What have I done?…
Acute Knee injuries are one of the most common injuries that are experienced on the sporting field. There are many structures that can be damaged, including the ligaments (both collateral and cruciate), the meniscus and the patella. Normally the knee will be injured by forcibly twisting when the foot is kept planted. The amount of force required to cause injury sometimes does not have to be very large. Usually the knee will swell considerably, become very painful, and range of motion will become restricted.’Clicking’, ‘giving way’ and ‘locking’ are common symptoms. To determine the exact area of damage, your Physiotherapist will perform a number of specific special tests on your knee. However, for an accurate diagnosis, the swelling and pain may have to subside somewhat first, as too many false positives (where everything hurts!) may occur early on. If severe, it may be appropriate to undergo an MRI scan to determine the exact cause of the injury and the most appropriate action. A referral by your doctor to an orthopaedic surgeon is necessary prior to having an MRI scan Kine Antwerpen.
So what does my Diagnosis actually mean?
The Cruciates: Anterior & Posterior Cruciate Ligaments The basis for treatment depends mainly upon what structure has been damaged. If the Anterior Cruciate Ligament (or ACL) is torn, as many footballers and netballers suffer, then surgical reconstruction of the ligament will likely result in the best outcome. This to some extent depends on your goals for recovery, your age and how physically active you are now and intend on being in the future. The Posterior Cruciate Ligament (or PCL) is less of a concern as the quadriceps muscle is perfectly positioned to compensate for any injury to the PCL. Rarely is surgery required and with 6 weeks of progressive rehabilitation, an athlete can expect to be back to near full fitness. The Meniscus Meniscal Injuries involving the cartilage discs within your knee are the most common injury and their treatment depends on how severe the injury is. If not severe, then there is a good chance that your symptoms will respond to conservative management under the guidance of your Physiotherapist. Strengthening and dynamic control work is essential.
What Do I Need to Do?
STAGE 1: ACUTE MANAGEMENT (1- 3 DAYS) Rest: Try not to take too much weight through the knee initially. For severe cases, crutches may be required.
Ice: Early & Often for 24 hours; 15-20 minutes every 2-4 hours. Compression: Bandage or taping to control swelling for 48 hours.
Elevation: Above waist height to assist in oedema control. Seek treatment. Correct diagnosis and EARLY management will often be the difference between an optimum and a poor recovery. Avoid alcohol, heat or heavy massage.
What Next?
STAGE 2: SUB-ACUTE MANAGEMENT (3-14 DAYS) Where range of motion begins to return, strength training begins and walking becomes easier. Progress off crutches as advised by your Physiotherapist. This stage will see the Physiotherapist use their manual therapy skills, with a primary goal to return Range of Motion. The Physiotherapist will prescribe exercises aimed at maintaining the strength of your muscles in different areas – and if appropriate, begin strength training about the knee.
STAGE 3: RETURN TO FUNCTION (14 DAYS – 21 DAYS) Range of motion is restored, strength training progresses, walking returns to normal. The patient now becomes more of a driver of the treatment, with a strong emphasis on exercise rehabilitation to ensure optimal return to function. However, it will be important to ensure that the rehabilitation program is closely monitored, so as not to aggravate the knee. At this stage, it is also important to ensure that muscle balance of the lower limb is maintained to ensure that secondary complications are avoided.
STAGE 4: RETURN TO SPORT (3-6 WEEKS) A return to sport will be partly dictated by the extent and nature of the injury. Your knee will be required to pass certain ‘fitness’ tests, much the same as what footballers do, before being allowed to resume training. Your Physiotherapist will guide you through this process and specify when and what you can do at training. Returning before your knee is capable of withstanding the demands of sport can be disastrous.
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