Knee Pain & Sports Injuries

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Meniscus injuries

Each knee has two menisci which are C-shaped pieces of cartilage that act as a cushion between the thighbone and shinbone. A torn meniscus is one of the most common knee injuries.

Causes of meniscus injuries include:

  • Sudden stops or turns
  • Forcefully twisting or rotating the knee
  • Squatting or kneeling
  • Heavy lifting

To prevent meniscus injuries:

  • Strengthen thigh muscles
  • Warm up properly prior to exercise
  • Build up gradually and rest properly between workouts
  • Wear the correct footwear to provide sufficient support

A range of tests may be used to diagnose meniscus injuries, including:

  • X-rays to rule out fractures.
  • MRI to identify torn cartilage.
  • Arthroscopy to look inside your knee joint.

Among the possible treatments for meniscus injuries are:

  • Rest and ice to prevent further damage and reduce swelling and pain.
  • Painkilling medication.
  • Physical therapy.
  • Surgery to repair or trim a torn meniscus.

Jumper’s Knee/Patellar Tendinitis

Jumper’s knee, also called patellar tendinitis, occurs most often in athletes who participate in sports involving frequent jumping, such as volleyball and basketball. It can also occur in non sportspeople.

Causes of jumper’s knee include:

  • Overuse of the patellar tendon resulting in tiny tears.
  • Weakening of the tendon leading to tendinopathy.
  • Physical exertion or a sudden increase in the intensity of training.
  • Tight hamstrings or thigh muscles which increase strain on the patellar tendon.
  • Chronic conditions such as rheumatoid arthritis, diabetes or lupus.

To prevent jumper’s knee:

  • Strengthen your thigh muscles to decrease stress on the patellar tendon.
  • Follow the advice of a professional coach to develop good techniques.
  • If you experience pain or discomfort, stop exercising.

A range of tests may be used to diagnose jumper’s knee, including:

  • X-rays to rule out fractures.
  • MRI to identify damage to the patellar tendon.
  • Ultrasound which can show tears in the tendon.

Among the possible treatments for jumper’s knee are:

  • Painkilling medication and anti-inflammatories.
  • Physical therapy including strengthening exercises and stretches.
  • A patellar tendon strap to relieve pain.
  • Iontophoresis to deliver corticosteroid medicine through your skin.
  • Platelet-rich plasma injections.
  • Surgical debridement of the patellar tendon.

Patellar Tendon Rupture

A ruptured patellar tendon normally occurs following an awkward landing from a jumping position. Sometimes you might hear a snapping sound or feel a popping sensation. You will normally be unable to walk following the injury.

Causes include:

  • Chronic tendonitis.
  • Sports-related injury.
  • Chronic disease leading to weakening of the patellar tendon.

To prevent a ruptured tendon, warm up properly before exercising and stop if you experience any pain. Take extra care if you have a medical condition that can cause tendon weakness.

Among the tests to diagnose a patellar tendon rupture are:

  • Physical examination including the straight leg raise test.
  • X-ray to rule out patellar fracture.
  • MRI to inspect the knee for soft tissue damage.

Among the possible treatments for patellar tendon rupture are:

  • Surgery to repair the torn tendon.
  • Rest your leg completely after surgery and follow a programme of physical therapy to rebuild the strength in your legs.
  • Only return to sport when advised it is safe to do so by your orthopaedic surgeon.

Medial Collateral Ligament (MCL) Injuries

The medial collateral ligament connects your thighbone to your shinbone, helping to keep your knee stable. An MCL injury is the most commonly occurring knee ligament injury. It can be a partial or a complete tear and can be accompanied by a cruciate ligament or meniscus tear.

Causes include:

  • A blow to the outside of your leg causing your knee to be pushed inwards.
  • Twisting your knee, for example as the result of a skiing injury.
  • Falling, particularly in older people.

To prevent an MCL injury listen to your body and stop when you are getting tired. Always wear the right footwear and be sure to warm up thoroughly before physical activity. A good coach can help you to develop the right technique.

The following may be used to diagnose a possible MCL injury:

  • Physical examination to assess for swelling and tenderness.
  • MRI scan to reveal the extent of any soft tissue damage.
  • X-ray to rule out possible fracture.

Among the possible treatments for a medial collateral ligament injury are:

  • Following the RICE method – rest the injured knee, ice to reduce swelling, compress with an elastic bandage, elevate the affected area.
  • Painkillers and anti-inflammatories can relieve pain and reduce swelling.
  • Physical therapy can help to recover strength and stability in the knee.
  • Surgery may be required to repair the damaged ligament.

Hamstring Injuries

A hamstring injury occurs in one of the three muscles that run along the back of your thigh. They are common in sports that involve sprinting and suddenly stopping or changing direction, such as football or tennis. They can also occur in dancers and runners.

Causes include:

  • Overstretching the hamstring muscles.
  • Sprinting, running or stretching.
  • Lack of strength or flexibility in the hamstring muscles.
  • Weakness or previous injury.

To prevent hamstring injuries build up your fitness gradually and do not overexert yourself. Strengthening exercises and regular stretching can help to prevent damage to hamstring muscles. It is important to warm up properly before exercising.

The following may be used to diagnose a hamstring injury:

  • Physical examination to check for swelling and tenderness in the back of your thigh.
  • MRI scan to identify tears in the muscle and tendons.
  • X-rays to check for small pieces of bone that have become detached from the main bone.

Treatments for hamstring injuries include:

  • Following the RICE method – rest the injured area, ice to reduce swelling, compress with an elastic bandage, elevate the affected area.
  • Painkillers and anti-inflammatories can relieve pain and reduce swelling.
  • Physical therapy can help to recover strength and stability in the hamstring muscles
  • Surgery may be required to reattach muscle that has been pulled away from the shinbone or pelvis.

Sprains/Strains

Knee sprains and strains occur when the ligaments in the knee joint become stretched or torn. These might include the Anterior Cruciate Ligament, the Posterior Cruciate Ligament, the Medial Collateral Ligament and the Lateral Collateral Ligament.

Causes of knee sprain include:

  • Sudden twists of the knee or stopping suddenly.
  • Over-straightening or hyperextension of the knee.
  • A direct blow to the knee.
  • Falling with the knee bent.
  • A vehicle accident.

To prevent knee sprains, build up your fitness gradually and do not overexert yourself or increase the intensity of your workout too quickly. Always warm up properly before exercising and use strengthening exercises and stretches to build muscle flexibility.

The following may be used to diagnose a sprained knee:

  • Physical examination to check for swelling and tenderness.
  • MRI scan to identify tears in the muscle and tendons.
  • X-rays to check for fractures, and small pieces of bone that may have become detached.

Treatments for knee sprains include:

  • Following the RICE method – rest the injured area, ice to reduce swelling, compress with an elastic bandage, elevate the affected area.
  • Painkillers and anti-inflammatories can relieve pain and reduce swelling.
  • Physical therapy can help to recover strength and stability in the knee.
  • Knee braces may help to support the injured joint.
  • Arthroscopic surgery may be used to reconstruct damaged ligament using your own tissue or donor tissue.

Osgood Schaltter Disease

Osgood Schlatter disease occurs most often in children and athletes who play sports that involve running and jumping, such as basketball, football and ballet, as well as climbing. It often develops following a growth spurt and causes a bony bump just below the knee. It may affect one or both knees and is the result of the thigh muscle pulling on the tendon that connects the kneecap to the top of the shinbone. Repeated stress can produce pain and swelling. Occasionally new bone growth can result in the development of a painful, bony lump.

It is not always possible to prevent the condition however it is linked to tightness in the thigh muscles so regular stretching to keep the muscles flexible may help. Regular exercise to strengthen the lower body may also help to prevent the condition.

The condition is normally diagnosed with a physical examination. An X-ray may also be used to rule out fractures and assess any damage to the area where the kneecap tendon attaches to the shinbone.

The condition does not often require treatment as the symptoms normally disappear when the bones stop growing. If it is painful, painkillers and anti-inflammatories may be used, along with physical therapy exercises to strengthen and stretch the thigh muscles. A patellar tendon strap may be used to relieve tension. In rare cases surgery may be needed to remove the bony overgrowth. It is important to rest the knee while it is healing and to avoid doing deep knee bends.

Prepatellar (Kneecap) Bursitis

Prepatellar bursitis is inflammation of the bursa at the front of the kneecap. Bursae are small fluid-filled sacs that help to cushion the bones and soft tissues and reduce friction. If irritation occurs, the bursa may become hot and inflamed. The condition is painful and causes tenderness, warmth and swelling.

Prepatellar bursitis is normally due to pressure from constant kneeling. It is common in gardeners, plumbers and other people whose job involves spending a long time on their knees. It can also be caused by a blow to the kneecap or by conditions such as gout or rheumatoid arthritis. Infectious bursitis is caused by bacterial infection, normally due to a puncture wound. It can cause a fever and requires urgent treatment with antibiotics.

To prevent the condition, avoid kneeling for extended periods wherever possible and use kneepads to cushion the kneecap.

A physical examination is used to diagnose prepatellar bursitis. You may be given an X-ray to rule out a fracture and/or an MRI or CT scan to check the extent and location of any soft tissue injuries. If your doctor thinks you may have infectious bursitis, a small sample of fluid may be drawn from the site and sent to the laboratory for testing.

The normal treatments for patellar bursitis include:

  • Following the RICE procedure – rest, ice to reduce swelling, compression and elevating the affected leg.
  • Anti-inflammatories may help to reduce swelling.
  • In some cases an injection of corticosteroid may help to relieve pain. The doctor will normally drain off excess fluid first using a needle.
  • In some cases, surgery may be needed to remove the bursa.

Whatever your age, our expertise can help you feel healthy, active and pain-free again.