Physiotherapy of Knee Injuries
Cartilage (Meniscal) Injuries
The cartilage or menisci are two discs which lie in the middle of the knee joint and act as shock absorbers for the knee joint. In sports the cartilage is most often damaged when the foot is on the ground, the knee is bent and the knee is then twisted. The most common symptoms of a meniscal injury are knee pain and swelling, often accompanied with a restriction of movement and clicking or locking of the knee joint.
Medial Collateral Ligament Injuries
The medial collateral ligament (MCL) is a band which lies on the inside of the knee joint and connects the femur or thigh bone to the tibia. It provides stability to the knee joint by preventing widening or opening of the joint. The MCL is most commonly injured by a force to the outside of the knee joint which causes the ligament on the inside of the knee joint to be stretched too far. It can also be caused by a severe twisting injury. The injury can range from overstretching or a tear of part of the ligament to a complete tear. The most common symptoms of an MCL injury are pain and tenderness directly over the ligament. There may also be swelling around the ligament and in more severe cases a feeling of instability in the knee joint.
Cruciate Ligament Injuries
The anterior and posterior cruciate ligaments are two ligaments on the inside of the knee joint which are responsible for stability in the joint. Although both can be injured it is the anterior cruciate ligament (ACL) which is most commonly injured in sports. It is usually injured during pivoting movements. There will usually be quite a lot of pain and swelling with an ACL injury and the knee may “give way” or feel very unstable.
Patellofemoral Pain (Runner’s Knee)
Patellofemoral pain is very common in athletes and particularly in runners, hence the name runner’s knee. It involves irritation of the cartilage on the undersurface of the kneecap. Normally the kneecap glides smoothly on the thigh bone or femur, however, often due to muscle imbalances around the hip and knee there may be more pressure under certain parts of the kneecap and the cartilage gets irritated in these areas thereby causing pain. The main symptoms of patellofemoral pain are pain around the kneecap, which may be aggravated by running.
Treatment of knee injuries will involve reducing any inflammation that may be present, manual therapy to restore normal range of motion and the provision of functional and sports- specific strengthening programmes aimed at returning the athlete back to sport. A biomechanical assessment may also identify any underlying muscle imbalances which may have predisposed the athlete to an injury and therefore prevent reoccurrence of the injury.