As a continuation of last week’s article, today the focus is on knee injuries, some common, and not so common, injuries of this vulnerable joint. The knee is one of the joints most prone to injury. Its structure and many components put it at risk for many types of injuries, which can result in pain, or loss of function.

Sometimes a knee injury happens suddenly, as a result of the knee being hit, fallen on, twisted, or moved beyond its intended range of motion. These injuries are widespread among athletes, and may result in tears to one of three major ligaments of the knee: the anterior cruciate ligament (ACL); medial collateral ligament (MCL);  posterior cruciate ligament (PCL) or the menisci; crescent-shaped wedges of cartilage within the knee designed to distribute your body weight across the joint.

At other times, knee injuries happen slowly. For example, a problem such as a leg-length discrepancy, or arthritis in the hip, that causes you to walk awkwardly, can throw off the alignment of the knee, leading to damage. Constant stress to the knee from sports or jobs that require bending and lifting, for example, can cause joint cartilage to wear down over time.

The following are some of the more regular knee injuries:

– Meniscal – Menisci is a piece of cartilage found where two bones meet, which protects and cushions the joint surface and bone ends.  It can be torn when the knee is bent and then twisted, such as turning to hit a tennis ball. If the outside of the knee is hit, during contact sports, for example, the ligaments can be torn as well. Meniscal injuries that are not repaired, increase the risk of developing osteoarthritis years later.

–  Anterior Cruciate and Posterior Cruciate Ligaments – A sudden twisting motion or change in direction can lead to injury of the anterior cruciate ligament. The posterior cruciate ligament, however, is more likely to be damaged from direct impact, such as being tackled in football. Medial cruciate ligament injuries are often the result of a direct blow to the outside of the knee. The anterior cruciate ligament is the one that normally tends to be injured.

– Tendon – Ranging from inflammation (tendinitis) to ruptures, tendon injuries can result if you overwork or over-stretch your tendon. Activities that can injure tendons include running, jumping, dancing and squatting, especially to lift heavy items.

–  Bursitis – Some injuries to the knee can lead to inflammation of the bursae, small fluid-filled sacs that normally cushion the knee, while reducing friction between the joint and surrounding ligaments, and tendons. Injury to bursa can lead to swelling, warmth, pain and stiffness.

–  Loose bodies – Sometimes an injury to the knee can cause a piece or pieces of bone, or joint cartilage, to break off into the joint space. These loose bodies may interfere with joint movement, causing pain.

– Osgood-Schlatter disease – Usually affecting pre-teen and young teenage boys, this condition is caused by repetitive stress on the upper area of the tibia, where the bone is growing. In children with this condition, the patellar tendon (which connects the knee cap and tibia), becomes inflamed, and may even tear away from the tibia.

– Dislocated kneecap – This occurs when an injury causes the patella, or kneecap, to move out of position. The movement of the kneecap is always visible and often intensely painful.

– Iliotibial band syndrome – This syndrome occurs when a band of tissue rubs against the outer portion of your femur (thigh bone), causing sharp, burning pain on the outer side of the knee. Although this can result from a direct injury to the knee, often the cause is the stress of long-term use, such as long-distance running.

– Plica syndrome – This condition occurs when bands of synovial tissue, called plica, are irritated by overuse or injury. Symptoms may include knee pain, swelling, locking, and weakness.

What Does a Knee Ligament Injury Feel Like?

An anterior cruciate ligament injury, or other ligament injury, is sometimes hard to diagnose. Symptoms of a knee ligament injury are:

• – Pain, often sudden and severe
• – A loud pop or snap during the injury
• – Swelling
• – A feeling of looseness in the joint
• – Inability to put weight on the point without pain.

Diagnoses / Treatment and Prognosis

Knee injuries are diagnosed by a history and physical. Sometimes an X-ray or MRI may be done. Treatment would depend, naturally, on the type and severity of the injury, and can involve RICE therapy (rest, ice, compression, elevation), physical therapy, immobilisation, or surgery.

Prognosis also depends on the type and severity of the injury, and the need for physical therapy or surgery. These injuries can be prevented by proper training, equipment, and maintaining a safe playing field, or home environment, to avoid falls. The ball is therefore in your court, to respond accordingly, in your own interest.

Finally, you would have noticed a change in my designation. Many people were unaware, but I was in the UK for the last 3 years, pursuing my Degree in Podiatry, which I successfully completed last month. Thanks to technology, the Express, and my mom, I was able to produce my Column as usual. The move was with you in mind, dear readers, so I could better serve you; consequently, Foot Health Services at the Clinic will be at another level. I therefore wish to publicly record my sincere appreciation to our clients, well-wishers, and  those of you who supported me in any way over this period, especially my editors. May you be richly blessed!

                                                     Your feet mirror your general health . . . cherish them!