KNEE
More information about each condition can be found below:-
How UFIXU manage knee injuries:
At UFIXU we will provide a short and effective home or gym exercise programme using the latest scientific research. Rest is important, although it is vital to build strength and conditioning into your rehabilitation. We will take a proactive approach and NOT rely on passive treatments (massage, acupuncture, manipulations etc) that have very minimal scientific evidence in helping long term. At UFIXU we pride ourselves on educating you on the best way to manage your injury so YOU can FIX YOU!
At UFIXU Physiotherapy we will take a full history and figure out the best treatment based on a number of factors including :
How old you are
Your overall health and health history
How much pain you have
How well you can handle specific medicines, procedures, or therapies
How long the condition is expected to last
Your opinion or preference
Runner’s Knee
What is it? Runner's knee means that you have dull pain around the front of the knee (patella). This is where the knee connects with the lower end of the thighbone (femur).
What is it caused by? Runner's knee may be caused by a structural defect, or a certain way of walking or running. Other causes may include:
A kneecap that is too high in the knee joint
Weak thigh muscles
Tight hamstrings
Tight Achilles tendon
Poor foot support
Walking or running with the feet rolling in while the thigh muscles pull the kneecap outward
Excessive training or overuse
Injury
What are the symptoms? Pain in and around the kneecap that happens when you are active. Or pain after sitting for a long time with the knees bent. This sometimes causes weakness or feelings of instability. Rubbing, grinding, or clicking sound of the kneecap that you hear when you bend and straighten your knee. Kneecap that is tender to the touch.The symptoms of runner's knee may look like other conditions and health problems. Always talk with a healthcare professional for a diagnosis.
How do I manage it? Stretching and strengthening exercises, especially for your quadricep muscles. Research has shown that eccentric loading (when the muscle lengthens) is extremely beneficial. DETAILS
Jumper’s Knee
What is it? Jumper's knee, also known as patellar tendinopathy, is a condition characterised by inflammation of your patellar tendon. This connects your kneecap (patella) to your shin bone (tibia). Jumper’s knee weakens your tendon, and, if untreated, can lead to tears in your tendon.
What is it caused by? Jumper’s knee is caused by overuse of your knee joint, such as frequent jumping on hard surfaces.
It’s usually a sports-related injury, linked to leg muscle contraction and the force of hitting the ground. This strains your tendon. With repeated stress, your tendon may become inflamed and/or develop degeneration.
What are the symptoms? Below are some of the most common symptoms of jumper's knee. However, you may experience symptoms differently. Symptoms may include:
Pain and tenderness around your patellar tendon
Swelling
Pain with jumping, running, or walking
Pain when bending or straightening your leg
Tenderness behind the lower part of your kneecap
The symptoms of jumper's knee may resemble other conditions or medical problems. Always see your healthcare professional for a diagnosis.
How do I manage it? Rest, applying ice, taping or wearing a knee support and massage therapy. DETAILS
Meniscus Tear
What is it? The meniscus is a crescent-shaped disc of cartilage found between the bones of the knee (the femur and tibia). Each knee has two menisci that cushion the joint. Depending on the severity of the tear, symptoms of a torn meniscus may include pain, swelling, stiffness, clicking or locking of the knee.
What is it caused by? Meniscus tears are common in contact sports like football as well as non contact sports requiring jumping and cutting such as volleyball and football. They can happen when a person changes direction suddenly while running, and often occur at the same time as other knee injuries, like an anterior cruciate ligament (ACL) injury. Meniscus tears are a special risk for older athletes since the meniscus weakens with age. More than 40% of people 65 or older have them.
What are the symptoms? Pain in the knee
Swelling
A popping sensation during the injury
Difficulty bending and straightening the leg
A tendency for your knee to get "stuck" or lock up
At first, the pain may not be bad. You might even play through the injury. But once the inflammation sets in, your knee will probably hurt quite a bit.
How do I manage it? DETAILS Meniscus tears are tough to prevent since they're usually the result of an accident. But some precautions might lower the risks of a knee injury. You should:
Keep your thigh muscles strong with regular exercises.
Warm up with light activities before taking part
Give your body time to rest between workouts. Fatigued muscles can increase your risk of injury.
Make sure your shoes have enough support and fit correctly.
Maintain flexibility.
Never abruptly increase the intensity of your workout
ACL
What is it? A ligament is a structure in the knee that holds the bones together and helps to control joint movement or motion. There is a ligament on each side of the knee (the collateral ligaments) and two ligaments deep inside the knee. The two ligaments inside the knee that “cross” each other are called the anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL). Both ligaments attach on one side to the end of the thighbone (femur) and on the other to the top of the shinbone (tibia). During activity, the ACL controls how far forward the tibia can "slide" relative to the femur: it essentially acts to prevent too much forward movement. While some degree of motion or sliding is normal and is required for knee function, too much motion may damage other structures in the knee which can lead to long term problems in some patients.
What is it caused by? The ACL can be injured or torn in a number of different ways. The most common mechanism is that of a sudden pivoting or cutting manoeuvre during sporting activity, which is commonly seen in football and basketball. The ligament can also tear due to work injuries or car accidents. At the time of the injury, a “pop” or “snap” can sometimes be felt or heard. The amount of pain experienced at the time of the injury is somewhat variable but can be quite severe. Typically, the person is unable to continue play or activity, and has the impression that a significant injury has occurred. Immediate swelling of the knee develops at the time of injury—within the first several hours—but the extent of swelling can be limited if the knee is immediately iced or splinted.
What are the symptoms?
A “pop” in the knee at the time of injury
Swelling of the knee
Inability to bear weight on leg (though some have little or no pain)
Instability of the knee
What are the different types of ACL injury or tears? ACL injuries are commonly classified in grades of 1, 2 or 3.
Grade 1
Grade 1 injuries include ACLs that have suffered mild damage, e.g., the ACL is mildly stretched but still provides adequate stability to the knee joint.
Grade 2
Grade 2 ACL injuries are rare and describe an ACL that is stretched and partially torn.
Grade 3
Grade 3 ACL tears happen when the ACL is torn completely in half and is no longer providing any stability to the knee joint.
How do I manage it? Treatment options are based on the patient’s symptoms, examination, the growth remaining in his or her growth plates, type of injury to the ligament, and the type of sports and activity goals. DETAILS
Nonsurgical
Nonsurgical treatment is most appropriate for grade 1 injuries. This would include immobilisation or bracing, Physiotherapy, and a gradual progression back to regular activities and sports.
Surgical
Surgical treatment is recommended for individuals with a grade 3 or complete ACL tear. Surgical options may vary based on the type of ACL injury, whether the patient has open or closed growth plates, and the type.
Tibial Spine Avulsion ACL Injury
Adolescents may also commonly have what is called a tibial spine avulsion ACL injury. With this type of injury, the ACL itself is not torn, but the bony attachment of the ligament to the tibia (lower leg bone) is pulled off. Depending on how far the bony attachment of the ligament is pulled off, the injury can result in weakness or instability of the knee if it is not fixed.
MCL
What is it? The medial collateral ligament (MCL) is one of the ligaments in the knee joint. A ligament is a tough, flexible band of tissue that holds bones and cartilage together.
The MCL is on the part of the knee closest to the other knee (the "medial" side). It connects the bottom of the thighbone (femur) to the top of the shinbone (tibia). The MCL helps keep the knee from moving side to side.
What is it caused by? When your outer knee is hit with force, and therefore causes a strain or tear. The MCL can tear if an injury stretches it too much. The tear might be partial (through a part of the MCL) or complete (all the way through the MCL). Most medial collateral ligament tears happen during athletic activity, such as when someone: changes direction or twists the knee while running and/or jumps and lands in a way that twists the knee. MCL tears happen most often during sports involving turning, cutting, and pivoting like skiing, football, basketball and tennis.
What are the symptoms? Pain alongside the inside of the knee, swelling and difficulty in walking. Most people who tear their MCL feel pain and a "pop" in their knee when the injury happens. Their knee usually swells soon after the injury, most of the time around the inside part of the knee. After the swelling goes down, they usually can walk, but feel pain when the inside of the knee is stretched, Also, the knee may feel unstable and can "give way" and make the person stumble or fall.
How do I manage it? Exercises to strengthen the leg muscles around your knee. DETAILS
Total Knee Replacement
What is it? Necessary when the knee joint is worn or damaged - affecting your mobility. Knee replacement, also called knee arthroplasty or total knee replacement, is a surgical procedure to resurface a knee damaged by arthritis. Metal and plastic parts are used to cap the ends of the bones that form the knee joint, along with the kneecap. This surgery may be considered for someone who has severe arthritis or a severe knee injury.
Various types of arthritis may affect the knee joint. Osteoarthritis, a degenerative joint disease that affects mostly middle-aged and older adults, may cause the breakdown of joint cartilage and adjacent bone in the knees. Rheumatoid arthritis, which causes inflammation of the synovial membrane and results in excessive synovial fluid, can lead to pain and stiffness. Traumatic arthritis, arthritis due to injury, may cause damage to the cartilage of the knee. The goal of knee replacement surgery is to resurface the parts of the knee joint that have been damaged and to relieve knee pain that cannot be controlled by other treatments.
What is it caused by? The most common cause of knee replacement surgery is osteoarthritis. Knee replacement surgery is a treatment for pain and disability in the knee. Osteoarthritis is characterised by the breakdown of joint cartilage. Damage to the cartilage and bones limits movement and may cause pain. People with severe degenerative joint disease may be unable to do normal activities that involve bending at the knee, such as walking or climbing stairs, because they are painful. The knee may swell or "give-way" because the joint is not stable.
Other forms of arthritis, such as rheumatoid arthritis and arthritis that results from a knee injury, may also lead to degeneration of the knee joint. In addition, fractures, torn cartilage, and/or torn ligaments may lead to irreversible damage to the knee joint.
How do I manage it? DETAILS If medical treatments are not satisfactory, knee replacement surgery may be an effective treatment. Some medical treatments for degenerative joint disease may include, but are not limited to, the following:
Anti-inflammatory medications
Glucosamine and chondroitin sulphate
Pain medications
Limiting painful activities
Assistive devices for walking (such as a walking stick)
Physiotherapy
Cortisone injections into the knee joint
Viscosupplementation injections (to add lubrication into the joint to make joint movement less painful)
Weight loss (for obese persons)
There may be other reasons for your doctor to recommend a knee replacement surgery.
Fat Pad Impingement
What is it? Occurs when the fat pad becomes pinched between the kneecap and the end of thigh. Fat pad impingement of the knee, also called Hoffa’s syndrome, is a common cause of pain in the front of the knee. However, we should differentiate this condition from other causes like patella tendinopathy or kneecap arthritis. The fat pads are found at the front of the knee just behind the patellar tendon and kneecap. Many doctors call them Hoffa’s fat pads. We think the fat pads act as shock absorbers during knee movement. Interestingly, the fat pads are the most sensitive structures in the knee, containing many sensitive nerves.
What is it caused by? Overload of the quadriceps - e.g when running or football. However, there are other reasons for pinching of the fat pads, including playing sports or a direct fall onto the knee. Generally, we think that too much activity or sport can cause pinching of the Hoffa’s fat pads between the knee cap and the femoral condyles. This pinching causes low-grade damage to Hoffa’s fat pads leading to inflammation and scar tissue. Usually, fat pad inflammation occurs with other knee conditions such as arthritis, patellar tendinopathy and meniscal tears.
What are the symptoms? Pain, swelling and inflammation. Typical complaints of fat pad syndrome include pain directly on the fat pads on either side of the kneecap and focal swelling. It is essential to rule out other causes of pain at the front of the knee, such as patella tendinopathy or kneecap arthritis. In some cases, imaging is needed to confirm the diagnosis. Often, we use ultrasound or MRI to look at the front of the knee. Usually, in Hoffa’s syndrome, we see swelling in the fat pads on MRI or high blood flow on ultrasound.
How do I manage it? Usually, we start with simple treatments. These treatments include exercise therapy to reduce the forces on the fat pads, leg stretching to relieve tightness. DETAILS
Bursitis
What is it? Knee bursitis is inflammation of a small fluid-filled sac (bursa) situated near your knee joint. Bursae reduce friction and cushion pressure points between your bones and the tendons, muscles and skin near your joints. Any of the bursa in your knee can become inflamed, but knee bursitis most commonly occurs over the kneecap or on the inner side of your knee below the joint.
What is it caused by?
Frequent and sustained pressure, such as from kneeling, especially on hard surfaces
Overuse or strenuous activity
A direct blow to your knee
Bacterial infection of the bursa
Complications from osteoarthritis, rheumatoid arthritis or gout in your knee
Knee bursitis is a common complaint, but your risk of developing this painful disorder can increase from:
Prolonged kneeling. People who work on their knees for long periods — carpet layers, plumbers and gardeners — are at increased risk of knee bursitis.
Participation in certain sports. Sports that result in direct blows or frequent falls on the knee — such as wrestling, football and volleyball — can increase your risk of knee bursitis. Runners can develop pain and inflammation in the pes anserine bursa, situated on the inner side of your knee below the joint.
Obesity and osteoarthritis. Pes anserine bursitis, affecting the inner side of your knee below the joint, often occurs in obese women with osteoarthritis.
What are the symptoms? Knee bursitis signs and symptoms vary, depending on which bursa is affected and what's causing the inflammation. In general, the affected portion of your knee might feel warm, tender and swollen when you put pressure on it. You might also feel pain when you move or even at rest. A sharp blow to the knee can cause symptoms to appear rapidly. But most cases of knee bursitis result from friction and irritation of the bursa that occurs in jobs that require a lot of kneeling on hard surfaces — so symptoms usually begin gradually and can worsen over time.
How do I manage it? DETAILS To avoid knee bursitis or prevent its recurrence:
Wear kneepads. If you're working on your knees or participating in sports that put your knees at risk, use padding to cushion and protect your knees.
Take breaks. If you're on your knees for a period of time, take regular breaks to stretch your legs and rest your knees.
Avoid excessive squatting. Excessive or repetitious bending of your knees increases the force on your knee joints.
Achieve and maintain a healthy weight. This can help take pressure off your knee joint.
