Knee Injury

Knee Injury

Whether you play sport socially or professionally, a knee injury can put you out of action. Physiotherapists provide expert advice and treatment to speed up recovery and get you active again following knee injury or surgery.

Types of knee injuries

Acute injuries: result from a sudden trauma, such as an awkward fall, collision or twist of the knee joint. Overuse injuries: result from continuous activity or overload, such as running, jumping, cycling, weight training or bush walking. These start gradually and usually relate to a range of factors such as structural or bio mechanical problems, training methods, footwear, technique or running style.

Acute injuries

The ligaments and menisic (cartilage) of the knee may be injured. 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 (meniscal) tears: the knee cartilages (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 successfully treated without surgery by physiotherapy treatment and supervised rehabilitation. If damage is sever, surgery mat be required. Physiotherapists work closely with medical practitioners, sports physician's and orthopaedic surgeons to assist recovery and rehabilitation.

Overuse Injuries

These are much more common that acute injuries, and usually effect the patello-femoral joint or patella tendon, if left untreated they often get progressively worse. Early diagnosis and treatment may result in a quick recovery, and less pain. Patello-femoral syndrome: squatting or stair climbing. Patella tendinopathy: the patella tendon joins the thigh muscle to the leg bone. Injury to this tendon may be known as 'jumper knee', because it commonly occurs with repeated jumping and landing activities (basketball, volleyball etc). Management tips: physiotherapy treatment is essential to reduce the 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:

• Warm-up and warm-down before and after exercise.
• Build up your exercise program gradually increasing the frequency, duration and intensity, but don't work  through pain.
• Maintain good general fitness and lower body strength and flexibility (especially calves, quadriceps and hamstrings).
• Practise standing on one leg to improve your balance and leg muscle strength.
• Skiers - get a qualified ski technician to check your binding settings (bindings must be set to weight and skill level). 

When to return to work/sport

Your physiotherapist will discuss the injury with you and estimate the time it will take to recover. This will vary from weeks to months depending on the severity of the injury. The pain and swelling associated with an acute injury subside much faster than the time it takes for the ligament and muscles to regain normal strength. Returning to work or sport too early may delay healing and prolong recovery. Your physiotherapist can teach you how to tape your knee or fit you with a knee brace if required. Your physiotherapist can help you to plan alternative ways to maintain your fitness and muscle strength while you are recovering from your knee injury.

What to do after a sprain

As soon as possible, and for 72 hours after injury, use the rice method: rest take it easy and only move within your limit of pain. Ice as soon as possible, and for 20 minutes every two hours, apply ice or a frozen gel pack wrapped in a damp towel. This helps to control bleeding and pain reduces secondary tissue damage. Compression bandage the knee firmly and include 5 cm above and below the joint. This helps to control swelling. Elevate as much as possible, elevate your leg higher than the level of your heart to reduce swelling.

How physiotherapy can help

Your physiotherapist will examine your knee to determine the type, extent and causes o your injury, and can order an x-ray or refer you to a doctor if needed. Early treatment will reduce any pain or swelling. Special techniques called mobilisation may help to increase the movement of your knee joint (if required), improving your recovery. Your physiotherapist will teach you exercises to improve the strength of the knee and other lower leg muscles to enhance your recovery and help prevent further injuries.

Rehabilitate

Recovery can start very early after an injury. Physiotherapy rehabilitation techniques will help reduce the time that your knee is painful and movement is restricted so that you can get back to work and sport more quickly. Rehabilitation also facilitates a good quality ligament repair and the return of normal muscle 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: heat, alcohol, running, massage.

Source of information - APA