Knee injuries are common whether they happen due to sports or even in regular activities. Some injuries are due to overuse and some as a result of Acute Trauma.
Most injuries would heal with rest, ice and time, but some may be difficult to resolve.
For those involved in active sports, a strong knee is very important for a good performance and to prevent injuries. Prevention is better than cure, thus having good strength and conditioning program before you increase your activities is always helpful as it reduces the risk of injuries.
Good quadriceps and hamstring strengths helps the knee function better and makes it less likely to get ligament or cartilage injuries during sports.
COMMON KNEE INJURIES
There are two menisci or cushions in your knee; each rests between the thigh bone (femur) the shin bone (tibia). Their function is to:
- Assist in distributing your body weight across the knee joint
- Increase joint stability
- Shock absorption
Acute injury involves twisting injury with foot anchored on the ground.
Medial Meniscus Injuries (inner) happen more frequently than the Lateral Meniscus Injury (outer). Players usually experience mechanical problems with the knee, often with the “locking or giving way”.
There may also be degeneration of the medial or lateral menisci with sports like runing.
Ligaments connect one bone to the other and the knee has four major ligaments:
The ligaments inside your knee joint are called ACL and PCL which cross in the center of the knee like a Cruicifix. These two provide stability to the knee especially in forward and backward movements in sports that involve pivoting and quick turning and twisiting on the knees
- ACL or Anterior Cruciate Ligament is a major stabilizer of the knee. Tears occur when twisting forcefully on a planted foot and this leads to instability and pain.
- PCL or Posteriour Cruciate Ligament gets injured by direct impact on front of the knee, usually when it is slightly bent. This results in instability with the “giving way” feel.
The ligaments on either side of the knee are called MCL and LCL. They provide sideways stability to the knee.
- MCL or Medial Collateral Ligament is on the inner side of the knee. It can be sprained when the knee is twisted in the straight position as being knocked sideways, like when being tackled in football.
- LCL or Lateral Collateral Ligament is on the outer side of the knee. It may get injured with sideward pressure on a straight knee.
A fracture may happen as a result of direct or indirect trauma and may involve the patella, femur or tibia.
OTHER COMMON KNEE PROBLEMS
Chondromalacia Patella CMP: Happens when the patella glides through the groove with a lateral shift during the knee movement. This causes irritation of the cartilage between the patella and the femur and often results in pain.
Pain is mainly with stair climbing, prolonged sitting and knee bending with weight bearing exercises. Pre-disposing factors may include flat fleet, overuse, tight muscles on the outer side of the knee, injury or weak muscles on the inside of the knee (vastus medialis).
Iliotibial Band Syndrome: is often seen in runners. It is a tight band of muscle and connective tissue on the outer thigh which causes stress on the knee resulting in pain with movements.
Osgood Schlatter’s Disease: is seen in adolescents who develop pain and a bump just below the knee due to constant overuse and traction on the insertion of the patellar tendon.
Immediate treatment should include: R.I.C.E.S. – Rest, Ice, Compression, Elevation and Support
The doctor may prescribe:
- Anti-inflammatories for pain and swelling
- X-rays or MRI depending on the injury
- Surgery if required
- Splinting or support for the knee
In non-operated as well as operated knee injuries, this is useful in regaining the pain relief as well as function. Early exercise with controlled movements prevents muscle atrophy.
Mobilization & Manual Therapy: Significant effect to restore restricted mobility of the knee joint and kneecap. This aids to reduce pain, muscle spasm and stiffness.
Interferential Therapy: The application of a medium-frequency electrical current stimulates the peripheral sensory and muscle nerve fibers and reduces pain and inflammation.
Electrical Stimulation: Re-establish/re-educate muscle activation and strength of the thigh (quadriceps muscle) through electrical stimulation. This reinforces stability and strength of the knee.
Ultrasound: The application of ultrasonic waves causing improved cell metabolism and cell membrane permeability, thereby enhancing tissue healing.
Exercise Therapy: Depending on the different phases of rehabilitation program, exercises may include stretches, gait re-education and muscle strength, stability and stamina.
A personalized exercise programme to be done at home and in clinic will include appropriate education and exercise progression to enable you to return to your highest functional level.
- Get a well planned exercise program for your knee muscles for preventing undue stress on the knee during sports.
- Use proper foot wear.
- Good practice and training for your sport will make accidents less common.
- Previous injuries that haven’t healed or been rehabilitated can increase risk of further injury – so get them checked.