The knee is one of the most commonly injured body parts. The knee joint is made up of four bones. The femur (thigh bone) attaches via ligaments and a capsule to the tibia (lower leg bone). Just below and running parallel to the tibia is the fibula. The patella (knee cap) travels over the knee joint as the knee bends.
The knee is able is able to bend and straighten and slightly rotate. The quadriceps muscles are at the front of the knee, and the hamstrings are behind. Ligaments hold the joint together.
Some common knee injuries include:
The meniscus is the cartilage in the knee between the femur and tibia. It is generally injured with twisting injuries where the foot is grounded. Symptoms include pain on one or both sides of the knee, occasional jarring of the knee and pain along the joint line. Mobility will often feel restricted and swelling may be present.
Physiotherapy management includes the use of ice to control inflammation, techniques to restore movement of the knee, ultrasound, and exercises to increase strength and stability. Strapping tape may also be used to offload the menisci, lower pain and provide stability.
In more severe cases, meniscal tears may require surgery.
Patellofemoral Joint Syndrome (PFJS)
Pain surrounding the patella (knee cap) can be caused by an uneven pull of muscles around the knee. This causes the patella to track towards one side (usually the outside of the knee) and creates friction behind the patella. Long term, this can lead to premature degeneration. Pain is often brought on by running, squatting and descending stairs.
Physiotherapy treatment targets correcting the muscle imbalance and includes; taping to realign the patella, massage to release tight muscles, a structured exercise programme to strengthen weak muscles and graduated return to activity. Great results are often seen for Patellofemoral pain with early physiotherapy intervention.
ITB Friction Syndrome
The iliotibial band (ITB) is the muscle running down the outer side of the thigh, attaching to the outside of the knee. Sometimes, this muscle band becomes overactive and tight, causing pain over the outer side of the knee. It is often brought on by running and cycling.
Management will typically include deep massage techniques to release tight muscles, strengthening exercises for weak muscles, acupuncture, ultrasound, taping techniques (including Kinesio Tape), advice concerning activity modification and a graduated return to exercise. Biomechanical issues must also be looked in to.
Cruciate Ligament Injuries
These ligaments are found inside the knee joint. They cross each other to form an “X” with the anterior cruciate ligament (ACL) at the front and the posterior cruciate ligament (PCL) at the rear. The cruciate ligaments have a critical role in stabilising the knee joint.
The most common of the cruciate ligaments to be injured, often due to a sporting injury, is the ACL. ACL tears can also occur following motor vehicle accidents, falls, and work-related injuries. Generally, ACL tears occur when pivoting or landing. The knee usually collapses when the ACL is torn.
Symptoms include pain and swelling, a feeling of “instability”, collapsing of the knee and pain with walking and sport.
An ACL injury can range from a minor sprain to a full tear. In the case of a full tear, surgery is usually required.
Physiotherapy management involves restoration of mobility of the knee, techniques to manage pain and swelling, strapping or bracing, strengthening and stability exercises and a graduated return to activity.
Collateral Ligament Injuries
These ligaments are found on either side of the knee. The medial or “inside” collateral ligament (MCL) connects the femur to the tibia. The lateral or “outside” collateral ligament (LCL) connects the femur to the fibula. The collateral ligaments control the sideways movement of your knee.
Injuries to the collateral ligaments are generally caused by a force that pushes the knee sideways.
Assessment will include specific tests to determine the structures involved and the degree of injury. Physiotherapy management will usually involve ultrasound, taping techniques to assist the knee while it heals, and exercises to return function and strength. Techniques to reduce the formation of scar tissue in the injured ligament and to prevent recurrence of the injury will also be used.
Seeing a Physiotherapist sooner rather then later will produce greater results in a shorter period of time. If you feel any pain at all make sure to seek professional advice.