms

Muscle Weakness

Sudden and or severe sensations of muscle weakness are a key indicator of muscle fatigue. Your legs may feel like “jelly”–wobbly and unable to support your weight.

Muscle Twitching

Involuntary muscle twitches in the legs is another common sign of muscle fatigue. This is particularly common in people diagnosed with fibromyalgia. The medical term for these twitches is myoclonic jerks.

Weak Grip

If you are experiencing muscle fatigue, your grip may be weak. For example, you may find you are unable to hold your water bottle or sports equipment.



Vigorous, sustained exercise is often responsible for muscle fatigue. You may have been doing an activity too long, or doing too much without proper training. Either way, if you know or suspect you are experiencing muscle fatigue remember to take a break. Otherwise, you are at far greater risk for injury–in part because your nerves are already frazzled from sending you signals to quit, and you may not be as able to detect when you are moving in a way that’s especially harmful.

Nervous fatigue and metabolic fatigue may be involved in overexertion related muscle fatigue. Nervous fatigue occurs because the nerve that generates the signal for a given muscle to contract has been holding that signal too long, and at too high a frequency. In other words, though your muscles could potentially do more with training, the nerve isn’t yet able to keep signaling them on.

Metabolic fatigue means your muscles either don’t have enough “fuel” or have too much of the byproducts of that fuel building up and messing with the ability of the muscle to function properly. Eating well, regularly, and enough to support your weight and activity level will help lower your risk of metabolic fatigue.

Neuromuscular Disease

Sometimes, muscular fatigue may be a symptom of neuromuscular disease. Neuromuscular diseases impact the ability of your muscles to function, and may be pathologies of the muscle or may be pathologies of the nerves and/or tissues surrounding the muscle.

If you’re struggling with muscle fatigue regularly, you should consult a sports medicine professional to identify to cause. They can help diagnose the issue, and use testing to identify an optimal workout for your body type so that your can get stronger the smart way.

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Sports Injuries of the Knee

Sports injuries are a serious concern for today’s athletes. While careful engagement in athletic activity can prevent injuries, accidents still happen. No one wants to lose the opportunity to play a favorite sport or contribute to their team, so many athletes take extensive steps to educate and physically prepare themselves. The right information can make all the difference: in a stressful situation, an athlete prepared with the appropriate knowledge of sports medicine can act quickly to avoid or mitigate the consequences of an injury. That knowledge begins with understanding the most common conditions sustained by athletes and treated by sports medicine experts.

Female runner knee sore

The knee is one of the most common areas of the body that is injured as you use your knees in almost every sport and with everyday activities. From soccer, where you are only allowed to use your lower part of your body, to volleyball where you make short, quick stops and turns, your knees take a lot of abuse and can restrict your athletic capability in both the short and the long term when injured. To understand a bit more about knee injuries, let us first take a look at the structure of the knee.

The knee consists of four bones and three main joints: the patellofemoral, which is the contact of the kneecap to the end of the femur; the tibiofemoral joint between the end of the femur and the top of the tibia; and the joint connecting the tibia to the top of the fibula.

Though our knees degenerate as we age leading to pain, knee pain is also caused by overuse from running and endurance sports as well as being caused by trauma where direct impact or excessive force causes damage to the ligaments, cartilage and bone.

Common sports injuries of the knee include:

  • Anterior Cruciate Ligament Tear (ACL): The ACL is an internal ligament in your knee that attaches the tibia to the femur, and when this is torn the knee becomes unstable or loose
  • Medial and Lateral Collateral Ligaments (MCL/LCL): The MCL and LCL are internal ligaments that attach the femur to the tibia and are often injured in contact sports
  • Meniscus Tear: The meniscus is a structure in your knee made of cartilage that wraps around the knee joint and supports it. When the meniscus is torn, there’s often pain and sensation of locking, catching or giving way. There are two menisci in the knee, the medial and lateral menisci
  • Tendinitis and Bursitis: Caused by inflammation of the structures about the knee. Examples include:
    • Pes Anserine Bursitis: causes pain on the inside of your knee
    • Patellar Tendinitis or Prepatellar Bursitis: causes pain and sometimes swelling of the front of your knee
  • Fractures: Fractures of the knee are not very common but are often debilitating. The kneecap is commonly fractured from a direct impact and the surface of the tibia is prone to injury from forces usually in the lateral direction.

So how do you know if you injured your knee?

If you are feeling pain in your knee or have any of the following symptoms with regards to you knee, you should have yourself evaluated by AOSMI’s Sports Medicine Specialists. Knee injury symptoms include:

  • Swelling
  • Stiffness
  • Warmth or redness
  • Instability or limping or unable to walk/put weight on the knee
  • Inability to fully straighten the knee
  • “Locking” or “popping” of the knee

Many conservative treatments are now available for sports knee injuries and most knee problems respond well to conservative treatment. At AOSMI, our Sports Medicine Specialists offer many different conservative treatment options including:

  • Medication: anti-inflammatories or supplements
  • Physical Therapy: used for rehabilitation of knee problems and to return you to normal activities. Strengthening programs are also available to prevent future injury and increase sports performance
  • Bracing: often helps with pain and instability during healing
  • Massage Therapy
  • Injections that are placed about the knee, typically for tendinitis, bursitis and arthritis
    • Steroid Injections: for pain and inflammation
    • PRP (Platelet-Rich Plasma) and Stem Cell Injections: used to assist the healing process for injuries to the cartilage and ligaments of the knee
    • Hyaluronic Acid: to supplement and nourish the cartilage to potentially restore it

With most sports knee injuries surgery is not required but in extreme cases, orthopedic knee surgery is performed to treat diseases and conditions that are not responding to more conservative treatments. Surgeries include minimally invasive/Arthroscopic surgery, ligament reconstruction, meniscal repair, joint replacement, open reduction and internal fixation (surgeries used to repair fractures), and cartilage repair, regrowth and regeneration. AOSMI Board-Certified, Sports Medicine Fellowship Trained Surgeons are specialized in the most advanced arthroscopic minimally invasive surgical techniques and will determine what will provide the most optimal outcome if surgery is necessary.

Your knee is very important as an athlete and simply for your overall mobility. If you feel that you may have injured your knee or have knee pain, get evaluated by physicians who understand what it means to be an athlete. At AOSMI, our Sports Medicine Specialists will work with you to get your injury healed as quickly as possible and back into the game. Call today to schedule your appointment – 732-720-2555!

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Anterior Ankle Impingement (Footballer’s Ankle)

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With football season in now started, there seems to be no better time to talk about anterior ankle impingement–AKA, footballer’s ankle. Footballer’s ankle has been the bane of many athletes, including dancers, runners, and soccer players. Athletes whose sport involves regular kicking motions are particularly vulnerable.

What is it?

This is a condition that may develop over time from repeated strain to the front of the ankle joint caused by flexing the foot–a motion that leads to those pesky calcific deposits. Or it may develop as a result of bone damage caused by the stress of that same motion (and also facilitating bone spur formation). Chronically weak ankles, especially in non-athletes, may also cause footballer’s ankle.

In any case, scar tissue, inflammation, and/or bone spurs develop in the front of the ankle joint, which limits the joint’s range of motion and often causes pain. A physical exam, x-rays, or in rare cases an MRI may be used to diagnose the condition.


Conservative treatments for footballer’s ankle include physical therapy designed to break down scar tissue in the joint, rest, anti-inflammatory medications, and corticosteroid injections. In more severe cases when conservative treatments are no longer effective, surgery is used to remove the scar tissue and/or bone spurs blocking the joint. Fortunately, this surgery does not have an extensive recovery time, and patients are often able to return to their normal activities fairly quickly.


Happily, the vast majority of patients with footballer’s ankle recover successfully and without any damage to their athletic ability–even patients who undergo surgery. The condition may reoccur, although your physical therapist will likely be able to recommend stretches, exercises, and/or medical devices to help lower your risk.

Suspect you may be developing a case of footballer’s ankle? Request an appointment with our sports medicine experts.

Athletic injuries, discomfort, or that nagging sense you aren’t achieving your full potential? Game on. Here at New Jersey Sports Medicine, our experts are here to heal the injured and help players at every level unlock their best selves. If you’re ready to hit a home run for your health, contact us today and request an appointment.