Knee Pain
Apart from the low back, the knee remains the biggest cause of musculo-skeletal pain and disability. Knee pain is a common complaint that can affect people of all ages - from the young who have pain under the knee cap and growing associated disorders, to the high profile athlete who ruptures their cruciate ligament to the majority of us who experience increasing knee pain as we get older.
Physiotherapy is extremely important for knee injuries. It is essential that not only is the pain or lack of movement resolved the quadriceps and other knee and hip musculature must be strengthened in order to reduce the load through the injured knee and therefore break the "cycle of pain and dysfunction".
Ligaments
There are 4 main stabilising ligments of the knee - Cruciates (anterior- ACL and posterior- PCL) and the medial (MCL) and lateral collateral ligaments (LCL)
Most commonly injury are the ACL, and MCL and less frequently the PCL and LCL and is usally done in a incident where the knee 'shifts' or dislocates Symptoms
- Immediately swelling
- Unable to carry on playing
- A feeling of instability or the knee giving away
Tips for Ligament Injuries
If you have the above symptoms -
Follow the RICE and HARM rules
It is probably a wise idea to get your knee assessed by a Physiotherapist as the ligament injuries can be significant and left untreated may lead to earlier degeneration of the knee
Cartilage
There are 2 half moon shaped pieces of cartilage in the knee which act as a shock absorber. Sometimes these can be torn usually in a rotation type injury or together with a ligament injury
Symptoms
- Swelling of the knee
- A sensation of catching or clicking in the knee
- Locking of the knee ( when it gets stuck in a position)
- Pain on rotational movement or pivoting
- Pain on the inside/ outside joint line or behind the knee
Tips of Cartilage Injuries
Follow the RICE and HARM rules
Try to normalise function as soon as possible (ie walk on the knee)
Cycling may be beneficial initially to help clear the swelling out of the knee
A large proprotion of meniscal injuries will settle with a appropriate strengtheing program supervised by a physiotherapist
Patellofemoral
This correlates to pain originating from under the knee caps is probably one of the most common injuries / pain syndromes we see in the clinic. Over time or with injury the relationship between muscles can change around the knee to create a issue with the way the patella move up and down in it's groove (patella tracking). This will increase pressure of one side of the knee cap underneath and will result in patellofemoral pain
Symptoms
- Pain in the knee with walking downhill, downstairs sitting for long periods
- Diffuse knee pain around the front of the knee
- Occasionally creaking or crunching sound from under the knee cap
- Pain on activity like jumping or running
Tips for Patellofemoral Pain
This is really a issue of strength in the core, hip, knee and ankle along with the way that we move (biomechanics) Taping the knee may be beneficial Foam roller on the outside of the leg ( ITB) Starting a strengtheing program for the core and hip stabilisers along with the knee muscles Dry needling my help shut of over active muscles
Tendon
The large tendon on the front of the knee can get either torn acutely or over a period of time develop tendonopathy ( degenerative tendon). This is more affected in jumpers like volleyballers, basketballers etc
Symptoms
- Point tenderness pain in the patella tendon
- Pain on jumping and loading the tendon
- A knee that "warms up" but feels worse after activity
Tips for Tendon Injuries
Acute tears should follow the RICE and HARM principle Tears should then progress through a progressive loading program to remodel the tendon
Tendinopathies
Are in a state of degeneration and a progressive strengtheing and loading program is required to return to the tendon to a state where it can handle load
