Knee Pain

Know More: The key to the knee is understanding the V.M.O.

Hedley Piper

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English

The Choir Press
12 October 2023

Musculoskeletal medicine; Pain & pain management; Coping with illness

Understanding of knee pains seems poor in many quarters. There is inaccurate guidance for the rehabilitation of the quadriceps muscles based on derivative information that was incorrect. The anatomy of the nerve to the vastus medialis oblique and functional considerations following from this have been ill understood in the orthopaedic and physiotherapy worlds. Knee Pain: Know More is written for the layman with a view to self-help. The hope is that a demand from the layperson for better treatment might trigger interest from the professionals. The Science section includes photos of the nerves to the quadriceps and discussion of the implications of their different sizes. For example the probable size of the motor units of the V.M.O. is that they are significantly smaller than the other quadriceps muscles, i.e. their function is fine control, steering and co-ordination, and not simply power production. In consequence they are much more susceptible to pain and the incoordination it causes. Simply put, re-education of the V.M.O. function can significantly reduce knee pain, speed recovery after injury including surgery, and often it can reduce the need for surgical intervention. There are opinions and simplifications to make the book more easily digested by the lay reader of which I am well aware, but the science, published and unpublished is accurate. There is no attempt to list references of papers on the knee and related topics. They would be vastly longer than the text in the book. They would be inappropriate for the layman and the professional should already be cognisant of them during their training.

By: Hedley Piper
Imprint: The Choir Press
Country of Publication: United Kingdom
Dimensions: Height: 234mm, Width: 156mm, Spine: 11mm
Weight: 307g
ISBN: 9781789633450
ISBN 10: 1789633451
Pages: 214
Publication Date: 12 October 2023
Audience: General/trade , ELT Advanced
Format: Paperback
Publisher's Status: Active

Hedley Piper, FRCS is a retired UK consultant orthopaedic surgeon. He trained in the NHS of the early 1970s. It was a surprisingly wide general surgical exposure. At 30 with his fellowship, he moved to practise for four years as a surgeon GP in a remote town in central British Columbia, Canada. (There was a rock at the roadside testifying to this.) Fielding all the trauma of logging, farming, mining and many miles of open, unpaved roads proved the benefit of those long hours at the NHS coal face. ‘Trauma’ took on new perspectives! Obstetrics and gynaecology, autopsy and social pathology were all in a day’s work. He refocused on orthopaedic surgery in 1978; three years of residency at McGill, Montreal, required a greater focus on the obscure details of orthopaedic pathologies. There was a lot to read and ingest. Then married with two children and nearly 10 years of very general orthopaedic practice in Montreal, hovering on the edge of academia but having to make a living, he returned to the UK in 1992 and was appointed as a consultant orthopaedic surgeon in Yorkshire. The irony of orthopaedic surgery is that it is the management of multiple aches and pains not really covered in formal orthopaedic training, possibly because those teaching and writing the books were still too young to actually have experienced aches and pains. The ideas in this book are based on 35 years of continuous and varied surgical practice—the problems of the knee being but a small part.