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Stress-related knee injuries
Stress-related knee injuries are usually the result of excessive, repetitive loads or incorrect performance, in which case the amount of load does not necessarily have to be high in order to cause tissue irritation. A common reason for the development of a stress injury is, for example, starting a new hobby or a sudden increase in load. In children, there are growth-related predisposing factors for knee strain injuries that do not necessarily require high load rates.
Anterior knee pain conditions:
A very common pain condition in the anterior part of the knee is PFPS (patellofemoral pain syndrome), i.e. an indeterminate pain condition localized in the patella or its area. The ailment in question is common in athletes and people aged 18-35 years, especially women. The cause of the pain is not known, but often in the background there is, for example, a patellar load disorder, the correction of which is the starting point for rehabilitation.
Patella tendon strain injury:
Soreness of the patella tendon is one of the most common knee strain injuries. The pain is located in the anterior part of the knee, below the patella. The most common movements that provoke pain are jumping, various efforts, as well as squats. In the most acute stage, pain may also come from touch and the area may be swollen. A stress injury to the patella tendon can also be called the "jumper's knee". In children, symptoms are common due to growing age. Stress injuries of the patella tendon also include Osgood-Schlatter disease, which is most characteristic in people aged 10-14 years (adults may experience a sequelae of the disease), as well as Sinding-Larsen-Johanson apophysitis, which is most characteristic in people aged 10-16 years.
Therapy:
Stress-related injuries to the patella tendon are often diagnosable without imaging. In the case of really intense and intense pain, it is a good idea to have the knee imaged with magnetic resonance imaging to rule out possible stress fractures. The treatment of a stress injury to the patella tendon is focused on lightening the load and individual rehabilitation, focusing on the development of the individual's performance techniques, versatility of training and pain relief. In the most acute stages, an anti-inflammatory drug can be used to treat pain, as well as cold therapy locally.
Stress injuries to the inner side of the knee:
Most commonly, the symptoms of the inner side of the knee are caused by the attachment points of the hamstring muscles in the upper part of the tibia, below the knee. This area is called pes anserinus and is subjected to a strong load from the knee flexing muscles. Also, the inner lateral ligament of the knee is attached very close to this area. Overloading the tendon attachment site can lead to swelling of the area and, consequently, to irritation of the bursa of the pes anserinus, or mucous sac.
Stress injuries to the outer side of the knee:
The most common stress injury to the outer side of the knee is a load pain on the iliac-tibia ligament on the outer side of the thigh, called a runner's knee. Between the tendon in question and the lower part of the femur, there is a mucous sac, which may become irritated under exertion and begin to show symptoms. The pain is localized on the outer side of the knee in the upper part and is provoked by exertion, such as running. The cause of the ailment may be poor mobility of the hip area, excessive stress, as well as tightness of the outer thighs. The verification of the injury does not require imaging, but the diagnosis is clinically deducible.
Therapy:
Treatment for the above pain conditions is lightening / modifying the load, as well as individual physiotherapeutic rehabilitation. Rehabilitation is aimed at correcting possible incorrect performance patterns, developing strength and mobility characteristics, and relieving pain. In acute pain situations, an anti-inflammatory drug and cold therapy can be used locally as emergency care.
Post-traumatic knee injuries
Acute knee injury is most commonly caused by sudden torsional movement of the knee, either due to an external load or due to a rapid change of direction. With acute knee injuries, examination by a doctor is necessary to clarify the diagnosis. The primary treatment for post-traumatic knee injuries is elevated posture and compression, as well as cryotherapy for pain relief. It is a good idea to seek medical examinations if, after trauma, the knee swells and cannot stand the reservation.
Rupture of the lateral ligament:
Rupture of the lateral ligaments of the knee is most often caused as a result of torque caused by external force, and more commonly, lateral ligament rupture enters the knee internal ligament (MCL). An injury to the inflatable is usually a partial lesion, in which case the ligament is not completely broken. A symptom of an injury is pain in the inner side of the knee, which begins immediately after the injury has occurred. In the first days, walking may be difficult, but may go smoothly at some level after the acute phase. Lateral torsion of the knee produces pain on the inner side of the knee.
Rupture of the outer lateral ligament (LCL) of the knee is less common and is often associated with a rupture of the anterior cruciate ligament or a multiligament injury of the knee. In the event of an injury, the knee sores from the outer side and is unstable laterally.
Therapy:
Depending on the severity of the rupture of the lateral ligaments, the treatment is either surgery or conservative treatment. Both after surgery and without surgery, rehabilitation is aimed at achieving the full range of motion of the knee, strengthening the muscles that support the knee, as well as examining and optimizing the kinetic chains in order to make the load on the knee as economical as possible. In acute stages, the treatment is a cold, a compress, as well as, if necessary, anti-inflammatory drugs.
Rupture of the cruciate ligament:
Knee cruciate ligaments include an anterior cruciate ligament (ACL) and atacharist ligament (PCL). Anterior cruciate ligament rupture is the most common sports-related knee injury in adults and is often caused by contact with another person or an uncontrolled evasive movement or change of direction, causing the tibia and femur to twist relative to each other. The injury is accompanied by swelling of the knee, as well as difficulty walking. However, walking may start to go better just a few days after the injury has occurred. In many cases, an anterior cruciate ligament injury is also accompanied by other accompanying injuries, such as rupture of the IUD or, in children, fracture of the site of attachment of the tendon. Anterior cruciate ligament rupture can be diagnosed by clinical examination, but magnetic resonance imaging is necessary to determine accompanying injuries. Partial rupture of the anterior cruciate ligament is rare.
Rupture of the posterior cruciate ligament of the knee is significantly less common and often occurs in adult sports or, for example, in traffic accidents. Often, damage to the posterior cruciate ligament is part of a multiligament injury, that is, several ligaments in the knee are damaged at the same time. In the event of a multiligament injury, the swelling of the knee is massive, and it is not possible to allocate to the leg. In these traumas, the injury energy is often high.
Therapy:
In ruptures of the cruciate ligaments, the degree of severity of the injury determines whether there is a need for surgical treatment. As a rule, in multiligament injuries, surgical treatment is necessary, and magnetic resonance imaging is always necessary to determine the degree of injury. As an acute treatment, compresses, colds and anti-inflammatory drugs act.
Rehabilitation of the anterior cruciate ligament is carried out individually, either conservatively or with surgical treatment. In each case, individual physiotherapy is necessary. Even if surgical treatment is chosen as the treatment method, physiotherapy is necessary even before the surgery. The treatment is aimed at restoring functional capacity and pain relief. As a result of a rupture of the anterior cruciate ligament, the knee may seem unstable and powerless, which is sought to be influenced by rehabilitation. Physiotherapy ensures the full range of motion of the knee and the power balance of the muscles that comprehensively affect the functioning of the knee, so that it is safe to return to everyday life or sports. Rehabilitation of the anterior cruciate ligament should be carried out carefully, with the help of a professional. The return to sports takes place gradually over a period of about 8-12 months.
Rehabilitation of the posterior cruciate ligament requires most surgical treatment for accompanying injuries. After surgery, knee orthosis is first used in rehabilitation, which supports a stable position of the knee. Otherwise, rehabilitation proceeds individually, strengthening the knee and surrounding tissues.
Rupture of the articular helix:
Rupture of the IUD can occur as a result of trauma or in people over 30-40 years of age as a result of degeneration. IUD injuries in children and adolescents often arise as a result of a fall, contact or sudden torsion injury and can be associated with a rupture of the anterior cruciate ligament at the same time. Degenerative IUD rupture does not require greater trauma, but may be caused by squatting, for example.
There are many types of IUD ruptures of the joints, the taut one can be torn by different styles. Less common, bag handle rupture often causes most of the symptoms. A ruptured IUD manifests itself as swelling of the knee, soreness when booking or walking on the leg, locking the knee or lack of extension and clicking.
Therapy:
Most commonly, post-traumatic IUD rupture is treated with surgical treatment and degenerative-related is treated conservatively. Postoperative rehabilitation takes place under the guidance of a physiotherapist, gradually burdening the knee. The aim of rehabilitation is to develop the range of motion of the knee, strengthen the tissues surrounding it and train the correct ways of performing movement patterns. The return to sports after an IUD injury occurs gradually over a period of about 3-5 months.
Patellar dislocation:
Patellal dislocation (patella luxation) is a situation in which the patella goes out of place. Often, in the event of an injury, the patella spontaneously goes back into place, which may make the injury difficult to diagnose. Sometimes, however, the patella remains abrasive and requires the help of a professional to put it in place. Due to dislocation of the patella, the inner supportive ligament is stretched, due to which the dislocation may recur later. In the event of an injury, magnetic resonance imaging is necessary to determine possible accompanying injuries. In the case of recurrent dislocations, magnetic resonance imaging is most commonly no longer required. The injury causes swelling and soreness in the knee. Pain can occur when walking, reserving for the leg and moving the knee.
Therapy:
Rehabilitation of patellar dislocation is most commonly done conservatively, without surgical treatment. In this case, physiotherapy focuses on the development of the knee extension force and the control of knee alignment. If the dislocation has caused accompanying injuries, such as fractures or ligament damage, surgery may be required.
Baker's cyst:
Baker's cyst is a consequence of a disease that causes hydration of the knee joint. For example, fluid swelling of the knee caused by a ligament injury may cause Baker's cyst to appear in the kneecap. It is most commonly found in middle age and always does not cause symptoms. In this case, it is often noted as a bulge visible in the kneecap. Baker's cyst, which causes pain, often occurs as a result of post-exertion pain or a deficit in the extension/flexor. Other symptoms may include heat, "pinging" of the popliteal fold, and pain when moving the knee.
Therapy:
As a treatment for Baker's cyst, a cold is used, as well as, if necessary, a course of anti-inflammatory drugs. Load reduction and treatment of the cause of the cyst (for example, ligament injury). Often the synovial fluid is absorbed back into the tissues on its own when the causative agent is eliminated.
Muscle injuries and muscle pains in the thigh area:
The thigh area in this text includes the front of the thigh, the back of the thigh, the closers, as well as the outer side of the thigh. Muscle injuries or muscle pain can be caused by cramps caused by muscle overload, excessive tissue stretching, intense muscle tension, delayed muscle pain (DOMS) caused by physical exertion, or a direct blow. Muscle strains and tears are common sports-related injuries, the treatment of which depends on the severity of tissue damage.
Most typically, muscle injuries in the thigh area are found in sports that include jumps, running, changes of direction and spurts. Also, contact species predispose to contusion injuries that arise from a direct impact on muscle tissue. Common areas for contusion injuries are the front of the thighs as well as the calf, these are also called wooden legs.
Depending on the mechanism of the injury/pain condition, the symptoms vary slightly. In delayed muscle pain, the muscle feels stiff, is possibly a little sensitive to touch and feels powerless. Muscle tears are really painful in the event of an injury, and walking, for example, may not be possible normally. The muscle's power output has decreased and its range of motion has decreased. The muscle is sensitive to touch and a bruise begins to form in the area.
Therapy:
With muscle injuries in the thigh area, treatment is always individual and only in the most severe cases requires surgical treatment. Physiotherapy focuses on regulating the overall load so that the tissue damage can heal and on restoring and developing muscle strength and mobility. Returning to sports is always individual and gradual. In the event of muscle tears, a doctor's examination is appropriate to determine the degree of tearing and to rule out possible further damage. In stress-related injuries, load management is the primary factor, in connection with which the adequacy of muscle strength and mobility in relation to the requirements of the sport is determined. Individual physical characteristics are developed together with a professional in order to eliminate the overload state and prevent new similar situations.
