Chronic Knee Injuries can affect many athletes, from the professional who trains twice daily to the Saturday morning netballer. The pain and dysfunction can be debilitating, and can lead to extended time off sport.
The knee is a complex joint, and is controlled by a number of muscles, tendons and ligaments. The majority of chronic knee injuries are due to either Tendinitis or Patello-Femoral Syndrome.
Tendinopathy
Tendons are cord-like bands of tissue which join muscle to bone. They can become pathological when a muscle is being overused, or used incorrectly (i.e. technique problems or biomechanical dysfunction). Around the knee, the Patella Tendon is the most commonly injured. It joins the quadriceps muscle to the lower leg, and can become inflamed by excessive or incorrect jumping or running. Tendinopathy is also very common in growing athletes, as the muscles become very tight and put added strain on the tendons.
The treatment of tendinopathy depends upon the stage it is in but generally focuses upon settling the acute flare (rest, ice massage), stretching and strengthening the tendon, and correcting any biomechanical or technique problems. The last issue is very important, because if these factors remain uncorrected the tendinitis will return.
Patello-Femoral Syndrome
Excessive stress to the surface of the patella (kneecap) can cause pain in the front of the knee. It is most commonly present in teenage girls, but can arise in any athlete. Commonly, the muscles on the outer part of the thigh become overly tight, and the inner muscles too weak. This leads to an imbalance of forces through the patella, which gets pulled to the side.
The treatment of Patello-Femoral Syndrome is similar to that of tendinopathy, and involves early rest and ice, stretching for tight outer muscles, strengthening of weak inner muscles, and correction of biomechanical or technique problems. Taping is often very helpful upon return to sport.
Chronic Knee Pain can be very debilitating, and the longer it is left untreated, the worse it will become. If you think that you are suffering from Chronic Knee Pain you should speak to your Physiotherapist, who will be able to prescribe exercises to help.
Jonathan Smith
Director of Thorpes Physiotherapy