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(Don’t) Go Weak in the Knees: Common Knee Injuries and Tips for avoiding them.

What do you call a humorous knee? Fun-ny! All jokes aside, knee injuries are no laughing matter. We frequently tend to overlook our knees when they are working properly but when an injury occurs we realize just how important our knees are and how much we rely on them.

Our knees are the largest joints in our bodies and are responsible for our ability to walk, run, kick and so much more. The knee is comprised of the end of our femur and tibia (which are the upper and lower leg bones), and our patella (kneecap) as well as several muscles and ligaments which help to stabilize the joint and allow for movement.

Since our knees are involved in every move we make and bear the load of our body weight, it should come as no surprise that sometimes minor knee injuries develop. Knee injuries can occur as a result of basic wear and tear or overuse but also commonly occur as a result of recreational activities, work-related tasks, or other accidents.

At the Orthopedic and Shoulder Center we treat a wide variety of knee related injuries, but some of the most common are:

1. Meniscus Tear

The meniscus serves to keep your knee steady by distributing and balancing your weight across the knee. A meniscus tear is a fairly common injury that can occur while twisting or turning while your foot is planted. This can happen while playing sports or lifting heavy objects. The tear may be mild, moderate, or severe. A mild tear may cause slight pain and swelling and will usually resolve itself in two to three weeks. A moderate tear may cause pain at the sides or center of your knee and will usually be accompanied by swelling that gets progressively worse. If the tear is severe you may not be able to straighten your leg. Treatment of a meniscus tear depends on the type of tear and severity.

2. Knee Sprains and Strains

Knee sprains occur when the ligaments in the knee are stretched or torn. Ligaments are responsible for holding the knee in place and holding the bones of the knee joint together. There are four ligaments that support and stabilize the knee; the posterior cruciate ligament (PCL) and the anterior cruciate ligament (ACL), the lateral collateral ligament (LCL) and the medial collateral ligament (MCL). The symptoms and treatment for a knee sprain depends on which ligament was injured. Basketball players may experience sprains or strains because of the sudden stops, cutting side to side, pivoting and jump stops that are all a part of the game.

The severity of ligament sprains is determined by the amount of tearing or stretching experienced by the ligament fibers and the level of instability caused as a result.

• In a Grade 1 knee sprain, a ligament is stretched. However, there is no tearing and instability.
• In a Grade 2 knee sprain, a ligament experiences partial tearing, followed by moderate instability.
• In a Grade 3 knee sprain, a ligament is completely torn and instability is high

Knee strains occur when the muscles and tendons surrounding it are stretched. It happens as a result of hyperextension or hyperflexion. When the knee is strained, pain can be experienced and there is dysfunction across the knee’s entire range of motion.

3. Dislocations of the Knee Joint or Knee Cap

The knee cap becomes dislocated when the patella is moved out of place. It usually occurs as a result of direct trauma or a sudden change in direction when the leg is planted causing the patella to slip towards the outside of the knee. Common symptoms of knee cap dislocation are knee pain, tenderness, and swelling. The knee may also appear deformed and you may not be able to straighten it. Treatment will depend on the severity of damage to the surrounding area.

When the tibia and fibula (another lower leg bone that makes up the knee joint) are out of place in relation to the femur the ligaments in the knee are likely torn, and this is considered a knee dislocation. A knee dislocation is considered a medical emergency as it cuts off circulation to the rest of your leg. It is best to go to the nearest emergency department for immediate treatment. After the knee is stabilized you should then follow up with your Orthopedic Surgeon to determine the extent of the damage done to the surrounding ligaments and the appropriate course of treatment. Thankfully, knee dislocations are very rare and do not occur in everyday life – they usually only occur after a major trauma, such as a car accident.

4. Knee Bursitis

Knee bursitis occurs when a small fluid filled sac, called the bursa, becomes irritated, infected or inflamed. There are 5 main bursae in each knee and their purpose is to absorb shock and impact as well as reduce joint friction. Knee bursitis can cause limited mobility. Your knee may also become swollen and feel warm to the touch. Bursitis can be caused by a direct blow to the knee or an infection. It can also be caused by excessive kneeling, like a gardener who spends many hours on their knees in a garden. The treatment for bursitis depends on how the injury occurred.

Diagnosing Knee Injuries

Knee injuries can be diagnosed through physical examinations, x-rays, musculoskeletal (MSK) ultrasounds, and/or MRI Scans. X-rays, MSK Ultrasound and MRI’s can provide a more in-depth diagnosis by showing the doctor the extent or severity of the injury. This helps the doctor determine the best treatment plan.

Treatment

Treatment varies according to the type of knee injury and severity. Often, many knee injuries can be effectively treated with PRICE (Protection, Rest, Ice, Compression, Elevation) along with some physical therapy and strengthening exercises. To address the pain that comes with these injuries, anti-inflammatory drugs such as naproxen or ibuprofen may be prescribed. Some conditions such as bursitis may be treated with cortisone injections. More serious injuries may require surgery but an Orthopedic Surgeon, like Dr. Lawrence Li, will need to make those determinations on a case by case basis.

Preventing Knee Injuries

We have put together a list of tips for you to help avoid knee injuries.

• Always stretch before and after exercising to help warm up the muscles surrounding your knee joint and keep them loose.
• Use correct techniques while exercising to avoid straining your muscles
• Don’t carry objects that are too heavy for you to carry safely
• Don’t stand on wobbly or unsteady objects, such as chairs, instead use a step stool
• Wear knee guards while participating in activities in which your knees may make hard contact with a solid surface- examples include volleyball and skating.
• Strengthening exercises can help to keep the knee strong and prevent injuries.
• Wearing proper footwear that is appropriate for the activity can reduce stress on the knees

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