The knee is the only soft tissue (synovial), weight bearing joint in the body. It is a common site for traumatic, degenerative and inflammatory disorders.
Patello-femoral pain syndrome is the most common overuse injury in the knee related predominantly to long distance running and jumping. The patient usually presents with diffuse ill-defined pain over the front of the knee. Pain is related to negotiating stairs, squatting and running on hard surfaces. Sitting for prolonged periods causes stiffness in the knee region. Crepitus (clicking) occurs in some cases. The quadracep muscle acts like a dynamic shock absorber and controls the gliding of the knee cap. It tends to be weak in these individuals which further predisposes the knee to injury. Poor lower limb biomechanics can also be a contributing factor.
How is PATELLO-FEMORAL PAIN treated by Physiotherapists?
The physiotherapy treatment involves pilates-like exercises to strengthen the inner thigh quad-stabilising muscles (VMO). The McConnell pattelo-femoral strapping technique is designed to support, deload and control the gliding of the knee cap. Acupuncture and electrotherapy modalities, deep tissue massage and mobilisation techniques are also used. Corrective shoe orthotics, wearing soft supportive training shoes and an ongoing modified cross-training exercises program designed by the physiotherapist will allow for complete recovery. Weight loss should also be encouraged.
Patellar tendonitis is an overuse condition related to inflammation of the knee tendon where it inserts into the tibial bone below the knee cap. This condition occurs particularly in high impact runners and ballet dancers.
How is PATELLAR TENDONITIS treated by Physiotherapists?
A supportive deloading brace and deep tissue massage, ultrasound and vmo (quad) strengthening exercises are advised.
Anterior cruciate ligament (ACL) is the most common ligament injured in high velocity sports. It is the most important ligament in the knee as it provides vital rotational stability to the knee joint. The mechanism of injury is usually rotation on a weight-bearing leg or hyper extension (i.e. changing direction whilst running). The patient is usually conscious of a ‘giving way’ feeling and is unable to continue playing. The physiotherapist will examine the knee using a series of stress tests to determine if the ACL is completely ruptured. MRI should be used to confirm diagnosis. Post reconstructive surgery, the patient will immediately commence on an accelerated ACL rehabilitation protocol.
How is ANTERIOR CRUCIATE LIGAMENT (ACL) injury treated by Physiotherapists?
Physiotherapy treatment will involve ice, electrotherapy modalities, mobilization techniques and deep tissue massage. Closed chain and functional rehabilitation exercises will be designed by the physiotherapist to strengthen quadriceps and hamstring muscles. Explosive sprinting and pivoting should be avoided for six months post surgery.
Medial meniscal injury is a torn cartilage (meniscus) which occurs predominately in the 20-30 year age group. This is a common sporting injury and also appears in occupations involving prolonged squatting or kneeling. Degenerative tears can also occur insidiously with the normal ageing process.
The mechanism of injury is rotation on a weight bearing leg, Pain is sudden, severe and located over the involved joint line. The patient is unable to continue with activity. Swelling is always present over the knee region with occasional locking if a fragment occurs.
How is MEDIAL MENISCAL INJURY treated by Physiotherapists
Physiotherapy treatment involves electrotherapy modalities, ultrasound and mobilization techniques. Sports specific rehabilitation exercises, strengthening the quadricep and hamstring muscles becomes imperative.