Along with the excitement of the fall months, which heralds a new football season, comes increased activity level in sports in both the school-age athlete and the “weekend warrior.” Hopeful, these athletes will have a winning season free of injury. However, some will not be as fortunate and will be temporarily sidelined due to a knee injury.
The knee joint transmits large forces during acceleration and deceleration and changes in direction, was well as provides the needed balance for agility and support. The knee is commonly injured due to its exposed position and because of high demands upon it.
The high demands of training in sports, ironically, can also have ill effects. Several conditions are associated with over activity. Patella tendonitis and Osgood-Schlatter disease cause pain and sometimes swelling in the front aspect of the knee are are caused by forceful jumping and landing. Also causing pain in the front of the knee is the common patellofemoral syndrome. Often caused by over training or jumping and squatting drills, patellofemoral syndrome can also occur by a direct blow to the front of the knee. Most overuse injuries respond to simple measures including changes in the training regimen, anti-inflammatory medication, ice, and periods of rest.
If a direct blow occurs from the side, such as to a football player with the foot planted, or if a twisting injury occurs, a more serious problem may be present. Typically, the athlete may hear or feel a “pop,” and will experience pain and swelling, and difficulty in walking.
Other symptoms may include a sense of instability in the knee, or a feeling of locking or catching within the knee. Stiffness and loss of motion may occur. Such injuries require more immediate attention, as damage to the bone, ligament or cartilage may have occurred.
In the growing athlete, the growth plates in the bones of the knee are susceptible to injury. Once bone growth has stopped, the ligaments or supporting tissue holding the bones together are more susceptible to stretching or tearing. The anterior cruciate ligament (ACL) is a commonly injured ligament which is located within the knee joint and is one of the major stabilizers of the knee. The cartilage surface of the bone can also be damaged, as can the menisus - the crescent shaped supporting tissue within the knee.
Immediate treatment for bone, ligament or cartilage injury is immobilization, ice elevation and compression. Appropriate medical follow-up is recommended because these injuries typically require surgery to achieve optimal return of function. Physical therapy after surgery is also crucial to returning the athlete to play.
As with many areas of medicine, prevention is still the best cure. Athletes are encouraged to gradually begin a workout regimen which is sport specific. Coaches and athletic trainers are helpful in this regard. Should an injury occur, it is comforting to know that with current surgical techniques, a full recovery is the norm rather than the exception.
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