Common Knee Injuries

Meniscal Injuries often occur when the knee is forcefully twisted with the foot on the ground. This type of injury is common in contact sports and sports where the knee is heavily loaded. this injury results in damage to the cartilage surface of the knee and is most common in the medial compartment of the knee. this occurs because the medial cartilage of the knee is fixed and therefore has less flexibility during movement resulting in an increased risk of tear.

Anterior Cruciate Ligament (ACL) tears occur when the knee is forcefully twisted or stressed during impact. the anterior cruciate ligament prevents anterior translation of the tibia on the femur. This means it prevents the lower leg moving forward relative to the upper thigh. When torn sometimes a pop is heard and there is significant swelling. ACL injuries often require surgical intevention and repair particularly in the sporting population. The most common graft used to replace the ACL is the hamstring tendon graft but patella tendons and synthetic versions are also used.

Posterior Cruciate Ligament (PCL) tears occur when the knee is forcefully twisted or stressed often during impact. The posterior cruciate ligament prevents posterior translation of the tibia on the femur and external rotation. This means it prevents the lower leg moving backwards relative to the upper thigh. When torn sometimes a pop is heard and there is significant swelling. PCL injuries can most often be maged conservatively however sometimes require require surgical intevention and repair particularly in the sporting population where rotatory stability is important.

Lateral Collateral Ligament (LCL) tears commonly occur when there is an excessive varus stress applied to the knee. This means that the lower leg is forced away from the other knee into a bow leg type position. These injuries are normally managed conservatively with bracing and physiotherapy management to maintain muscle control reduce swelling and control range of motion.

Medial Collateral Ligaments (MCL) are often damaged when an excessive valgus stress is applied to the knee. This normally means the foot is planted and a force is directed from the outside of the knee as the knee is pushed into a knock knee position. These ligament injuires are managed conservatively with an emphasis on reducing swelling, maintaining range of motion and muscle control to allow the ligament  to heal.

Articular Cartilage damage can occur when either the cartilage on the ends of the long bones on the knee becomes damaged either through wear and tear or trauma. These injuries can vary in severity and depending on the degree of damage to the bone may require surgical intervention. One such opertaion is microfracture where the bone in the joint is scraped or damaged to promote bleeding into the damaged area eventually forming an internal scar which acts like the cartilage. Physiotherapy is required post operatively to reduce swelling, maintain range of motion, muscle strength and control.

Patella Dislocation occurs when the patella is forced out of the groove onto the lateral aspect of the femur. Non traumatic disloctaions are treated with physiotherapy and control exercises, second dislocations are often treated surgically with a washout and recurrent dislocations are stabilised with surgery. Each of these scenarios requires physiotherapy to reduce pain, swelling and improve range of motion and muscle control.

Fat Pad Impingement can occur as a result of hyperextension of the knee. This condition can be extremely painful with swelling and tenderness extending below the patella tendon. Physiotherapy can be used to maintain range of motion reduce swelling and improve muscle control around the knee.

Patellofemoral pain is also commonly referred to as "runners knee". The condition arises when here is a mismatch between the muscles that control the position of the kneecap during movement. Commonly this occurs when the lateral muscles of the thigh become excessively overactive and the muscles of the inner thigh become underactive. This often results in a lateral shift of the patella during functional tasks such as walking up and down stairs. Normally the patella is held in a groove by optimal muscle activity. In patello femoral pain the aberrant kneecap position creates inflammation and pain.

Patella Tendinopathy is a degenerative condition of the tendon which connects the patella (kneecap) to the long bone of the shin. It arises due to excessive loading over a long period of time. The degenertaive nature of this condition means that the physiological changes in the tendon can be present well before pain begins. This condition is best managed with specific eccentric exercises to load the tendon and improve the structure in addition to changes in equipment, training load and modification of biomechanics. With correct management the time to recovery can be anywhere between three to twelve months.

Osgood-Schlatters lesion occurs due to degnerative change in the region of insertion of the patella (kneecap) on the long bone of the lower leg. This condition occurs in girls and boys between the ages of ten and fifteen years. It occurs in periods of rapid growth and high levels of physical activity. Modification of activity and changes in biomechanics through the use of various devices may limit the discomfort associated with the condition. The condition is self limiting and does not normally cause problems in the long term.

Bursitis is inflammation of the fluid filled sacs that surround the knee and provide protection for ligaments and other structures from friction during movement. These bursae can become inflammed and sore particularly in those who kneel excessively. Managment of these conditions requires reduction of swelling and increasing muscle control around the knee and hip.