Specific Knee Injury Diseases and Conditions List
Common knee problems. Runners Knee Iliotibial Band Friction Syndrome. Patellar Tendonitis (Jumper’s Knee).Goosefoot (Pes Anserine) Bursitis of the Knee. Tendonitis and Treatment. Meniscus injury. Meniscal Tears. Meniscus Tears and Treatment. Symptoms of Knee Injury.Knee Ligament Injury. Medial Collateral Ligament (MCL), Anterior Curciate Ligament (ACL), Posterior Cruciate Ligament (PCL). Lateral Collateral Ligament (LCL). Ligament Injury and Treatment. Knee injury Diseases and Conditions, Chondromalacia, Pellegrini-Stieda syndrome, Baker cyst, Arthritis
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The knee and what is its function?
The knee is a joint which has three parts. The thigh bone (femur) meets the large shin bone (tibia) forming the main knee joint. This joint has an inner (medial) and an outer (lateral) compartment. The kneecap (patella) joins the femur to form a third joint, called the patellofemoral joint.
The knee is a joint which has three parts. The thigh bone (femur) meets the large shin bone (tibia) forming the main knee joint. This joint has an inner (medial) and an outer (lateral) compartment. The kneecap (patella) joins the femur to form a third joint, called the patellofemoral joint.
The knee joint is surrounded by a joint capsule with ligaments strapping the inside and outside of the joint (collateral ligaments) as well as crossing within the joint (cruciate ligaments). These ligaments provide stability and strength to the knee joint.
The meniscus is a thickened cartilage pad between the two joints formed by the femur and tibia. The meniscus acts as a smooth surface for the joint to move on. The knee joint is surrounded by fluid-filled sacs called bursae, which serve as gliding surfaces that reduce friction of the tendons. Below the kneecap, there is a large tendon (patellar tendon) which attaches to the front of the tibia bone. There are large blood vessels passing through the area behind the knee (referred to as the popliteal space). The large muscles of the thigh move the knee. In the front of the thigh, the quadriceps muscles extend the knee joint. In the back of the thigh, the hamstring muscles flex the knee. The knee also rotates slightly under guidance of specific muscles of the thigh.
The knee functions to allow movement of the leg and is critical to normal walking. The knee flexes normally to a maximum of 120 degrees and extends to 0 degrees. The bursae, or fluid-filled sacs, serve as gliding surfaces for the tendons to reduce the force of friction as these tendons move. The knee is a weight-bearing joint. Each meniscus serves to evenly load the surface during weight-bearing and also aids in disbursing joint fluid for joint lubrication.
Knee Pain
Knee pain can be caused by injury, degeneration, arthritis, infrequently infection, and rarely bone tumours. The knee joint is the most commonly involved joint in rheumatic diseases, immune diseases that affect various tissues of the body including the joints to cause arthritis.
Ligaments within the knee (cruciate ligaments) and on the inner and outer sides of the knee (collateral ligaments) can be sprained or torn.
Surgical repair of ligament injury can involve suturing, grafting, and synthetic graft repair. Routine x-rays do not reveal ligament or meniscus tears, but can be used to exclude other problems of the bones and other tissues.
Injury and Symptoms
Injury can affect any of the ligaments, bursae, or tendons surrounding the knee joint. Injury can also affect the ligaments, cartilage, menisci (plural for meniscus), and bones forming the joint. The design of the knee joint and that it is an active weight-bearing joint are factors in making the knee one of the most injured joints of the human body.
(View our Cold Laser Therapy section under conditions treated).
Ligament Injury and Treatment
Trauma can cause a severe injury to the ligaments on the inner (medial) portion of the knee, the outer (lateral) portion of the knee (lateral collateral ligament), or within the knee (cruciate ligaments). Injuries to these areas are noticed as immediate knee pain, but are difficult to localize. A collateral ligament injury is felt on the inner or outer portion of the knee. A collateral ligament injury is tenderness over and around the area of the ligament involved. A cruciate ligament injury is felt within the knee. It is sometimes noticed with a “popping” sensation with the initial trauma. A ligament injury to the knee is painful and may be swollen the knee pain is usually worsened by bending the knee, putting weight on the knee, or even walking. The severity of the injury can vary from minor stretching or tearing of the ligament, such as a sprain to severe and complete tear of the ligament the knee can have more than one area injured in a single traumatic event.
Ligament injuries are initially treated with ice packs and immobilization, with rest and elevation. It is generally initially recommended to avoid bearing weight on the injured joint, and crutches may be required for walking. Some patients are placed in splints or braces to immobilize the joint to decrease pain and promote healing. Arthroscopic or open surgery may be necessary to repair severe injuries.
(View our Cold Laser Therapy section under conditions treated)
Meniscus Tears and Treatment
The meniscus can be torn with the shearing forces of rotation that are applied to the knee during sharp, rapid motions. This is especially common in sports such as football and other rapid motion activities. There is a higher incidence with aging and degeneration of the underlying cartilage. Several tears can be present in an individual meniscus. A meniscal tear may have a rapid onset of a popping sensation with a certain activity or movement of the knee. Occasionally, it is associated with swelling in the knee It is also associated with locking or an unstable sensation in the knee joint. X-rays while they do not reveal a meniscal tear can be used to exclude other problems of the knee. The meniscal tear can be diagnosed in one of three ways: arthroscopy, arthrography, or an MRI. Arthroscopy is a surgical technique by which a small diameter video camera is inserted through tiny incisions on the sides of the knee for the purposes of examining and repairing internal knee joint problems. Micro instruments can be used during arthroscopy to repair the torn meniscus.
(View Cold Laser Therapy section under conditions treated)
Arthrography is a radiology technique whereby a contrast liquid is directly injected into the knee joint and internal structures of the knee joint thereby become visible on x-ray film. An MRI scan is another radiology technique whereby magnetic fields and a computer combine to produce two- or three-dimensional images of the internal structures of the body. It does not use x-rays, and can give accurate information about the internal structures of the knee when considering a surgical intervention. Meniscal tears are often visible using an MRI scanner. MRI scans have largely replaced arthrography in diagnosing meniscal tears of the knee. Meniscal tears are generally repaired arthroscopically.
(View Cold Laser Therapy section under conditions treated).
Tendonitis and Treatment
Knee Pain and tendonitis of the knee occurs in the front of the knee below the kneecap at the patellar tendon (patellar tendonitis) or in the back of the knee at the popliteal tendon (popliteal tendonitis). Tendonitis is an inflammation of the tendon, which often occurs by a strain or impacted sport such as jumping. Patellar tendonitis also has the name “jumper’s knee.” Tendonitis is diagnosed based on the presence of pain and tenderness localized to the tendon. It is treated with ice packs, and cold laser therapy {see our cold laser section} cortisone injections, which can be given for tendonitis elsewhere, are generally avoided in patellar tendonitis because there are reports of risk of tendon rupture as a result of corticosteroids in this area. In severe cases, surgery can be required. A rupture of the tendon below or above the kneecap can occur. This may lead to bleeding within the knee joint and severe pain with knee movement. Surgery of the ruptured tendon is often necessary.
(View our Cold Laser Therapy section under Conditions treated).
Diseases or Conditions
Diseases or conditions that involve the knee joint, the soft tissues and bones surrounding the knee, or the nerves that supply sensation to the knee area can result in knee pain. In fact, the knee joint is the most commonly affected joint in rheumatic diseases, immune diseases that involve various tissues of the body including the joints to cause arthritis.
Arthritis.
Arthritis is inflammation within a joint. The causes of knee joint inflammation range from types of arthritis such as osteoarthritis, which is a degeneration, or wear and tear, of the cartilage of the knee, to inflammatory types of arthritis (such as rheumatoid arthritis or gout). Treatment of the arthritis is directed according to the nature of the specific type with cold laser being one of the most effective types of treatment in managing the inflammation.
Baker cyst
Baker cyst is another common cause of pain at the back of the knee resulting from swelling of the knee joint from arthritis leading to a localized collection of fluid accumulating in a cyst behind the knee.
Tumours
Tumours and Infections of the bone or joint can rarely be a serious cause of knee pain and have associated signs of infection including fever, extreme heat, warmth of the joint, chills of the body, and may be associated with puncture wounds in the area around the knee.
Pellegrini-Stieda syndrome
Pellegrini-Stieda syndrome is a calcification of the collateral ligament on the inside of the knee joint. With this condition, the knee can become inflamed and can be treated conservatively with ice packs, immobilization, and rest. Infrequently, it requires a local injection of corticosteroids.
Chondromalacia
Chondromalacia refers to a softening of the cartilage under the kneecap (patella). It is a common cause of deep knee pain and stiffness in young women and can be associated with pain and stiffness after prolonged sitting or climbing stairs. Treatment with anti-inflammatory medications, ice packs and rest may help. (See our Cold Laser Therapy Section under Inflammatory conditions.). Bursitis of the knee occurs on the inside of the knee (anserine bursitis) and the front of the kneecap (patellar bursitis, or commonly known as “housemaid’s knee”). Bursitis is generally treated with ice packs, immobilization, and anti-inflammatory medications or Cold laser therapy.
(View our Cold Laser Therapy section under inflammatory conditions.)
TOG GaitScan™
Our GaitScan™ System is a revolutionary diagnostic tool for assessing patient’s foot biomechanics. GaitScan™ has an industry high 4096 sensors and scans at an industry high 300Hz (scans per second). These measurements provide today’s Chiropractors with a sophisticated explanation of foot mechanics and assists them with orthotic and/or shoe solutions.
Orthotics are custom made shoe inserts designed to correct faulty foot biomechanics. Orthotics may be helpful in relieving your knee pain by reducing stress and strain through the knee joint.
Knee ligaments; Knee Pain, Sports Injuries. Cold Laser Treatment.
Knee Ligaments Medial Collateral, Anterior Curciate, Posterior Cruciate, Lateral Collateral Ligaments
View our Cold laser section for treatment for these injuries, under inflammatory conditions in our ”Treatments” section. Cold Laser Therapy accelerates the healing process, thus saving time and returning to your sport sooner than you normally would if you had taken normal medication. World class athletes and the military use this method of reducing both pain and injury time
Ligaments connect one bone to another within the joins and contribute stability and flexibility of the joint.
Medial Collateral Ligament.
This ligament is on the one on the inside of the knee and is taut when the leg is straight. The ligament itself is strong but can be sprained or completely ruptured by simultaneous twisting and straightening of the leg.
Anterior Cruciate Ligament.
The anterior cruciate ligament or ACL runs from the outside of the back of the thigh bone to the inside of the front or anterior of the shin bone. The two cruciate ligaments cross over each other; the ACL crosses in front of the Posterior Cruciate Ligament. Together they stabilize the front to back movements of the knee.
The ACL is half the strength of your Medial Collateral Ligament (MCL). This ligament is the most likely knee ligament to be injured during sporting activities.
Posterior Cruciate Ligament.
The Posterior Cruciate Ligament or PCL starts from the inside edge of your thigh bone and inserts to the back or posterior aspect of your shin bone.
Lateral Collateral Ligament.
The Lateral Collateral Ligament or LCL runs from the bottom of the thigh bone to the top of the shin bone on the outside of knee joint.
Other Soft Tissue Injuries.
The soft tissues around the knee can also be injured.
Sports that involve twisting of the upper leg while the foot is planted on the floor may lead to a tear of the meniscus. The menisci are two crescent shaped discs of shock absorbing cartilage located between the bones of knee joint.
The patellar tendon is also known as the patellar ligament, and connects the kneecap to the thigh muscle. If the knee is bent too far back, this tendon may also tear.
Symptoms of Knee Injuries
The symptoms for most ligament injuries will be similar, these include:
· Pain
· swelling
· Instability
Complete rupture of the ACL, may cause a popping sound which in turn may lead to a snap inside the knee, as if the knee has given way.
Meniscus Injury will cause pain on either inside or outside of the knee joint. This will bring on swelling, the knee may lock or feel as if it’s catching or grinding.
Damage to the patellar tendon means the leg will be unable to straighten properly. This will then lead to knee pain, swelling and weakness.
Causes of Knee Injuries
If the knee receives an impact or a movement exceeding its usual range of movement, for example if you have a fall or land awkwardly this may result in such an injury.
· sports combining running, jumping and stopping with quick change
Of direction such as football rugby, tennis etc.
· pre-existing condition such as osteoarthritis.
· impact of the knee or Knees on the dashboard in a car accident will result in PCL damage and is called the “dashboard injury”.
Diagnosis of Knee Injuries
Chiropractors or Physiotherapists will examine the knee, only then will various tests will be undertaken to establish which ligament is injured.
MCL injuries: Chiropractors or Physiotherapists will find out how badly the ligament is damaged by testing the range of movement by moving the lower leg outwards while holding your upper leg still. There are three grades of knee injury.
· Grade 1 is a sprain.
· Grade 2 is a partial tear
· Grade 3 is a complete tear
ACL integrity is tested by a chiropractor, by pulling the lower leg forward with the thigh held still and the leg bent.
If a Chiropractor suspect’s injury to a PCL, they will check the range of movement in the knee and lower leg. X-rays are valuable in diagnosis of this particular injury.
There are four major ligaments in the knee: the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL) and two collateral ligaments. These ligaments work together to stabilize the knee during motion. The most commonly injured ligament is the anterior cruciate ligament with tears occurring on twisting or sporting activities such as netball, basketball, tennis and football. This ligament can also get injured as a result of direct blow to the knee such as those that occur in football or rugby.
An ACL tear usually occurs suddenly and is often accompanied by a “popping” sound. The tera will be accompanied by swelling of the joint that can last up to 1 hour. The movement of the knee will also be uncomfortable and joint would feel unstable. Physical examination performed by chiropractor would usually confirm the diagnosis. Magnetic resonance image (MRI) scan can also be used. In case of complete tears, the anterior cruciate ligament cannot repair itself and thus the ligament function is lost.
Meniscus injuries
There are two menisci in each knee. The menisci are the cartilages shaped like a crescent and positioned between thigh bone (femur) and knee bone (tibia). The menisci function as shock absorbers and stabilizers of the knee joint. The meniscus on the inside of the knee is medial meniscus and the outside of the knee is called lateral meniscus. The medial meniscus absorbs some of the load around 25% in the inner compartment and the lateral meniscus absorbs around half of the load in the outer compartment.
Meniscal Tears
The meniscal tear usually occurs when menisci are trapped between the moving bones of the femur and tibia. The menisci cartilage only gets blood supply to the outer third of the outer zone thus limiting ability to heal if torn. Most tears occur in the centre of the meniscus because this is the part of the meniscus that gets trapped between the moving bones. These inner tears and many of the outer tears do not heal.
Symptoms
Pain on the inside of the joint or behind the joint is the most common symptom of a meniscal tear. Meniscal tear can also be accompanied by catching and occasionally locking of the joint. Swelling always means there is something wrong inside the knee and is commonly associated with meniscal tears.
Knee Pain
Knee ligament injuries for further in depth information on knee pain and injury, please go to top left corner under “Pain” or “Conditions” and for Cold Laser Therapy please go to “Treatments”.
