The knee is the largest joint in the body and is subject to a wide range of conditions that can cause chronic (persistent, ongoing) pain and difficulties performing sports, gentle exercising or even walking.
Many of these conditions can be treated successfully without surgery if they are properly diagnosed.
For this reason, it is important to have a prompt diagnosis to reduce the impact of the problem and to prevent long-term instability in the joint.
Sports associated with knee injuries:
- Contact sports
- Sports that involve twisting and turning such as basketball, tennis and football
- Running, particularly long distance
- Cycling, particularly long distance
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Causes & Symptoms
Sports related knee pain is typically the result of long-term wear and tear, where the knee joint is subjected to repetitive motion. It can however, be caused from an isolated event involving too much stress or strain on the knee joint, as well as from accidental injury or a fall. Sometimes knee pain can be the result of two or more related conditions.
Knee related injuries can also be caused from either improper warm-up prior to sports activity, or increasing the sports activity too quickly, or too rigorously.
Possible knee injuries include:
Jumpers knee (Patellar tendonitis)
This is an injury caused by repetitive strain from excessive running or jumping. It is common in many sports people and causes pain in the front of the knee. The overuse of the joint causes inflammation and degeneration of the patella tendon.
Symptoms include: tenderness, swelling, aching and stiffness first thing in the morning or following exercise.
Meniscal tear
Tears to the meniscus cartilage, which acts as a shock absorber in the knee joint, are amongst the most common injuries to the knee. They are often the cause of a sudden movement or twist, or possibly a tackle, which causes the cartilage to tear.
The meniscus cartilage does wear as you age, so older people can experience a tear just simply by getting up from a chair from an awkward position. With this condition your age, the type and duration of exercise and sports you do needs to be considered, as well the general state of the knee joint itself.
The most common symptoms of meniscus tear are:
- Pain, stiffness and swelling
- Catching or locking of your knee and it may make a popping sound
- The sensation of your knee feeling unstable or gives way when you try to stand
- Your knee will not move through its full range of motion
Ligament injury
In the knee, there is a short band of fibrous tissue that connects bones to other bones within the joint. An injury to the knee ligament is usually due to a sharp change in direction, landing wrong after a jump, or from a force to the knee, such as a tackle in football or rugby.
Depending on the severity of the injury, symptoms may include:
- Pain, swelling and bruising
- The sensation of your knee feeling unstable
- Not able to put weight on your knee
Sometimes a mild ligament injury can heal with resting and physiotherapy over a few weeks. However, more severe damage to the ligament may require treatment such as wearing supportive braces to help the healing process, which may still take up to several months to return to full performance.
Patella tendon ruptures
Patella tendon ruptures are common in sports people or athletes with a history of patella tendon injuries, or Jumpers Knee. It can be an extremely painful injury where you will be unable to put weight on the knee, or straighten the knee joint.
Symptoms include severe pain, specifically at the bottom of the knee and a swelling of the knee.
Hamstring injuries
An injury to the hamstring tendon, or hamstring tendonitis, can cause pain to the back of the thigh or knee. This pain can be exasperated with continued activity.
With tendonitis the tendon becomes inflamed and swollen.
Hamstring injuries usually occur when the muscles or tendons are stretched beyond their limits, typically following explosive motions, including sprinting, lunging and jumping. This is why warming up sufficiently before sports, and stretching sufficiently following, is so important.
Hamstring injuries tend to be recurring in athletes and sportspeople so having the correct treatment is vital to assist you with your performance.
Iliotibial Band Syndrome (ITB)
ITB syndrome is one of the most common injuries for runners and other sports people. It is an overuse injury caused from repetitive motion.
The Iliotibial band is a structural fascia/ligament running from the hip to the top of the shin, down the outside of the thigh. When injured it can cause pain and swelling on the outside of the knee.
It is commonly mistaken for other knee related sports injuries, which is why accurate diagnosis is vital to help you get back to exercising and training as soon as practically possible.
Osteoarthritis
Osteoarthritis causes pain, stiffness and loss of function in the knee. It is more common in older people and is often not related to sports activity, although generally athletes and sportspeople, particularly sports such as long-distance running and football can have an increased risk of arthritis in later years.
Diagnosis of arthritis is important to assess treatment options, for which there are non-operative and operative options available to help you improve your symptoms.
Read more about Arthritis and treatment options
Sprains and strains
Twisting, overuse or overstretching in sports can subject the knee to various sprains and strains. These range from mild to severe. Mild sprains and injuries may heal on their own, by reducing or stopping activity all together until the pain ceases.
However, if you are an athlete interested in maintaining a level of performance you will likely want to seek the help of professionals that can correctly diagnose your injury and suggest the best treatment option.
Dislocated kneecap
When your kneecap dislocates, the patella (kneecap) comes out of the groove in the joint where it usually glides over when bending or straightening your knee. Typically a dislocated kneecap is caused b a sudden and jarring change in direction, although it can occur following a collision.
Upon dislocation there is often a popping sound followed by severe pain and usually you will be unable to walk. The knee is prone to swelling and you will be unable to straighten the affected leg.
Osgood-Schlatter’s disease
Osgood-Schlatter’s disease is typically found in teenagers and young adults. It is an inflammation of the area that attaches the patellar tendon (kneecap ligament) to the tibia (shinbone).
Whilst participation in sports may be safe, depending on the pain levels, physical activity can put additional stress on the tendon insertion onto the bone, so some sports may be best avoided. These may include athletics and any sports that involve running or jumping.
Prepatellar Bursitis
Bursas are fluid filled sacks that overlie joints. They reduce friction and protect overlying soft tissues, allowing pain-free movement of the joint.
Prepatellar burtisis is most common with people in professions that require constant kneeling, such as carpet layers, builders, roofers and plumbers. However, it can be caused by a trauma to the knee. Athletes participating in sports such as rugby, football, wrestling and basketball are at risk of this injury.
Symptoms include that the knee is red and warm and kneeling or bending makes the pain and swelling worse.
Treatments for knee injuries range from non-operative or minimally invasive care through to complex joint reconstruction and replacement.
Diagnosis
Many conditions that cause chronic and long-lasting pain to the knee can often, if properly diagnosed, be successfully treated without a major operation.
If you can’t put weight on your knee, or move it normally, you should see your doctor. Or if your knee locks, or gives way, this is a sign you should find out about the underlying cause.
Seek urgent medical help if your knee becomes very painful or it is badly swollen or changes shape, or if you develop a fever or have redness or heat around the knee. You may be offered a scan to ascertain what is causing the pain.
Treatment
Some sports related knee injuries could improve by reducing or stopping the activity that causes painful symptoms.
However, this can be frustrating if you enjoy sports and want to continue with your usual routine.
Many sports related injuries require proper treatment, following accurate diagnosis.
These pointers may help in the short-term:
- Apply ice to inflammation
- Monitor pain and link it to associated activities
- Stop doing the activities that cause pain – this is important to prevent further damage
- Replace old sports equipment, such as footwear – a shoe with a thick sole may help absorb shock and protect the knee joint. Orthotics may be useful too.
- Ensure to adequately stretch before and following any exercise
- Consider a daily Vitamin D and Calcium supplement
Non-operative and minimally invasive knee treatments
Muscular damage, torn cartilage or ligaments and early-onset osteoarthritis are all conditions that can benefit from either non-operative or minimally invasive treatment.
Operative treatments for the knee
For some conditions, particularly those which have developed over many years and not been treated (or for which non-operative treatments have run their course) it is necessary to carry out a full or partial knee replacement or more extensive surgery (particularly following trauma injuries).
Operations can also be needed to upgrade, replace or otherwise revise an existing knee replacement.
Risks
One main risk of sports related knee injuries is not seeking the correct treatment in a timely manner.
Injuries that are not treated may lead to long-term knee arthritis or require joint resurfacing or replacement surgery at a later date.
FAQ’s
Will a sporting injury to the knee heal by itself?
It may do depending on the nature of the injury. However, if it does not heal completely you may be left with chronic pain or restricted movement. It is always a good idea to get medical advice if you suffer an injury or have an accident.
How can I tell the difference between the pain of osteoarthritis and a torn ligament?
The pain of a traumatic injury like a torn ligament is sharp and sudden. You are likely to know exactly when the injury occurred. By contrast, the pain of osteoarthritis is a dull, ongoing pain, which worsens over time.
How can I protect my knees from injury?
If you are playing sport or running, it is important to know when to stop. The more tired you get the more susceptible you are to injury. Also, maintaining a healthy body weight avoids putting too much strain on the knees.
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