Knee Meniscal Injuries
Injury to one of the two crescent-shaped cartilage pads between the two joints formed by the femur (the thigh bone) and the tibia (the shin bone) is Meniscal injury. A partial or total tear of a meniscus may occur when a person quickly twists or rotates the upper leg while the foot stays still (for example, when dribbling a basketball around an opponent or turning to hit a tennis ball). After any injury the knee may click, lock, or feel weak. Symptoms of meniscal injury may disappear on their own but frequently, symptoms persist or return and require treatment.
Knee Ligament Sprains
A knee sprain means that you have injured one of the ligaments in and/or around the knee joint. A sprain is caused by a ligament being stretched too far. The symptoms of a sprain are typically pain, swelling, and bruising of the affected joint. The collateral ligament sprains will affect lateral stability and the cruciate sprains will affect stability in the frontal plane. Many knee sprains can be treated conservatively however if there is significant instability, there may need to be surgical intervention.
Your joints move by the power of your muscles. The muscles attach to your joints through tissues called tendons. The tendons transfer the force from your muscle across the joint and cause it to move.
Sometimes this tendon becomes inflamed because it was injured (such as a direct blow to the thigh) or overused (such as biking up hills).
When the tendon is inflamed, doctors add the ending “itis,” and thus, we call this Tendonitis/Tendonosis.
Chronic cases are called tendonosis, indicating chronic inflammation. In some cases, the tendon actually tears in half, and this is called a tendon rupture. If you can’t straighten your knee because of pain over your tendons, seek immediate medical treatment.
Tendonitis/Tendonosis pain is usually described as an ache that can be sharp with exiting from a chair or with squatting. The pain is usually improved with rest. Usually the patellar tendon in the front of your knee is most involved. This is called “patellar Tendonitis/Tendonosis” or “jumper’s knee.” This syndrome is frequently caused by imbalances of the knee muscles and hip muscles causing the knee cap to “track” incorrectly. Further, biomechanical issues in the foot can be a contributing factor. This pain is usually located over the front of your knee and is described as a deep aching pain. It is sometimes associated with swelling and is usually worse when your knee is bent for long periods of time such sitting in a car or bus.
The pain is also worse with such activities as running, biking, squatting, kneeling or stair climbing (either up or down stairs).
It is sometimes associated with mild or moderate swelling of the knee and some people report a grinding feeling in their kneecap. It is more common in younger females especially after a growth spurt where the knee must carry more weight.
This causes irritation and inflammation on the undersurface of the knee cap and ultimately cartilage degeneration.
Identifying the causes of the pain and inflammation and directing functional treatment have very good outcomes for these conditions.
Iliotibial Band Friction Syndrome
The iliotibial band is a thick band of tissue that extends from the thigh down over the knee and attaches to the tibia. When the knee bends (flexion) and straightens (extension), the iliotibial band slides over the bony parts of the outer knee (lateral femoral epicondyle).
The term iliotibial band friction syndrome (ITBFS) refers specifically to a syndrome of lateral knee pain related to irritation and inflammation of the distal portion of the iliotibial band at, or just distal to, the point at which it crosses the lateral femoral epicondyle.
Iliotibial band friction syndrome is an overuse injury caused by repetitive friction of the iliotibial band across the lateral femoral epicondyle. It is a well-recognized cause of knee pain in runners, so it is commonly called “runner’s knee,” although the condition is not unique to runners, nor is lateral knee pain the only manifestation of iliotibial band injury.
It is now frequently seen in cyclists, weight lifters, skiers and soccer players. It has also been found that injury to the iliotibial band and related structures may be noted as lateral “hip” or lateral thigh pain, as well as lateral knee pain.
When evaluating for ITBFS, examining the lower back, specifically the sacroiliac joints as well as the feet is an important consideration. Conservative management will typically resolve this condition.