Sports Injuries : Knee Pain
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If you've ever injured your knee, you're not alone. Knee injuries have actually become pretty common. One of the main reasons they're common is that with so many teens playing sports, knees can be overused, leading to several types of injuries, some of which can't be repaired. So what are some of these knee injuries and what can you do to prevent them?
What's in a Knee?
To understand knee injuries, first you have to understand the knee. The knee is a joint, which means it sits between the area where bones connect. It's actually the largest joint in the body. Your knees provide stability and flexibility for your body and allow your legs to bend, swivel, and straighten. The knee is made up of several body parts like bones, cartilage, muscles, ligaments, and tendons, all working as one. So when we talk about a knee injury, it could be stress or damage to any of these parts. |
Bones and Cartilage
The knee sits in the middle of three bones: the tibia (your shin bone), the femur (your thigh bone), and the patella (the knee cap). The patella is a flat, triangular bone that protects the knee joint.
The ends of the femur and the patella are covered in articular cartilage. Articular cartilage acts like a cushion and to keep the femur, patella, and tibia from grinding against each other. On the top of the tibia, extra pads of cartilage called menisci help absorb the body's weight (if you're talking about one, it's called a meniscus). Each knee has two menisci - the inside (medial) meniscus and the outside (lateral) meniscus.
Muscles
The muscles in the knee include the quadriceps, a large muscle at the front of the thigh, and the hamstring, which is located at the back of the thigh. The quadriceps muscle helps you straighten and extend your leg, and the hamstring helps you bend your knee.
Tendons and Ligaments
Several tendons and ligaments work together to help the knee move naturally.
Tendons are like cables of strong tissue that connect muscles to bones. The tendons in the knee are the quadriceps tendon and the patellar tendon. The quadriceps tendon connects to the top of the patella (kneecap) and allows you to extend your leg. The patellar tendon connects to the bottom of your kneecap and attaches to the top of the tibia (shinbone).
Ligaments are like cables of strong tissue that connect bones to bones or cartilage to bones. There are four ligaments in the knee that help connect the femur to the tibia and keep your legs stable:
- medial collateral ligament (MCL) - The MCL connects your femur to your tibia along the inside of your knee. It keeps the inner part of your knee stable and helps control the sideways motion of your knee, like keeping it from bending inward.
- lateral collateral ligament (LCL) - The LCL connects your femur to your tibia along the outside of your knee. It keeps the outer part of your knee stable and helps control the sideways motion of your knee, like keeping it from bending outward.
- anterior cruciate ligament (ACL) - The ACL connects your femur to your tibia at the center of the knee. It helps control forward motion and rotation, like keeping your shinbone from sliding out in front of your thighbone.
- posterior cruciate ligament (PCL) - The PCL connects your femur to your tibia at the back of the knee. It helps control the knee's backward motion, like keeping the shinbone from sliding out under the thighbone.
Types of Knee Injuries
Now that you know all about its working parts, you probably realize that there are a bunch of ways to injure a knee. Common causes for injuries are overuse (from repetitive motions, like in many sports), sudden stops or twists, or direct blows to the knee. Here are some of the more common injuries:
Sprains
A sprain means you've stretched or torn a ligament. Common knee sprains usually involve damage to the ACL and/or MCL. The most serious sprains involve complete tears of one or more of the knee ligaments. Symptoms of knee sprains include:
- a popping or snapping sound in the knee at the time of injury
- pain that seems to come from within the knee, especially with movement
- not being able to put any weight on that leg
- swelling
- fluid behind the kneecap
- the knee feels loose or unstable
Strains
A strain means you've partially or completely torn a muscle or tendon. With knee strains, you may feel symptoms similar to a sprain and may see bruises around the injured area.
Tendinitis
Tendinitis happens when a tendon gets irritated or inflamed. It is often caused by overuse. A person with tendinitis might have pain or tenderness when walking, or when bending, extending, or lifting a leg.
Meniscal Tears
Damage to the menisci is a really common sports injury, especially in sports where sudden changes in speed or side-to-side movements can cause them to tear. Meniscal injuries often occur together with severe sprains, especially those involving the ACL. Meniscal injuries can cause tenderness, tightness, and swelling around the front of the knee. Sometimes fluid collects around the knee (this is called effusion).
Fractures and Dislocations
A fracture is a cracked, broken, or shattered bone. You may have trouble moving that bone and it's likely there's a lot of pain. Patellar dislocation happens when the patella (the kneecap) is knocked off to the side of the knee joint, by twisting or some kind of impact. Sometimes it will go back to its normal position by itself, but usually it will need to be put back into place by a doctor. Symptoms include swelling and a lot of pain at the front of your knee. There will usually be an abnormal bulge on the side of your knee, and you may be unable to walk.
Cartilage Injuries
Sometimes a small piece of bone or cartilage softens or breaks off from the end of a bone, causing long-term knee pain. This is called osteochondritis dessicans (OCD). Symptoms of OCD include pain, swelling, an inability to extend the leg, and stiffness, catching, or popping sensations with knee movement. Treatment can include resting the knee, wearing a cast for a couple of months, and sometimes surgery in older teens. Chondromalacia happens when the cartilage in the knee joint softens because of injury, muscle weakness, or overuse, and the patella and the thighbone may rub together. This causes pain and aching, especially when a person walks up stairs or hills. Treatment may involve surgery.
Other Conditions of the Knee
Bursitis
A bursa is a sac filled with fluid located near a joint. If a bursa in the knee becomes inflamed and swollen from overuse or constant friction, it can develop into a condition called bursitis. Symptoms of bursitis in the knee include warmth, tenderness, swelling, and pain on the front of the kneecap.
Osgood-Schlatter Disease
Osgood-Schlatter disease is a painful disorder caused by repetitive stress on the front end of the tibia where the patellar tendon connects to the bone. It happens most frequently in young athletes between the ages of 10 to 15 years. Symptoms include a bump below the knee joint that's painful to the touch and is also painful with activity. Pain is relieved with rest.
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