| There are two main types of knee joint injury; acute | | | | nutrients are supplied to injured areas and the |
| and chronic. Acute injuries occur in an instant (e.g. | | | | lymphatic system can remove waste products. During |
| bone fracture) and chronic injuries (e.g. stress | | | | rehabilitation the primary focus is to regain joint and |
| fractures and tendinitis) occur over a period of time | | | | muscle flexibility (range of motion), strength, power, |
| and are usually classified as overuse injuries. Here I | | | | endurance, balance and proprioception (special |
| am mainly addressing acute injuries. They may vary in | | | | positioning and coordination of limbs) in gentle work |
| severity from mild to moderate and severe. Sprains | | | | out routines. |
| (an injury to ligaments that connect bone to bone) | | | | In the final 3 months of injury recovery the focus of |
| and strains (an injury to tendons that connect bone | | | | the conditioning stage is to reduce the risk of future |
| to muscle) may also be classified as first degree | | | | injuries by identifying the likely causes of the original |
| (least severe with mild stretching) to second degree | | | | injury (e.g. muscle imbalances, incorrect gait) and |
| and third degree (most severe with complete | | | | eliminating them in more strenuous work out routines! |
| rupture). Hence, for example, the expression knee | | | | (e.g. to restore muscle balance, improve muscle |
| strain is often used when in fact it is a knee sprain | | | | strength and flexibility). |
| because it really involves ligament damage. | | | | Whatever part of the body is injured it is important |
| The knee is stabilised and supported by four main | | | | to remember that it is part of a larger system and |
| ligaments. The medial collateral ligament (mcl) spans | | | | can never be treated in isolation. In the case of the |
| the medial side (inside) of each knee and prevents | | | | knee for example, it is stabilised and mobilised by |
| the knee joint opening up when a force is applied to | | | | both the main lower and upper leg muscles. This |
| the outside of the knee (e.g. due to a football tackle). | | | | means that leg work out routines are necessary. |
| At the centre of the knee joint are two ligaments | | | | The first priority is to regain the full knee joint range |
| that form a cross or cruciate ligament arrangement. | | | | of motion with simple bending and straightening |
| One is called the posterior cruciate ligament (pcl) and | | | | exercises followed by gentle rotations. This should be |
| the other the anterior cruciate ligament (acl). The pcl | | | | followed by slightly more intense leg stretching |
| holds the knee together from the back and the acl | | | | exercises (e.g. calves, hamstrings and quadriceps) and |
| stabilises the knee from the front. Acl knee injury is | | | | isometric exercises (e.g. pushing against a wall with |
| very common in high impact sports involving lots of | | | | the foot whilst keeping the ankle still). |
| direction changes where a foot may be | | | | Once some of the strength and flexibility has been |
| instantaneously planted on the floor and the knee | | | | regained gym machines provide a safer unsupervised |
| strongly rotated or hit (e.g. basketball, football, | | | | way of strengthening the legs (e.g. calf raises, leg |
| rugby). There is always a large demand for acl rehab | | | | curls). Alternatively a certified personal trainer can |
| and mcl recovery because of how common these | | | | provide supervised free weight exercises. |
| injuries are in sports. | | | | In the final rehabilitation stage it is necessary to |
| The menisci (medial and lateral) rest on the ends of | | | | restore the ability of the nervous system in the |
| the main lower leg bones (Tibia) and provide C | | | | injured area to control the position and function of |
| shaped energy absorbing cushions between the | | | | muscles, tendons and ligaments. Most soft tissue |
| upper leg bones (Femurs) and Tibias to reduce | | | | injuries will lead to nerve damage and the body must |
| contact friction and evenly distribute impact loads. | | | | be retrained to control balance and proprioception. |
| Meniscal tears may be caused by forceful twisting of | | | | Some of the exercises include standing on one leg |
| the knee (e.g. netball), are often associated with | | | | with/without the eyes shut and the use of specialist |
| ligament sprains and cause rough edges on the | | | | equipment such as balance disks, BOSU's and Swiss |
| previously smoothly sliding surfaces. | | | | balls. Proprioception exercises include training drills |
| There are many other forms of other knee injuries | | | | used in a client's sport (e.g. dribbling with a football) |
| as well, including Bursitis (inflammation of one of the | | | | and plyometrics (e.g. jumping, hopping, skipping, |
| fourteen fluid filled sacks in the knee area due to for | | | | bounding, figures of eight). |
| example, repetitive jumping and improper gait), | | | | With the basic leg function restored the conditioning |
| Osteochondritis Dissecans (loose cartilage becomes | | | | stage involves client specific work out routines and |
| trapped in the joint) and Patella injury (for example, | | | | the use of a certified personal trainer is |
| knee cap injury caused by tight tendons and | | | | recommended. The objective is to identify potential |
| incorrect patella positioning, patella tendinitus and | | | | causes of the injury and use specialist work out |
| cartilage damage). | | | | routines to minimise or eliminate them. This often |
| Sports injury rehabilitation begins in the first 3 days | | | | means strengthening and increasing the flexibility of |
| after the soft tissue injury. The first priority is RICER | | | | certain parts of the body and/or recommending |
| treatment. This stands for Rest, Ice, Compression, | | | | lifestyle changes (e.g. being more active, eating more |
| Elevation and immediate Referral to an injury | | | | healthily, wearing foot insoles). |
| specialist to establish the exact nature of the injury | | | | Much of this approach also applies to knee surgery |
| and recommend initial treatment. | | | | recovery but it is essential to ensure that for |
| For the next 3 weeks rehabilitation consists of 2 | | | | example, a personal trainer works in close conjunction |
| important elements. The first is managing the | | | | with the medical care provider (e.g. injury consultant) |
| formation of scar tissue with a physiotherapist and | | | | to ensure that the specific needs of an individual's |
| the second is to restore the function of the legs by | | | | situation are taken into consideration. |
| being active. Being active will ensure that oxygen and | | | | |