Apex Sports Clinic

Rise Above: Comprehensive Recovery and Treatment for Knee Injuries

Is maintaining proper knee health important ?

The knee is a complex joint that plays a pivotal role and maintaining knee health is an important aspect of overall wellness especially for athletes who depend on their knees for mobility and speed. Whether jumping or running, an athlete’s knee can endure a great amount of stress. In order to boost an athlete’s performance, one must make time to maintain proper care of their knees for a prolonged career.

The knee provides stability and balance and also serves as a medium to absorb the impact during sports activities. The knee helps reduce stress on the other parts of the body. Strengthening the muscles and maintaining good flexibility helps to prevent knee injuries. Some of the common knee injuries are caused due to sudden twisting or pivoting, direct impact on the knee, repetitive stress on the knee joint, improper landing, muscle weakness or even inadequate warm up exercises.

Types of Knee Injuries

1. LIGAMENT INJURIES

Anterior Cruciate Ligament (ACL) tear
The ACL is a major ligament that preserves the knee joint. This ligament helps to control the movement of the tibia (shinbone) and the femur (thighbone). A tear of the ACL occurs when the athlete makes a sudden change in the direction. Rapid pivoting, cutting, or sidestepping movements can also stress the ACL and cause it to tear.

Medial Collateral Ligament (MCL) sprain
The MCL acts as a stabilising ligament located on the inner side of the knee. This ligament prevents the knee from bending outward excessively. When the outer part of the knee gets hit or damaged such as a tackle in football or a collision in basketball, this can cause a sprain in the MCL causing pain and soon becoming unstable.

Posterior Cruciate Ligament (PCL) injury
The PCL ligament is also another important ligament that helps to stabilise the knee joint. A PCL injury occurs when there is a direct hit on the knee while landing on a bent knee or a ‘dashboard’ injury. PCL injuries are less common than ACL injuries, but they can still have a significant impact on knee function. Overextending the knee beyond its normal range of motion can also cause PCL injuries.

2. MENISCUS TEARS

The Meniscus is a C-shaped structure in the knee joint which serves as a cushion and also a stabiliser. The meniscus serves as a cushion between the femur (thighbone) and tibia (shinbone). Each knee has two menisci: the medial meniscus (on the inner side of the knee) and the lateral meniscus (on the outer side of the knee). Meniscus tears is a common injury when there is a twist or a rotation of the knee during activities like football or basketball.

3. PATELLAR TENDONITIS

Patellar Tendonitis also known as jumper’s knee is a condition which occurs when there is an inflammation in the patellar tendon. This tendon connects the kneecap (patella) to the shinbone (tibia). Repeated stress, improper technique, tight muscles or change in the intensity of training can lead to Patellar Tendonitis. An increased amount of tension on the patellar tendon may result either in weakness in the quadriceps or the adjoining muscles.

4. ILIOTIBIAL BAND SYNDROME (ITBS)

ITBS is a common injury that affects the Iliotibial (IT) band. The IT band is a thick band which runs from the hip to the outer side of the knee. This injury often occurs when there is a repetitive knee bending during activities like cycling or running. ITBS is caused due to uneven leg lengths, inappropriate shoes or repeated movements of the joint such as running or cycling. The pain may begin as a dull ache during activity and worsen over time. This injury is slightly more common in women than men.

PREVENTION AND PROTECTION

It is important to strengthen the knee for better flexibility and mobility. Quadriceps strengthening is one of the most important strengthening techniques to protect and prevent injuries. Exercises like
Leg extensions,
Squats,
And Lunges,
can help strengthen the quadriceps and improve flexibility allowing the athlete to perform movements more efficiently. It also contributes to overall power and speed and reduces the risk of injury in the hip and ankles.
Proper warm-up and cool-down techniques also act as a crucial tool to protect and prevent injuries. Engaging in 5-10 minutes of light cardio like walking or cycling improves blood flow and performing stretches such as leg swings or walking lunges helps to prepare the body for any sport activity. This practice helps to improve flexibility in the knee and in the surrounding muscles, reducing the risk of tightness and injury, prevents muscle cramps, increases blood circulation and helps in the removal of metabolic waste in the body. This technique makes the knee more resilient to injury.
Use of protective gear like proper shoes, knee braces and supports, arch support, pads and guards and orthotics. These gears protect the knees from injury and offer support during exercising. While knee braces and supports provide stability and protection against excessive movement, properly fitted shoes provide shock absorption, stability, and gripping. Arch support enhances comfort and prevents inappropriate stress on the knee joint by reducing weakness in the legs and knees and enhancing balance. The knees are protected from damage, impairment, and direct collision by pads and guards. By addressing certain physical difficulties, custom orthotics offer proper support and alignment, hence lowering the risk of knee injury and enhancing overall knee health.

HOW TO IDENTIFY A KNEE INJURY?

In case you experience,
A sudden or persistent knee pain when at rest, exercising.
Knee swelling, which could be a sign of accumulation of fluid or inflammation.
Knee pain when bending or straightening
Knee stiffness, particularly in the morning or after extended periods of inactivity.
Unusual sounds occurring from the knee, such popping, clicking, or grinding.
Noticeable deformity in the knee appearance that might point to a fracture or dislocation.

WHEN TO SEEK MEDICAL HELP?

You must seek medical help when there is

A severe pain that is not relieved by RICE (rest, ice, compression, and elevation)
Difficulty in bearing weight on the affected limb.
Knee swelling that is severe or chronic.
A knee that feels unstable or gives way.
A clearly deformed knee, suggesting a fracture or dislocation.
Incapacity to move the knee joint because of discomfort or other problems.

DIAGNOSIS AND TREATMENT

DIAGNOSIS – Evaluation of the patient’s symptoms, medical history, physical examination, diagnostic testing (such as imaging) and other evaluations are all necessary in the diagnosis of a knee injury. This comprehensive method helps medical professionals in precisely identifying the type, location, and severity of the damage, enabling them to design a successful treatment strategy customised to the patient’s requirements.

TREATMENT

Several conservative treatment options are available for knee injuries that can help control symptoms while promoting recovery. These consist of rest, ice, compression, elevation and medication.

Rest: Restricting activity that puts strain or pain on the damaged region is necessary when resting the knee. This delays additional damage and allows the knee to recover.
Ice: By narrowing blood vessels and reducing inflammation, using ice packs to the injured knee for 15 to 20 minutes every two to three hours helps lessen swelling and discomfort.
Compression: Applying a knee brace or elastic bandage to the knee gently compresses it, which helps to minimise swelling and offers support.
Elevation: When lying down, raising the knee above the level of the heart promotes fluid outflow and helps in the reduction of swelling.

Physical therapy and rehabilitation also helps in treatment. This includes a range of techniques to support the healing and general health of athletes with knee injuries. A medical professional can design customised workout plans to improve range of motion, strengthen the knee, and increase flexibility. Heat or cold treatment, electrical stimulation, ultrasound, and other techniques also help in the reduction of pain and promotion of healing. Exercises improve stability and guard against injuries in the future.

When conservative measures like rest, physical therapy, and medication fail to significantly reduce the symptoms of a knee injury or when the injury is severe, surgery may be an option. For a variety of knee conditions, including fractures, meniscus tears, ligament tears, and cartilage loss, surgery may be required.

Some of the common surgery option include,
Arthroscopy: a minimally invasive technique where a knee injury such as a meniscus tear, cartilage damage, or ligament damage is diagnosed and treated by a surgeon using a small camera (arthroscope) and specialised tools.
Reconstruction of the Knee Ligament: It is a surgery to replace or repair injured ligaments, such as the PCL and ACL, in the knee. This could involve using tissue from a donor (allograft) or from another area of the body (autograft).
Meniscus Repair: Meniscus surgery is performed to repair damaged tissue that serves as a cushion between the tibia and femur.
Arthroplasty, or knee replacement: Severe inflammation or substantial joint deterioration may require a whole or partial knee replacement. Damaged joint surfaces are replaced with prosthetic parts during this procedure.
Repairing cartilage: Damaged cartilage can be repaired using techniques including osteochondral autograft transplantation (OAT), autologous chondrocyte implantation (ACI), and microfracture.

RECOVERY AND REHABILITATION

Recovery and rehabilitation are essential parts of knee injury treatment that guarantee a successful return to regular sports activities and exercise. Depending on the type and severity of the damage, different procedures apply.

Sprains: With appropriate rest and care, recovery usually takes a few days to a few weeks.
Tears in the meniscus: Depending on whether surgery is necessary, recovery can take four to eight weeks for mild tears and up to three months for more serious injuries.
Ligament Damage (such as PCL, MCL, and ACL): The duration of recovery varies according to the intensity and type of treatment. While less severe injuries (particularly those that occur after surgery) could heal in a few weeks, more serious injuries might take up to six months to fully heal.
Cartilage Damage: It may take many months to recover, depending on the amount of the injury and whether surgery is required.
Fractures: Depending on the type and location of the fracture, bone healing often takes six to twelve weeks. Rehabilitation and total recovery may take several months.

Since the knee is a vital joint involved in several activities, including running, jumping etc, maintaining knee health is crucial for achieving peak sports performance. Athletes may maximise their performance while lowering their chance of injury when their knees are working properly. Athletes can sustain strength, flexibility, and stability in their knees, all of which are necessary for optimal performance in a variety of sports.
Therefore, to maintain their knee health and performance, athletes should seek treatment as soon as they experience pain or injury and give priority to preventative measures including appropriate training methods, protective equipment, and strength and flexibility exercises.