Knee injuries are very common in athletes, the knee is a critical joint which lacks the support other joints, like the hips and shoulders do. The knee is also quite a complex structure, the bone of the upper leg (Femur) meets the bones of the lower leg (Tibia and Fibula) and the knee cap (Patella), with all three are connected by a mass of tendons, ligaments, cartilage, and Synovial fluid. There are a number of ways this structure can be damaged, and the result is instability and quite often pain whilst walking, standing, and running.
Careful rehabilitation of the knee is vital after injury to restore function. The complex nature of the structures in the knee means that it is easy to exacerbate injury by day to day movements, cause further injury, or, during the healing process misalign components of the knee as they recover. For these reasons, a knee injury will most certainly grant you a referral to a physiotherapist.
Conditions like Runner’s knee are investigated by a physio’s careful manipulation and palpation of a joint, in this injury for example, your therapist will be looking for a notable tenderness in the widest part of your knee, the Lateral Epicondyle. Other injuries, like knee factures for example, are easy to diagnose because of their acute nature, but rehabilitation becomes the tricky part as the injury often causes secondary damage to supporting knee structures which will need to be rehabilitated slowly.
Both ACL injuries and patellar fractures are acute conditions and tend to be dealt with medically or surgically first. The physio’s role in these can vary depending on the practitioner and the hospital. Some will participate in the early diagnosis because of their expertise in dealing with physical trauma, but mostly they will be called in during the longer rehabilitation phase. After immobilising the knee during patellar fractures for example, it is vital to restore functionality in all available planes of movement slowly and carefully, both to prevent future pathologies like osteoarthritis, and to allow you full use of your leg again. A physio will instruct initially in how to stretch and move the leg, often suggesting you wear a brace, and then introduce resistance training to strengthen the knee and supporting musculature.
The knee is a load bearing structure, and it is this characteristic which makes it both prone to injury and difficult to rehabilitate. This is where pool exercises are beneficial, allowing a broad range of movement with some resistance, but without the burden of bearing full weight. During the initial stages of injury, cold therapy (ice packs etc.) are used to limit bleeding within the joint, and later on a physiotherapist will often recommend the use of similar techniques to prevent further injury after exercise.
Runner’s knee is known to respond extremely well to physiotherapy which aims to both treat the injury and prevent future recurrence both by strengthening the knee and leg and by adjusting contributory postural and alignment issues. Runner’s knee is typically caused both by overuse and by poor technique, the latter of which can be worked on by the physio. Not unlike other knee injuries, the use of cold therapy, compression from knee support, and resistance training will all be used by your physio.
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