Runners knee
Referred to as iliotibial band syndrome is often experienced by runners
Pain is felt on the outer aspect of the knee. Pain is usually aggravated by running or climbing stairs. The ITB is a fibrous band which runs from the hip to the knee. As we bend and extend the knee the ITB moves over the lateral aspect of the knee. Overuse of this muscle can lead to the build up of inflammation in this area.
Treatment
- Stretch the ITB by crossing the injured leg in front of the painful leg. Bend trunk forwards and reach towards the back leg.
- Stretch other tight muscles such as the quadriceps and gluteus muscles.
- Strengthening of weak muscles in the hip.
- Wear appropriate running shoes.
- Ice the painful area.
- Massage the ITB to reduce tightness.
- Make use of a foam roller to release tightness.
- A physiotherapist can help determine specific muscle imbalances which can then be addressed during treatment.
Patellofemoral Pain
Pain that is felt around the front of the knee. Pain is often a dull sensation and is aggravated by activities such as walking, running, jumping, climbing stairs, or sitting for long periods of time. The pain my arise as a result of muscle imbalances around the knee and hip or poor alignment of the knee cap. Excessive medial rotation of the knee during squatting positions as well as repetitive movements such as jumping can contribute to the anterior knee pain.
Treatment
- Stretch out tight muscles such as the quadriceps, hamstrings and calf.
- Strengthen the quadricep muscles and hip abductor muscles. This helps to maintain good alignment of the patella during bending, reducing the stress on the knee cap.
- Strengthening of core muscles also helps to ensure better force distribution through the lower limb.
- Ice the painful area.
- Ensure you are training in the appropriate shoes.
- A physiotherapist can help determine specific muscle imbalances which can then be addressed during treatment.
Ligament injuries
Tears to the ligaments of the knee such as the anterior cruciate ligament, posterior cruciate ligament or collateral ligaments can occur during falls, sudden changes in direction, twisting movements and collisions. A popping sound may be heard. You may experience swelling around the knee. A sensation of the knee wanting to give way may be felt during walking. Weight bearing may be painful and there may be a reduced range of motion of the knee.
It is important to get an accurate diagnosis by a professional to determine the severity of the injury and for appropriate management guidelines. In severe cases surgery may be warranted.
Treatment
- Treatment will vary according to which specific ligament is damaged and the extent of the injury.
- Crutches may be used initially if weight bearing is too painful.
- Apply ice to the injured area to reduce swelling.
- A brace may be worn or taping may be applied for additional support to the leg.
- Strengthening of the muscles around the knee will help provide stability to the knee.
- It is important to include proprioceptive and balance exercises in the rehab program to prevent re injury.
- It is advised to stay away from contact sports until the knee has fully healed.
Meniscal tear
The meniscus is a wedge shaped fibrocartilage that is found within the knee joint. It acts as a shock absorber preventing damage to the surface of our bones and it allows for rotational stability during twisting movements. Damage to the meniscus can occur either over time as a result of degeneration or traumatically during a sudden twisting motion with the leg fixed to the ground and the knee slightly bent. Tears to the meniscus can result in pain during weight bearing. A popping, clicking or locking sensation may be felt during walking. There may be reduced range of movement to the knee due to pain and swelling.
Treatment
- In some cases where the knee locks and is unable to extend surgery may be warranted
- Conservative treatment will consist of icing to help with pain and swelling
- Physiotherapy will assist to regain full pain free movement
- Strengthening of the muscles around the knee
- Proprioceptive and balance retraining
Other causes of knee pain
- Bakers cyst
- Muscle strains
- Pinched nerve
- Dislocation of the patella
- Arthritis
General Precautions To Avoid Knee Pain and Injury
- Maintain good flexibility of the lower limbs through regular stretching.
- Strengthen muscles of the lower limb and hip to provide good stability to the knee and allow for good alignment of the knee cap.
- When bending or squatting ensure that the hip and knee are aligned and that the knee does not pass over the foot.
- Focus on strengthening the hip abductors, quadriceps, hamstrings and calf muscles.
- Include proprioceptive, balance and core exercises into your training programme.
- Wear appropriate shoes during sporting activities. Shoes should offer good shock absorption for running and jumping activities as well as help to maintain the arch of the foot in a neutral position.
- Ensure you warm up and cool down appropriately when exercising.
- If you play a particular sport it is worthwhile to have a separate training program to strengthen muscles that will help in your particular sport.