Acute knee injuries can arise from sudden trauma, such as an awkward fall, collision or twist of the joint. Overuse injuries result from continuous activity or overload, such as running, jumping, cycling, weight training or bushwalking.
These start gradually and usually relate to a range of factors such as structural or biomechanical problems, training methods, footwear, technique, running style and/or insufficient resting periods.The knee joint is comprised of various components including ligaments and menisci (cartilage) which are susceptible to injury.
Ligament sprain (or tear): Ligaments stabilise or strengthen joints. Over-stretching can cause tears to the ligament fibres, resulting in pain, swelling, loss of movement and giving way (instability).
Cartilage (meniscus) tears: The knee cartilage (or menisci) also provide stability to the knee joint. They are mostly torn during weight-bearing activities that involve twisting and turning. A torn cartilage (or meniscus) results in pain, swelling and locking or catching of the joint.
Management tips: Many injuries may be treated successfully through physiotherapy and a supervised exercise rehabilitation programme without requirement for surgery. Depending on the severity of the damage, surgery may be indicated.
These are much more common than acute injuries of the knee and typically affect the patello-femoral joint or patellar tendon. If left untreated they often become more progressively sore. Early diagnosis and management will often result in a quicker recovery and, more importantly, reduced pain.
Patello-femoral syndrome: Patello-femoral (or kneecap) pain affects approximately 20% of the population, and is associated with activities such as running, squatting or stair climbing.
Patellar tendinopathy: The patellar tendon joins the thigh muscle to the leg bone. Injury to this tendon may be known as “jumper’s knee”, because it commonly occurs with repeated jumping and landing activities (basketball, volleyball etc).
Management tips: Physiotherapy treatment is essential to reduce pain and disability associated with overuse knee injuries. In addition, physiotherapists are well trained to address potential aggravating factors that may have contributed to the development of the overuse injury.
Can Knee Injuries be prevented?
You may reduce the chance and severity of knee injuries by implementing the following strategies:
- Appropriate warm up and cool down procedures before and after exercise respectively.
- Gradually increase the frequency, duration and intensity of your exercise programme, but don’t work through pain.
- Maintain good general fitness, lower body strength and flexibility (especially calf, quadriceps and hamstring).
- Take care of your core muscles. They are central to movement and help promote stability and appropriate biomechanics.
- Practice standing on one leg to improve your balance and leg muscle strength
Skiers – get a qualified ski technician to check your binding setting (bindings must be set to weight and skill level)
When to return to work/sport
Your physiotherapist will discuss the injury with you and give you a timeframe for anticipated recovery and return to sport. This will vary from weeks to months in time and is dependant upon the severity of the injury and how the injury is managed. The pain and swelling that is commonly associated with acute injuries subsides much faster than it takes for the damaged structure to regain pre-injury strength levels. Returning to work or sport too early may delay healing, prolong recovery and, in unfortunate cases, worsen the severity of the original injury.
Your physiotherapist can teach you various and alternative methods to assist in stabilising the injured knee by fitting you with a brace, demonstrating and providing various strapping techniques whilst teaching you exercises to maintain fitness and strength whilst recovering from injury.
Good recovery begins with the application of the RICE and NO HARM protocols which promote reduced swelling and pain associated with injury. Physiotherapy rehabilitation techniques will help reduce the time that it takes for your painful knee to recover and return to work and/or sport more quickly. Rehabilitation also facilitates a good quality ligament repair and the return of normal muscle strength and nerve function. Avoid any of the HARM factors in the first 48 hours to prevent increased swelling and help your recovery. The HARM factors are:
Don’t forget to apply the RICE factors which are: