The knee is a weight-bearing, hinge joint and is the largest joint in the body. Its unique anatomy and physical demands require multiple soft tissue structures to support the bony framework. The structures, including ligaments, tendons, cartilage, and two menisci, are more frequently injured than the bones. Thankfully, many knee injuries don’t require surgery and can heal using non-operative techniques. Since there are many different kinds of knee injuries, a sports medicine specialist can help provide the best treatment through proper evaluation of history and a physical exam.
Patellar tendonitis is a common sports injury in athletes of all ages. It is also known as “jumper’s knee.” It occurs when the tendon connecting the kneecap and shinbone becomes irritated. Frequent jumping is a major cause of this injury, so it is common in volleyball and basketball players – especially middle- and high-school-aged athletes in these sports. Treatment often involves activity modification and short term use of anti-inflammatories.
Osgood-Schlatter is a common knee condition in adolescents and is a side effect of growth spurts when tendons, bones and muscles are changing rapidly. Young athletes are at even greater risk because of the stress they put on their knees. It is usually characterized by pain on the end of the tibia bone in the knee joint, especially when pressed on. It is treated with anti-inflammatories and stretching exercises.
Patellofemoral Pain Syndrome
Patellofemoral pain syndrome is another common knee condition frequently seen in runners. Athletes typically have pain in the front of the knee, usually around the knee cap. The pain is worse with running, ascending stairs, or rising from a seated position. The injury usually occurs with activity and is not typically induced by trauma. Treatment of patellofemoral pain syndrome focuses on exercises to improve quadriceps strength, hip stabilizer strength, and lengthening the hamstring through stretching.
Iliotibial Band Syndrome
Iliotibial band syndrome, also called IT band syndrome or ITBS, is usually described as pain on the outside part of the knee, usually occurring after a period of activity. This condition can occur when someone increases their activity load quickly, changes footwear, and/or is not diligent about stretching the outer muscles of the thigh. It is treated by stretching exercises for the IT band.
Another common injury in young athletes is an anterior cruciate ligament (ACL) injury. Unfortunately, the rate of ACL tears has increased over the past 20 years. Females are at greater risk than males. ACL injuries can occur in both contact and non-contact sports.
The ACL works to stabilize the knee. It is typically injured during a twisting or turning motion. If the ligament is damaged, the knee becomes unstable. This can result in future knee injuries and early arthritis. Most ACL injuries will require surgery to fix it, although there are a few cases of high-level athletes who compete with a torn ACL.
ACL injuries can be distinguished by a popping sound or by sudden pain with immediate swelling in the knee. In younger patients, symptoms may not occur right away. However, if your child is experiencing limited knee movement, swelling, or an unstable knee, you should visit a sports specialist.
Forceful twisting or turning too quickly when your feet are planted on the ground can cause a meniscal tear: a tear to the shock-absorbing pads of cartilage in the knee.
A meniscus tear can lead to knee pain or other mechanical symptoms such as popping, clicking or locking of the knee. Some athletes can still walk or continue to be active with a torn meniscus, usually after rehabilitation. Many active people can continue to be active and have no symptoms, or only minor symptoms, with a torn meniscus.
The common occurrence of knee injuries should not deter athletes from playing. Young athletes and their parents can benefit from a greater understanding of how to prevent knee injuries and what to expect should the athlete sustain a knee injury.
The first step in preventing knee injuries is ensuring that coaches implement an evidence-based ACL injury prevention program that starts in the preseason and continues throughout the season. This training focuses on increasing strength, dynamic balance, and flexibility and should be done several times a week. Ask your coach what training is being done to prevent ACL and other knee injuries. A sports medicine specialist could also assist with this information if the coach does not know.
In addition to these common knee injuries, there are a variety of other muscles and tendons that can be injured in and around the knee. A thorough examination is important to determine the cause of the athlete’s knee pain. A sports medicine physician with specialized training in the diagnosis of knee injuries can help clarify the athlete’s injury and provide treatment recommendations to keep you in the game.
Dr. Michael Seifert is a board-certified sports medicine specialist who helps patients heal from and prevent activity-related injuries in both athletes and aspiring athletes. He is a lifelong soccer player and Lake Nona resident. He works at the UCF Health office in Lake Nona. Visit ucfhealth.com for more information.