Knee Injuries
Knee injuries and pain are extremely common and affects people of all ages. The knee joint is more vulnerable to injury because it takes the whole weight of the body and it takes extra force during regular activities like running, jumping and stair climbing. The causes are usually minor like strain and sprain where the pain is relieved within a few days. Sometimes, knee pain is caused by more serious injuries like from a fall, or from sports such as football, skiing, and netball. These might require a specialist medical care.
The common knee injuries include:
Patellofemoral pain syndrome
Patellofemoral pain syndrome (PFPS) is one of the most common knee complaints of all ages where the pain is felt behind the kneecap. Usually, kneecap pain is due to excessive kneecap (patella) pressure on the thigh bone (femur) from malalignment of patella. This results in irritation of the cartilage. The most common causes of patellar malalignment are an abnormal muscle imbalance and poor biomechanical control. In most cases, Iliotibial band (IT band) tightness is also observed. The sports where PFPS is typically seen are those when running, jumping, and landing or squatting is required.
Physiotherapy is one of the most effective treatment for this condition where the muscle imbalance is normalised through specific set of exercises. At MoveFree Physio we provide clear return to sport program for athletes.
Patellar Tendonitis
Patellar tendonitis or jumper’s knee is an inflammation of the patellar tendon that connects the kneecap (patella) to the shinbone (tibia). Patellar tendinitis usually results from repetitive trauma or overuse, particularly from sports activities involving jumping such as basketball and volleyball. Pain over the patellar tendon (below the kneecap) is the first symptom of this condition, especially during jumping or kneeling.
In acute phase, physiotherapy is aimed at reducing pain and inflammation. At a later stage, individualized exercise program targeting muscle strength, stability and flexibility is warranted. Sport specific rehabilitation is required for athletes to return back to sport. Shock wave therapy is also useful in aiding the recovery. At MoveFree Physio we offer both focused and radial shock wave therapy for patellar tendonitis.
ITB syndrome
ITB syndrome (Iliotibial band syndrome) is an overuse injury resulting from the inflammation of the iliotibial band. IT band is the tough group of fibers that starts from iliac crest of hip, runs along outside of the thigh, to get attached to the outer side of the shin bone. Being an overuse injury, ITB syndrome is caused by repeated trauma rather than a specific incident. It occurs when the IT band and the outer bony prominence of your thigh bone rub against each other. It commonly occurs in athletes, cyclists and runners due to training errors like quickly increasing distance with running or cycling and poor running techniques.
At MoveFree Physio we provide gait and running analysis using a computerized system to identify biomechanical abnormalities in runners which helps to optimize the running techniques in athletes.
In acute phase, physiotherapy is aimed at reducing pain and inflammation. At a later stage, individualized exercise program targeting muscle strength, stability and flexibility is warranted. Shock wave therapy is also useful in aiding the recovery. At MoveFree Physio we offer both focused and radial shock wave therapy for ITB syndrome.
Ligament injuries
A ligament is a short band of tough fibrous tissue which connects bones to other bones. Its main function is to provide stability to the joint by limiting the amount of mobility. Knee ligament injury is common in sporting activities that involves a sharp change in direction, landing wrong from a jump, or a blunt force hit to the knee, such as in football tackles. The muscle weakness or incoordination are usually a predisposing factor for ligament injuries.
The major knee ligament injuries include:
- ACL: Anterior Cruciate Ligament Injury
- PCL: Posterior Cruciate Ligament injury
- MCL: Medial collateral Ligament Injury
- LCL: Lateral Collateral Ligament Injury
It is always best to seek a professional advice when you suspect ligament injuries. The common signs of ligament injuries include:
- Pain and swelling
- Knee “gives way” or “buckles”
- Difficulty to weight bear
- “Pop” or “Snap” sound in the joint
- Sudden movement abnormalities
Hamstring Injury
A hamstring injury is a strain or tear to the tendon or the muscle bulk at the back of the thigh. They are common in athletes who participate in sports that require sprinting. There are three grades of hamstring injury:
- Grade I: A mild muscle pull or strain, may take a few days to heal
- Grade II: A partial muscle tear, may take around 6 weeks to heal
- Grade III: A complete muscle tear, may take up to three months to heal
A hamstring injury can occur if any of the tendons or muscles are stretched beyond their limit. Poor intermuscular coordination and eccentric strength in the hamstring muscle during the swing phase of sprinting is the primary reason for the injury.
At MoveFree Physio we provide gait and running analysis using a computerized system to identify biomechanical abnormalities in runners which helps to optimize the running techniques to prevent reoccurrence of hamstring injury.
Meniscus Injury
Meniscus is a fibrocartilage located in between the thigh bone (femur) and shin bone (tibia). Each knee has two meniscus, medial and lateral meniscus which cushions and stabilizes the knee joint. In the younger population, meniscal tear is usually traumatic by a sudden bend or twist in the knee. Elderly people are more prone to get degenerative meniscal tears as the cartilage wears out and weakens with age. The typical symptoms of meniscus injury are clicking, popping or locking of the knee, accompanied by pain along the knee joint line.
In acute phase, physiotherapy is aimed at reducing pain and inflammation. At a later stage, individualized exercise program targeting muscle strength and knee joint stability is warranted to restore normal function. Severe meniscus tear may require surgical intervention.
Osteoarthritis (OA) Knee
Osteoarthritis Knee is a common condition which happens not only to the aging population but to the young people too. OA Knee is known as an irreversible wear-and-tear condition of the knee cartilage. This condition may cause reduced joint space in the knee which increases the pressure and friction between the bones. After being exposed to prolonged friction and pressure, the knee joint may exhibit symptoms such as stiffness, pain, swelling eventually losing its range of motion and ability to weight bear. Trauma, over-usage of the knee, obesity, wrong movements, poor biomechanics are some common factors contributing to the early degeneration of the knee. OA knee is often graded on radiographs according to the criteria of Kellgreen and Lawrence, an ordinal scale of 5 levels:
- Grade 0, normal radiograph;
- Grade 1, doubtful narrowing of the joint space and possible osteophytes;
- Grade 2, definite osteophytes and absent or questionable narrowing of the joint space;
- Grade 3, moderate osteophytes and joint space narrowing, some sclerosis, and possible deformity; and
- Grade 4, large osteophytes, marked narrowing of joint space, severe sclerosis and definite deformity.
Through early assessment and evaluation, we can identify the real cause of the problem, which is essential to provide a rehab program to improve flexibility, strength and functional mobility of the knee.