Archive for January, 2009

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Knee Injuries

Saturday, January 31st, 2009

Knee Problems?

What Do the Knees Do?

The knees provide stable support for the body. They also allow the legs to bend and straighten. Both flexibility and stability are needed to stand, walk, run, crouch, jump, and turn. Other parts of the body help the knees do their job. These are:

  • Bones
  • Cartilage
  • Muscles
  • Ligaments
  • Tendons.

If any of these parts are injured, the knee may hurt and not be able to do its job.

Who Gets Knee Problems?

Men, women, and children can have knee problems. They occur in people of all races and ethnic backgrounds.

What Causes Knee Problems?

Mechanical knee problems can be caused by:

  • A direct blow or sudden movements that strain the knee
  • Osteoarthritis in the knee, resulting from wear and tear on its parts.

Inflammatory knee problems can be caused by certain rheumatic diseases, such as rheumatoid arthritis and systemic lupus erythematosus (lupus). These diseases cause swelling which can damage the knees permanently.

How Are Knee Problems Diagnosed?

Doctors diagnose knee problems by using:

  • Medical history
  • Physical examination
  • Diagnostic tests (such as x rays, bone scan, CAT scan, MRI, arthroscopy, and biopsy).

Arthritis in the Knees

The most common type of arthritis of the knee is osteoarthritis. In this disease, the cartilage in the knee gradually wears away. Treatments for osteoarthritis are:

  • Medicines to reduce pain, such as aspirin and acetaminophen
  • Medicines to reduce swelling and inflammation, such as ibuprofen and nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Exercises to improve movement and strength
  • Weight loss.

Rheumatoid arthritis is another type of arthritis that affects the knee. In rheumatoid arthritis, the knee becomes inflamed and cartilage may be destroyed. Treatment includes:

  • Physical therapy
  • Medications
  • Knee replacement surgery (for a seriously damaged knee).

Cartilage Injuries and Disorders

Chondromalacia (KON-dro-muh-lay-she-uh) occurs when the cartilage of the knee cap softens. This can be caused by injury, overuse, or muscle weakness, or if parts of the knee are out of alignment. Chondromalacia can develop if a blow to the knee cap tears off a piece of cartilage or a piece of cartilage containing a bone fragment.

The meniscus (meh-NISS-kus) is a C-shaped piece of cartilage that acts like a pad between the femur (thigh bone) and tibia (shin bone). It is easily injured if the knee is twisted while bearing weight. A partial or total tear may occur. If the tear is tiny, the meniscus stays connected to the front and back of the knee. If the tear is large, the meniscus may be left hanging by a thread of cartilage. The seriousness of the injury depends on the location and the size of the tear.

Treatment for cartilage injuries includes:

  • Exercises to strengthen muscles
  • Electrical stimulation to strengthen muscles
  • Surgery for severe injuries.

Illustration depicting a lateral view of the knee, showing the location of: Quadriceps tendon; Patella; Lateral collateral ligament; articular cartilage; Patellar tendon; Meniscus; Tibia; Medial collateral ligament; Anterior cruciate ligament; Posterior cruciate ligament; and Femur.

Ligament Injuries

Two commonly injured ligaments in the knee are the anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL). An injury to these ligaments is sometimes called a “sprain.” The ACL is most often stretched or torn (or both) by a sudden twisting motion. The PCL is usually injured by a direct impact, such as in an automobile accident or football tackle.

The medial and lateral collateral ligaments are usually injured by a blow to the outer side of the knee. This can stretch and tear a ligament. These blows frequently occur in sports such as football or hockey.

Ligament injuries are treated with:

  • Ice packs (right after the injury) to reduce swelling
  • Exercises to strengthen muscles
  • A brace
  • Surgery (for more severe injuries).

Tendon Injuries and Disorders

The three main types of tendon injuries and disorders are:

  • Tendinitis and ruptured tendons
  • Osgood-Schlatter disease
  • Iliotibial band syndrome

Tendon injuries range from tendinitis (inflammation of a tendon) to a ruptured (torn) tendon. Torn tendons most often occur from:

  • Overusing a tendon (particularly in some sports). The tendon stretches like a worn-out rubber band and becomes inflamed.
  • Trying to break a fall. If thigh muscles contract, the tendon can tear. This is most likely to happen in older people with weak tendons.

One type of tendinitis of the knee is called jumper’s knee. In sports that require jumping, such as basketball, the tendon can become inflamed or can tear.

Osgood-Schlatter disease is caused by stress or tension on part of the growth area of the upper shin bone. It causes swelling in the knee and upper part of the shin bone. It can happen if a person’s tendon tears away from the bone, taking a piece of bone with it. Young people who run and jump while playing sports can have this type of injury.

Iliotibial band syndrome occurs when a tendon rubs over the outer bone of the knee causing swelling. It happens if the knee is overused for a long time. This sometimes occurs in sports training.

Treatment for tendon injuries and disorders includes:

  • Rest
  • Ice
  • Elevation
  • Medicines such as aspirin or ibuprofen to relieve pain and reduce swelling
  • Limiting sports activity
  • Exercise for stretching and strengthening
  • A cast, if there is a partial tear
  • Surgery for complete tears or very severe injuries.

Other Knee Injuries

Osteochondritis dissecans (OS-tee-oh-kon-DRI-tis DIS-secans) occurs when not enough blood goes to part of the bone under a joint surface. The bone and cartilage gradually loosen and cause pain. Some cartilage may break off and cause sharp pain, weakness, and locking of the joint. A person with this condition may develop osteoarthritis. Surgery is the main treatment.

  • If cartilage fragments have not broken loose, a surgeon may pin or screw them in place. This can stimulate new blood flow to the cartilage.
  • If fragments are loose, the surgeon may scrape the cavity to reach fresh bone and add a bone graft to fix the fragments in position.
  • Research is being done to investigate cartilage and tissue transplants.

Plica (PLI-kah) syndrome occurs when bands of tissue in the knee called plicae swell from overuse or injury. Treatments for this syndrome are:

  • Medicines such as aspirin or ibuprofen to reduce swelling
  • Rest
  • Ice
  • Elastic bandage on the knee
  • Exercises to strengthen muscles
  • Cortisone injection into the plicae
  • Surgery to remove the plicae if the first treatments do not fix the problem.

What Kinds of Doctors Treat Knee Problems?

Injuries and diseases of the knees are usually treated by an orthopaedist (a doctor who treats problems with bones, joints, ligaments, tendons, and muscles).

How Can People Prevent Knee Problems?

Some knee problems (such as those resulting from an accident) can’t be prevented. But many knee problems can be prevented by doing the following:

  • Warm up before playing sports. Walking and stretching are good warm-up exercises. Stretching the muscles in the front and the back of the thighs is a good way to warm up the knees.
  • Make the leg muscles strong by doing certain exercises (for example, walking up stairs, riding a stationary bicycle, or working out with weights).
  • Avoid sudden changes in the intensity of exercise.
  • Increase the force or duration of activity slowly.
  • Wear shoes that fit and are in good condition.
  • Maintain a healthy weight. Extra weight puts pressure on the knees.

What Types of Exercise Are Best for Someone With Knee Problems?

Three types of exercise are best for people with arthritis:

  • Range-of-motion exercises. These exercises help maintain or increase flexibility. They also help relieve stiffness in the knee.
  • Strengthening exercises. These exercises help maintain or increase muscle strength. Strong muscles help support and protect joints with arthritis.
  • Aerobic or endurance exercises. These exercises improve heart function and blood circulation. They also help control weight. Some studies show that aerobic exercise can reduce swelling in some joints.

Source: National Institutes of Health

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Whiplash

Saturday, January 31st, 2009

What is Whiplash?

Whiplash-a soft tissue injury to the neck-is also called neck sprain or neck strain. It is characterized by a collection of symptoms that occur following damage to the neck, usually because of sudden extension and flexion. The disorder commonly occurs as the result of an automobile accident and may include injury to intervertebral joints, discs, and ligaments, cervical muscles, and nerve roots. Symptoms such as neck pain may be present directly after the injury or may be delayed for several days. In addition to neck pain, other symptoms may include neck stiffness, injuries to the muscles and ligaments (myofascial injuries), headache, dizziness, abnormal sensations such as burning or prickling (paresthesias), or shoulder or back pain. In addition, some people experience cognitive, somatic, or psychological conditions such as memory loss, concentration impairment, nervousness/irritability, sleep disturbances, fatigue, or depression.

Is there any treatment?

 

Treatment for individuals with whiplash may include pain medications, nonsteroidal anti-inflammatory drugs, antidepressants, muscle relaxants, and a cervical collar (usually worn for 2 to 3 weeks). Range of motion exercises, physical therapy, and cervical traction may also be prescribed. Supplemental heat application may relieve muscle tension.

 

What is the prognosis?

 

Generally, prognosis for individuals with whiplash is good. The neck and head pain clears within a few days or weeks. Most patients recover within 3 months after the injury, however, some may continue to have residual neck pain and headaches.
SOURCE: National Institutes of Health

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Cell phones and Driving

Saturday, January 31st, 2009
Q.  Does cell phone use while driving cause traffic crashes?  

A.  Research shows that driving while using a cell phone can pose a serious cognitive distraction and degrade driver performance.  The data are insufficient to quantify crashes caused by cell phone use specifically, but NHTSA estimates that driver distraction from all sources contributes to 25 percent of all police-reported traffic crashes.

Q.  Is it safe to use hands-free (headset, speakerphone, or other device) cell phones while driving?

A.   The available research indicates that whether it is a hands-free or hand-held cell phone, the cognitive distraction is significant enough to degrade a driver’s performance.  This can cause a driver to miss key visual and audio cues needed to avoid a crash.

Q.  In an emergency should I use my cell phone while driving?

A.  As a general rule, drivers should make every effort to move to a safe place off of the road before using a cell phone.  However, in emergency situations a driver must use their judgment regarding the urgency of the situation and the necessity to use a cell phone while driving.

Q.  Is NHTSA conducting further research to better quantify the safety impact of using cell phones while driving? 

A.  NHTSA is conducting research projects on driver cell phone use and will continue to monitor the research of others on this subject.  As we learn more about the impact of cell phone use on driver performance and crash risk, and as wireless technologies evolve and expand, NHTSA will make its findings public.

Q. Is talking on a cell phone any worse than having a conversation with someone in the car?

A. Any activity a driver engages while driving has the potential to distract the driver from the primary task of driving.  Some research findings comparing cell phone use to passenger conversations while driving, show each to be equally risky, while others show cell phone use to be more risky.  A significant difference between the two is the fact that a passenger can monitor the driving situation along with the driver and pause for, or alert the driver to, potential hazards, whereas a person on the other end of the phone line is unaware of the roadway situation. 

Q.  What do the studies say about the relative risk of cell phone use when compared to other tasks like eating or drinking?

A.  The current research does not provide a definitive answer as to which behavior is riskier.  In a controlled study, comparing eating and operating a voice-activated cell phone to continuously operating a CD player, it was found that the CD player operation was more distracting than the other activities.  In a test track study conducted by NHTSA, the results showed that manual dialing was about as distracting as grooming/eating, but less distracting than reading or changing CDs.  It is also important to keep in mind that some activities are carried out more frequently and for longer periods of time and may result in greater risk.

SOURCE: National Highway Traffic Safety Administration  

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Ice Storms, Winter Weather, and Car accidents

Wednesday, January 28th, 2009

Every winter there is an uptick in the number of new client calls to Virginia, Maryand, and Washignton, D.C. injury lawyers. Invariably there has been a recent change in the weather (for the worse), and someone has been involved in an accident. In some areas of the country the general popuilation knows how to handle the winter weather, and they prepare for it. In the mid-atlantic states of Virginia, Maryland and in Washington D.C, where some winters may not receive any snow or ice, the general poulation is usually not prepared, and nor sufficiently experienced in winter driving. This is especially true during the first winter weather event of the season.

Despite the increase in calls of people seeking the help of lawyers after an accident, unfortunately the weather plays a large role in whether a case is accepted. When someone claims there was black ice, or some other road condition that contributed to the accident, it becomes an uphill battle to prove that the other driver was responsibile, especially when the police report clearly identifies the roads as wet, icy or snow covered.  For this reason, there is a need to look beyond the road conditions, to the actual driving of the defendant to determine whether he or she should be held responsible. Was the other driver speeding? This would be especially dangerous on snowy or icy roads. Was the other driver attempting to perform some maneuver which regardless of the weather conditions would be negligent? Was the other driver’s windshield and windows free of ice and snow? If visibility is an issue, this might be the key to the case.  It makes complete sense to consult with a lawyer following an accident, and especially so after a weather related accident. The best advise is what your parents likely told you, stay off the roads during bad weather and slow down.

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Uninsured/Underinsured Motorist Coverage in times of recession – Part 2

Tuesday, January 27th, 2009

The real reason to have uninsured/underinsured motorist coverage is to protect yourself, your family, and your passengers in the event that you are injured by someone who either doesn’t have any insurance or doesn’t have enough insurance to cover your damages. Should the responsible driver not have any automobile insurance coverage whatsoever, you might very well be limited to the limits of your own policy. 

Consider if you are involved in an accident with an uninsured driver. Should you have tried to save a few bucks, as many people do, and purchased a minimum limits policy under Virginia law, you would have only a maximum of $25,000 to cover the all the losses of any one indivdual. If more than one person was injured in the accident there would be a maximum of $50,000 to compensate you and your passengers. It is all too easy to think of situations where limits of $25,000/$50,000 would be woefully inadequate. In times of recession, people might just miss that car insurance bill, or put off paying it, for any number of reasons. With an expected increase uninsured drivers on our roads, it makes complete sense to revisit your unisured/underinsured automobile insurance limits. 

In Virginia, every driver receives uninsured/underinsured motorist coverage with the same limits as the liability limits. You can always ask for more coverage, but that is entirely up to you. If the idea is to fully protect your family, you would want the highest limits your automobile insurance carrier offers.Automobile insurance carriers offer different maximums. Some insurers will offer a one Million single limit policy. Other insurance carriers might max out at $500,000.00. It makes absolute sense to get the highest uninsured/underinsured motorist coverage available.  The cost is not prohibitive, and the peace of mind that you receive by purchasing higher limits is worth the cost.

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Uninsured/Underinsured Motorist Coverage in times of Recession-Part 1

Saturday, January 24th, 2009

Many times I have been told by clients that they don’t want to involve their own personal automobile insurance policy in connection with their recent car accident. I usually hear something like “I shouldn’t be forced to use my own insurance because of someone else’s negligence” or “Why should my insurance be forced to fix my car when its the other guy’s fault”. While it is understandable that people don’t want to risk having their insurance rates go up, there are many situations where using your own insurance is no longer a choice, but a necessity.

The common understanding regarding automobile insurance is that it is there to pay others in the event that you cause injury due to your negligence. Personal automobile insurance in Virginia provides for minimum liability coverage limits of $25,000/$50,000.

This minimum limit means that your personal automobile insurance carrier will pay a maximum of $25,000 per person, and $50,000 per accident for injuries arising from any one accident. In the event you injure someone as a result of your negligence, the other person will receive a maximum of $25,000 from your personal automobile liability insurance, and not a penny more. However, there are many situations where $25,000/$50,000 in coverage is wholly insufficient.

Consider the following: You to hit another car with 5 occupants, and severely injure all 5 people. Because of your low limits of liability coverage, each person receives a maximum of $5,000 each, despite the severity of their injuries. I have seen too many cases over the years where unfortunately there wasn’t enough insurance coverage to pay for otherwise serious injuries.

In the event there was an accident where someone died, the surviving family members would be able to recover a maximum of $25,000 from your insurance. How would you feel if a family member died as a result of someone else’s negligence, and the maximum recoverable from the insurance was only $25,000.

The real problem arises when the injured party, not satisfied with the low insurance payout, begins to take steps to collect money directly from you. Your life savings could be put at risk all because you tried to save a few bucks paying a little less in auto insurance each year. This is generally a bad idea. Having higher limits of liability protects your assets in the event you have a claim where you might be held at fault for greater than $25,000 minimum limit available to any individual plaintiff. Virginia Liability policies range from 25,000/50,000 to 50,000/100,000, 100/300, 300/500, and 500/1mil. Having high Liability limits in Virginia, by law, also provides you with uninsured/underinsured motorist coverage equal to your liability coverage limits unless you elect otherwise. Having high underinsured motorist coverage limitscasn make the difference between receiving full recovery or receiving only what the defendant has in coverage. In this day and age, you should never rely upon the insurance coverage of someone else to provide you with the benefits you need. You need to protect yourself and your loved ones. One of the eaisiest ways to protect yourself and your family is to purchase high uninsured/underinsured motorist coverage. Continued in Part 2.

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Uninsured Motorists- About one in six drivers in the U.S. might be driving without insurance by 2010

Thursday, January 22nd, 2009

What happens if the person who injures you in a car accident has no insurance. Unfortunately, our sagging economy affects whether drivers can afford insurance, and causes some to allow their personal automobile insurance to lapse. Consider the following:

About one in six drivers in the U.S. might be driving without insurance by 2010, according to a recent study.

The estimated percentage of uninsured motorists decreased to 13.8 percent in 2007 from 14.9 percent in 2003, but it’s expected to sharply increase because of the recession, the Malvern, Penn.-based Insurance Research Council reported Wednesday.

The council estimated the number of uninsured motorists by using a ratio of insurance claims made by people injured by uninsured drivers to claims by people injured by insured drivers.

An increase of 1 percent in the unemployment rate is associated with an increase of nearly three-quarters of a percent in the uninsured motorist rate, the council reported. The council expects the rate to rise from 13.8 percent in 2007 to 16.1 percent in 2010.

How do you protect yourself and your family from uninsured drivers? The answer is relatively simple. When you purchase or renew your personal automobile insurance policy, consider your uninsured/underinsured insurance limits. You should make sure that you have enough of this coverage to cover you and your loved ones in the event of an accident.

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Fatalities on Virginia Roads -2007

Saturday, January 17th, 2009

Don’t become a statistic. Consider these facts, and take action to keep yourself safe.

  • Check your tires. The number one defect which contributed to fatalities on Virginia roads in 2007 was defects in the tires. Too many people do not pay attention to the tread on their tires. Considering that over two deaths per month on Virginia roads in 2007, it would be a good idea to periodically check your tires. Both under-inflation and over-inflation can cause a tire to lose its ability to grip the road as it was designed. Tires that are bald are dangerous and should be replaced. Any physical damage to the sidewall of the tire could contribute to causing an accident or worse. Pay attention to your tires and avoid becoming a just another statistic.
     
  • Slow down. The amount of time that can be gained by speeding is negligible. You might that you’re making up lost time as you speed on the roads, but you are putting yourself needlessly at risk. The number one factor contributing to Virginia fatalities in 2007 was speed. Fully 13% of all deaths on Virginia roads were caused by excessive speed. 
     
  • Stay in the right hand lane, and yield to other drivers. The second and third most common driver errors contributing to deaths on Virginia roads in 2007 were driving to the left of center line,and failing to yield. If you can drive in the right hand lane, do so. Let other cars pass and turn in front of yours. Stay safe.
     
  • Don’t drive when you are tired. There were 38 deaths on Virginia roads in 2007 caused by drivers who were either fatigued, or asleep. Over three people per month died becase they should have been sleeping instead of driving. If your tired or sleepy, pull over and get some rest, your life may depend on it.
     
  • Don’t drink and drive. Common sense. There were 82 deaths on Virginia roads in 2007 related to drinking and driving. If you must drink, do it at home and stay there. Use a designated driver, or call a taxi. It makes no sense to drink and drive.
     
  • Slow down in bad weather. It was raining during 66 Virginia traffic accident fatalities in 2007. 
     
  • Do not try to pass in a no passing zone. 19% of all Virginia vehicle fatalities occurred a driver was trying to pass another car in a no passing zone. 177 persons were killed as a result of someone who couldn’t wait, or thought the car in front was driving too slow.  No passing zones are there for a reason. Please obey the Virginia traffic laws and keep yourself and your family safe.

Source: 2007 Virginia Traffic Crash Facts: Virginia Department of Motor Vehicles

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2007 Virginia Car Accident Facts

Saturday, January 17th, 2009

2007 VIRGINIA TRAFFIC ACCIDENT FACTS

  • 1,626 persons were killed on Virginia roads in 2007, the last year with available statistics according to the Virginia Department of Motor Vehicles. That number represents a 6.76% increase from 2006.
  • While the number of deaths on Virginia roads increased in 2007, there were 68,822 injury accidents which represents 6.17% decrease in the number of injury accidents from 2006
  • There were 145,405 traffic accidents in Virginia in 2007, which represents a 4.14% decrease from 2006.
  • In all of Virginia, there were 378 persons needlessly killed in alcohol related crashes, a 1.07% increase from the prior year.
  • There were 7,130 persons injured in alcohol related crashes, which represents a 5.48% decrease from 2006.
  • 30 Virginia teenagers were killed in alcohol related accidents, representing approx. 3% of all Virginia traffic fatalities.
  • 759 Virginia teenagers were injured in alcohol related accidents.
  • In Virginia statewide for all of 2006, 25,243 persons were tested with a blood alcohol content of (BAC) of.08 percent or greater. This represents a 1.27% increase from the prior year. The average BAC of tested drinking drivers was .1407. Approximately 80% of of those drunk drivers were male.
  • In Virginia in 2006, 28,787 persons were convicted of DWI/DUI, a 2.73% decrease from 2006.
  • October 2007 was  the most dangerous month on Virginia roadways with the highest number of accidents (14,147), and the highest number of fatal crashes.
  • December 2007 was the most dangerous month of the year on Virginia roads with 1,079 alcohol related accidents. There were more alcohol related fatalities in September than in any other month in Virginia in 2007.
  • In Virginia there is on average one accident every 3.61 minutes. One driver out of approximately 20 is involved in a car accident each year. Roughly 3 lives are lost per day because of traffic crashes. 189 persons are injured per day as a result of traffic crashes.

Source: 2007 Virginia Traffic Crash Facts, Virginia Department of  Motor Vehicles.

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Virginia Motorcycle Accident Facts

Wednesday, January 14th, 2009
  • In 2007, roughly 12% of all motor vehicle fatalities statewide were motorcycle accidents. Motorcycles represent 3.3% of all traffic injuries.
  • There were 2,601 motorcycle accidents in 2007, 126 of those were fatal accidents or 13.4 percent of all motorcycle accidents.
  • In 2007, there were 165,584 motorcycles registered in Virginia with 1.6 percent of those involved in accidents.
  • Of the reported accidents, the number one driver action contributing to an accident was driving too fast.
  • The second most common driver action contributing to the accident was following to close.
  • The age group of motorcyclists who were most likely to be involved in a motorcycle accident was between 21 and 25 years old.
  • Roughly 90% of all motorcyclists involved in accidents were males.
  • 73% of all motorcycle accidents occurred during daylight hours.

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