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Knee Injuries & Education

Knee Injuries & Education

The knee joint has an important role in ambulation (walking and running) and is specifically designed to hinge and move in a forward, not backward orientation. It is the largest joint in the body and is comprised of 4 bones, Femur (thigh bone), Tibia (shin bone), Fibula (small outside shin bone) and Patella (floating knee cap). Articular cartilage coats the ends of the bones and is designed to absorb shock and friction forces. Ligaments provide stability to a joint by attaching bone to bone. Muscles also provide stability but are responsible for moving the limbs and providing power to the joint.

OSGOOD-SCHLATTERS

OSGOOD-SCHLATTERS
Definition: Though it's one of the most common causes of knee pain in adolescents, it's not really a disease but rather an overuse injury. Although it can be quite painful, it will usually resolve within 12 to 24 months. Osgood-Schlatter disease (OSD) is an inflammation of the bone, cartilage, and/or tendon at the top of the shinbone (tibia), where the tendon from the kneecap (patella) attaches. Most often only one knee is affected.
Function:The function of the bony protuberance of the shin bone (below the knee) is to provide a place for the attachment of the patella tendon (which comes from the thigh muscles and knee cap).
Mechanism of Injury

OSD is an overuse of the patella tendon causing stress to the attachment site. This leads to a 'bump' on the shin just below the knee.

Signs & Symptoms

• Swelling and or tenderness on the shin bone just below the knee
• Pain that worsens with exercise
• Limping after exercise
• Tightness of the muscles surrounding the knee

Causes

Teens increase their risk for OSD if they play sports involving running, twisting, and jumping, such as basketball, football, volleyball, soccer, tennis, figure skating, and gymnastics. Doctors disagree about the mechanics that cause the injury but agree that adolecent growth spurts, overuse and physical stress are involved.

Pedorthic Treatments

Custom made Orthotics can be an effective method to reduce your knee discomfort as they are designed to redistribute and load the foot in a different way in order to decrease stress on the knee structures. Pedorthists use interventions such as supporting your medial/inside arch to reduce internal rotation of the tibia/shin bone. Proper footwear is also pivotal to your recovery. Footwear that is properly fitted to encourage proper function of the shin bone may be helpful. Talk to your Pedorthist about proper footwear choices for you.

Other Treatment

•Resting, or avoiding activity
• Physiotherapy for stretching of tight structures
• Braces to disperse load at the patella and/or tendon
• Knee pads

ILIOTIBIAL BAND FRICTION
SYNDROME

ILIOTIBIAL BAND FRICTION
SYNDROME
Definition:Iliotibial Band Friction Syndrome (ITBS) is considered an overuse syndrome, often referred to as runners knee. The Iliotibial band is a long strong band of connective tissue that starts at the pelvis, runs over the hip and inserts just below the outside of the knee.
Function:The job of the Iliotibial band is to help stabilize the knee and hip during the motion of walking or running.
Mechanism of Injury

With repeated flexion and extension (bend and straighten) of the knee, the Iliotibial band can rub on the outside of the knee which causes friction, causing the band to become inflammed.

Signs & Symptoms

ITBFS creates a burning or aching pain, usually within 10 minutes of exercise, on the outside of the knee and can be tender if you apply pressure to the area.

Causes

• A rapid increase in the training/running.
• Running on uneven surfaces or excessive downhill running.
• Excessive intoeing (pigeon toed).
• Bow legs.
• Overpronation (ankles rolling inward towards the ground)
• Leg length discrepancy (one leg shorter than the other).
• Overworn footwear - running/walking on uneven or angled surfaces

Pedorthic Treatments

Custom made Orthotics can be an effective method to help reduce friction on the Iliotibial Band. They are able to correct biomechanical impairments and redistribute the load to the foot in a different way in order to decrease the pull and friction on the Iliotibial Band. Proper footwear is also essential to your recovery. Talk to your Pedorthist about proper footwear choices for you.

Other Treatment

• HEAT/ICE: heat 10-15 minutes on the hip area and ice on the outer knee to reduce swelling.
• OTHER TREATMENT may include pain medication, physiotherapy, massage therapy and cupping, kinesiotaping and foam roller therapy.

KNEE OA

KNEE OA
Definition:Known as the 'wear and tear' arthritis...Osteoarthritis (OA) is a slow progressive degenerative disease in which the joint cartilage and underlying bone gradually wears away. In severe cases when the joint cartilage (tough material that covers and protects the ends of bones) has worn away, the thickened bone ends rub against each other (bone on bone). This results in a deformity of the joint and normal activity becomes painful and difficult.
Mechanism of Injury

The exact cause of OA is unknown, joint damage can be due to repetitive movement (also known as 'wear and tear') or the result of an injury. Arthritis is the erosion of the cartilage, the part of the joint that covers the ends of the bones. Cartilage acts as a shock absorber and allows the joint to move smoothly. As cartilage breaks down, the ends of the bones thicken and the joint may lose its normal shape. With further cartilage breakdown, the ends of the bones may begin to rub together, causing pain.

Signs & Symptoms

• Pain and/or swelling which is often worse in the morning
• Stiffness or swelling in the joint making it difficult to straighten/bend knee
• Increased pain after activity such as walking, stair climbing, kneeling, and sitting for prolonged periods
• Muscle weakness around the joint

Causes

• More common as we age
• Family history of OA
• Previous injury of the knee
• Repeated stress on the joint such as heavy physical activity
• Being overweight

Pedorthic Treatments

Custom made Orthotics can be an effective method to help reduce forces in the painful area and unload the damaged knee joint. Proper footwear is also essential to your recovery. Talk to your Pedorthist about proper footwear choices for you.

Other Treatment

• Physiotherapy
• Knee bracing
• Viscosupplementation
• Surgical intervention in extreme cases

PFPS

PFPS
Definition:Patellofemoral Pain Syndrome (PFPS) is the most common cause of general knee pain. It characteristically causes pain in and around the knee cap.
Function:The knee cap (patella) is a small triangular bone in the front of your knee that is designed to move and glide with the knee as it flexes. It glides up and down along a groove at the end of your thigh bone (femur) and gives the front thigh muscles (quadriceps) more leverage when straightening the leg. The patella also acts as a 'bumper' to protect the other bones in the knee from falls and collision
Mechanism of Injury

PFPS is generally caused by an abnormality of the knee cap (patella). The patella is designed to glide and track in its groove over the lower end of the thigh bone (femur). When PFPS occurs, there can be an 'off-kilter' tracking of the knee cap causing the underside of the patella to grate and become irritated leading to inflammation and pain.

Signs & Symptoms

• Most common symptom is a dull ache underneath and around knee cap especially while walking downstairs, squatting, or getting up from a prolonged seated position
• May also feel like it 'catches' when bending the knee
• May experience painful 'grinding' or 'creaking' sensations

Causes

• Females are at greater risk than males in general due to having wider hips
• Flat feet/overpronated feet
• Knock kneed (genu valgum)
• Overuse or improper training
• Weak glutes and imbalanced thigh muscles

Pedorthic Treatments

Custom made Orthotics can be an effective method to properly orient the tibia/shin bone. They are able to correct biomechanical impairments and redistribute the load to the foot in a different way in order to decrease the stress on the knee complex. Proper footwear is also essential to your recovery. Talk to your Pedorthist about proper footwear choices for you.

Other Treatment

• Physiotherapy
• Bracing
• Taping techniques

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