Knee Pain and Injuries

Your knee is the connecting joint between your femur (thigh bone), tibia and fibula (shin bones), and patella (knee cap). It’s main movements are bending and straightening, but it also allows for some rotation.

It generally takes a lot of load and impact throughout our lives, particularly in athletes. These high loads, in conjunction with the twisting mechanisms involved in various sports and activities often result in it becoming commonly injured.

Here are more details of a few of the issues we deal with regularly, or you can book an appointment via the button below:

A few of the injuries or issues we treat:

• ACL strains or Tears

• MCL, LCL PCL Strains or Tears

• Meniscus Strains

• Post Surgical Rehabilitation

• Knee Osteoarthritis (OA)

• ITB Friction Syndrome

• Patellofemoral Pain Syndrome

• Patella and Quadriceps Tendinopathy (Tendonitis)

• Stress Fractures of the Femur or Tibia

• Hamstring Strains

• Runner’s or Jumper’s Knee

• General Lack of Knee Strength and Mobility

1. Knee Joint Sprains - i.e Ligament Tears

The knee relies on four main ligaments for its stability – two cruciate and two collateral ligaments.

Cruciate ligament injuries (ACL and PCL)

The Anterior Cruciate Ligament (ACL) and the Posterior Cruciate Ligament (PCL) are the main stabilisers of the knee joint.

The ACL and PCL are structures frequently injured in sports, such as AFL and netball, where there are requirements to twist and turn suddenly and jump and land, both of which can be potentially risky movements for the unprepared knee. PCL injuries can also occur when a significant force is applied to the front of a bent knee, e.g., in motor vehicle accidents or in a rugby tackle.

While some cruciate ligament tears can heal on their own, a high proportion require surgical repair to restore the knee’s stability, particularly in athletes who require a high degree of stability for their sport.

ACLs may be repaired surgically in a procedure commonly known as a knee reconstruction, where either the hamstring tendon or patella tendon is used to create a ‘new’ ACL. It is generally recommended to wait six to eight weeks post-injury to re-assess healing and determine if surgery is required, as well as begin “Prehab”, which strengthens the muscles around the knee prior to surgery and has been shown to improve the recovery process.

Correct rehabilitation after an ACL reconstruction is extremely important. Initially the focus is on managing swelling and restoring range of movement, followed by strength, balance training and control of the join.

The quality of rehabilitation and the patient’s compliance has a large impact on the effectiveness of surgical outcome. While every case is different, patients can expect to be able to return to some degree of running at approximately four months post-operatively and higher level skills such as jumping and change of direction somewhere between six to twelve months after knee reconstruction. It is worth noting that even though some people may be able to return to those activities fairly soon the graft (reconstructed ligament) is often still healing and developing between the 12 - 24 month mark.

Collateral ligament injuries (MCL and LCL)

The Medial Collateral Ligament (MCL) and Lateral Collateral Ligament (LCL) are on the inside and outside of the knee joint, respectively. Collateral ligament tears occur when force is placed on the knee causing it bend inward or outwards. If the applied force exceeds the range of the ligament, then it will result in a sprain or a tear.

MCL and LCL injuries are usually less serious than cruciate problems. Ruptures of these ligaments may still require surgery, but the more common sprains typically resolve in between 3-8 weeks, depending on severity.

Osteoarthritis

Osteoarthritis is the term used to describe the breaking down or degeneration of cartilage (the shock absorbers) beyond what the body would normally regenerate, known as chondrogenesis. There is no known specific cause, but osteoarthritis in the knees is more likely to happen in those with genetic links and people over 50, and is more common in women than men.

It is also more likely to occur after joint injury, overuse and in people with unhealthy lifestyle factors or obesity.

Is is unknown exactly what causes the pain, and is now thought to have an inflammatory factor (swelling and pain causing chemicals associated with poor health and injury). This means that even if a person were to have severely degenerated cartilage, they may still live a fairly pain free and functional life if the inflammation is less of a factor. On the flipside this may be why people with fairly clear knee joints on scans might still experience a lot of pain and disability in their knee.

Generally the treatment for knee osteoarthritis will be to improve the function, mobility and strength around the knee and control loads to a tolerable level. Living a healthy lifestyle which aims to reduce inflammation, avoid weight gain and manage pain and stress are also hugely important. Medication which helps to manage these factors may also be a necessary part of the treatment puzzle.

In some case knee replacement, or more recently partial replacement surgery may be necessary, but generally this is only recommended once all conservative treatment measures have been adequately trialed.

A few of the other injuries or issues we treat:

• Meniscus tears

• Post Surgical Rehabilitation

• Patellofemoral Pain Syndrome

• Patella and Quadriceps Tendinopathy (Tendonitis)

• Stress Fractures of the Femur or Tibia

• Hamstring Strains

• Lack of Knee Strength and Mobility

• Runner’s or Jumper’s Knee

Need to see us for your knee pain or injury? Click the button below or feel free to send us an email with your questions.
Appointments available in West Perth, Osborne Park or Joondalup.