Knee Injuries Unfolded
This article breaks down the basics of some common knee injuries.
- Treatment for knee injuries is more advanced than ever before—it’s possible to fully recover from most knee injuries.
- Knee injuries are often caused by a sudden trauma or are a result of overuse/overtraining. The knee is one of the human body’s most complex joints.
- Damage to the knee joint can take on many forms and knee injuries often occur in conjunction with one another.
- Knee injuries are the most common sports-related ailment
- 42% of overuse injuries occur within the knee
It’s hard to maintain an active lifestyle with sore shoulders, stiff legs or tired hamstrings; it’s impossible to maintain it with a knee injury. Knee injuries can be painful and inconvenient at best, and debilitating and life changing at worst. This article breaks down the basics of some common knee injuries. Understanding the problem can be the first step on the road to prevention and/or recovery.
SHOULD I SEE A DOCTOR?
The answer to this question depends largely on the amount of pain you are feeling. You should always see a doctor if you have become incapacitated or unable to perform your daily activities. The more stubborn of us tend to try to stay active through the pain. Ignoring a problem because it complicates your training is a good way to develop a more significant injury. So be honest with yourself, and with your body. If something doesn’t feel right, visit a professional.
INJURY RUN DOWN
There are four main ligaments in the knee joint that can be ruptured or torn: the medial collateral ligament (MCL), the lateral collateral ligament (LCL), the anterior cruciate ligament (ACL), and the posterior cruciate ligament (PCL). Tears in one of these ligaments often require long periods of rest, rehabilitation, and possibly even surgery. Most ligament injuries are graded on a scale of I to III based on their severity with some stage III tears (and higher) requiring surgery. Symptoms of ligament injuries include swelling; difficulty putting weight on the knee and a sensation that the knee will give way or buckle; and pain at the injury site.
The MCL and LCL connect the thigh bone (femur) to the smaller bones in the lower leg. Located on either side of your knee, these ligaments are responsible for keeping your knee stable as it bends. The MCL is located on the inside of your knee and is often injured when there is trauma to the outside of your knee that forces the MCL beyond its capacity. The LCL is located on the outside of the knee and is therefore susceptible to injury when the inside of the knee receives a major blow. LCL tears are much less common than MCL tears but are not as quick to heal as the MCL. Severe MCL and LCL tears often occur in conjunction with an ACL or PCL tear. Most MCL and LCL tears alone will not require surgery.
The ACL and PCL are the knee’s two major ligaments. The ACL keeps your knee stable when you twist and turn and the PCL keeps your knee from hyper extending backwards. Injuries to these ligaments are often caused by sudden collisions that force a tear in the ligament, or, as in the case of the ACL, sudden twisting or sharp changes of direction. PCL injuries often go undiagnosed but have similar symptoms to other ligament injuries.
IT Band Syndrome
ITBS, or iliotibial band syndrome is a common overuse injury that is particularly common in runners. The IT band is a thick band of tissue that runs down the outside of the thigh and connects with the tibia just below the knee. It helps with stability and hip abduction. When the IT band becomes tight from overuse, repetitive motion or overtraining, it can become inflamed and irritated, causing pain and swelling. ITBS can also result from a mechanical problem, such as a difference in leg lengths or an imbalance in your stride.
With ITBS there is a painful, burning sensation along the outside of the knee, which typically worsens during lengthier workouts. With severe cases you might be able to hear a clicking sound as the IT band rubs across the bone. Targeted stretching, icing, and anti-inflammatories can help reduce the pain, and incorporating speedwork or cross training into workouts can help prevent overuse.
PFS, or patellofemoral pain syndrome, is another typical overuse injury. Because of it’s prevalence in runners, it’s commonly referred to as Runner’s Knee. Pain is typically felt under or behind the kneecap on the front of the knee. The patella, or kneecap, sits in a groove, known as the femoral groove, and PFS refers to the pain resulting from any misalignment or irritation created as the kneecap moves in that groove. PFS can be caused by any number of things, including biomechanical issues, muscles that are too tight or too loose, worn out cartilage in the knee, inadequate footwear, and, in particular, overtraining. Pain, swelling, tenderness, and a feeling of weakness in the knee accompany PFS, which can be treated with RICE and certain strengthening and stretching exercises.
Tendonitis occurs when a tendon (the tissue that connects muscle to bone) becomes inflamed. The patellar tendon connects the kneecap (patella) to the shin bone (tibia) and helps the knee extend and push off the ground. When the patellar tendon becomes inflamed and irritated the condition is known as patellar tendinitis, often referred to as Jumper’s Knee. Symptoms include pain when bending the knee, stiffness, and swelling at the tendon site. Patellar tendonitis presents in up to 20% of all athletes who engage in jumping as part of their sport due to the immense demands placed on the patellar tendon during activities like sprinting, basketball, and volleyball.
The patellar tendon functions, in part, as an extension of the quadriceps group, so pain in the patellar tendon might be related to imbalances or weaknesses in your quads and/or hamstrings. One of the main causes of patellar tendonitis, however, is overuse and overtraining. Tendonitis typically occurs because of repeated demands placed on the tendon without proper time for rest or healing between workouts. Depending on severity, tendonitis can be treated with rest, ice therapy, anti-inflammatories to reduce swelling, and strengthening exercises to protect the tendon.
Cartilage injuries in the knee typically take the form of a torn meniscus. The meniscus is cartilage in the knee that acts as a shock absorber – it is shaped like a C and acts as a cushion and stabilizer. Whenever there is too much shock to the knee (in the form of twisting, deceleration, sprinting, pivoting, or being tackled or hit), the meniscus can rupture or tear. These tears can become more likely as knee cartilage wears as we age. Meniscal tears can be minor, moderate or severe. Tears will cause pain, swelling, tenderness, or, in the case of severe tears, popping and locking in the knee. Typical treatment will include rest, ice, elevation, and compression as well as strengthening exercises to support the knee joint. Surgery may be required in severe cases where part of the torn meniscus moves into the joint space.
Although there are many other factors that can damage our knees (disease, arthritis, bursitis, etc.), many knee injuries present as overuse injuries. Overtraining, whether you are a runner, jumper, or a biker, can lead to misalignment, muscle imbalances and weaknesses that leave the door open for injury. Sometimes we can’t help it—we’ll get tackled from the side or have the misfortune to be in a car accident or unplanned collision—but for everything that we can’t control, there are many things that we can. Take a look at your stride, ensure you wear proper footwear with plenty of support, re-evaluate your posture when you run and always address small aches and pains before they get worse. A little extra care can go a long way.