Knee Pain

Patellofemoral pain

What is it:

Patellofemoral pain syndrome (PFPS), also known as runner’s knee, is pain experienced in the knee that affects 1 in 4 of all people at some point in their life. It is considered an overuse injury, where the patella is not sliding normally and smoothly over the knee joint when moving the knee. This can cause irritation of the knee joint, damage to the articular cartilage, inflammation and pain.

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Causes/risk factors:

  • Imbalances of the muscles that connect to the knee. Usually the medial muscles in the thigh are weaker and the lateral muscles are stronger, this results in the patella tracking more laterally.
  • Overuse and increase of training
  • Trauma to the knee
  • Poor footwear
  • Sport that requires excessive jumping and knee bending
  • Poor alignment of the lower limbs

Signs & Symptoms:

  • Pain around and behind the kneecap
  • Inflammation (warmth, redness, swelling)
  • Pain after activity
  • Pain when walking upstairs, jumping, running or when patella changes position.
  • Pain after prolonged sitting

Self-management:

  • Rest, Ice, Elevate and compress to settle the pain
  • Climbing, squatting, sharp change of direction and jumping should be avoided.
  • Low impact activity such as swimming and biking as alternative activity

Podiatry treatment:

  • Stretching and strengthening program
  • Strapping
  • Footwear assessment and advice
  • Activity modification
  • Orthotics therapy to address any biomechanical abnormalities

 

Anterior cruciate ligament (ACL) injury

What is it?

The anterior cruciate ligament (ACL) is an important structure that is found in the knee. It is found in the middle of the knee and runs diagonally to connect the shin bone (tibia) and the thigh bone (femur). The ACL’s main function is to prevent excessive forward motion of the shin bone (tibia). The ACL also helps stabilise the knee through a variety of different movements. Injury to the ACL is very common and can range from a sprain, partial tear or complete tear.

Common causes/risk factors:
ACL injuries are typically caused in high impact sports that require a quick change of direction such as soccer and netball.
* Direct trauma
* Rapid change of direction
* Incorrect landing technique after jumping
* Over extending the knee
* Females
* Ligamentous laxity
* Previously torn ACLs
* Sudden deceleration

Symptoms:
* A ‘popping’ sound can typically be heard when rupturing the ACL
* Feeling of instability or knee giving way
* Swelling
* Severe pain and inability to continue activity
* Reduced range of motion

Treatment:
* It is important to apply the RICE concept (rest, ice, compression, elevate) when the injury first occurs. This is to help relieve some of the pain and swelling associated.
* Seeing a physiotherapist or GP is important to access if there is a rupture or significant tear. This will involve an ultrasound, x-ray or MRI to confirm the diagnosis.
* Knee brace
* Surgery may be required if ruptured or significantly teared.

Podiatry treatment:
* Rebuild strength in the knee and surrounding muscles
* Increase range of motion
* Orthotic therapy to control the motion of the foot and leg which affects knee positioning
* Brace fitting
* Footwear advice