Once the Juvenile athlete begins to experience knee pain, then the amount of sports activity during the week should be reduced to sports every 2nd day. This weekly sports load is then assessed to see if knee pain decreases or stays the same. If knee pain decreases over a 4 week period then an exercise knee strengthening program coupled with this reduced sports weekly activity that contains rest days is used to treat knee pain. Completely stopping sport is advisable only when the pain is sudden and severe with a locking sensation suggesting issues such as a Patella Sleeve fracture or Osteochondritis Dissecans as outlined in last week’s article. Exercises should be performed 3 times per week coupled with reduced sport activity. If there is good adherence to the exercises by the Juvenile, then there is a greater chance of overcoming the knee pain.
Reduce Sports Activity Load
Use a pain scale of 1-10 to rate their knee pain as criteria for training with severe pain rated as 10/10 and extremely mild pain rated as 1/10. If the pain scale is less than 3/10 then they can train. If the pain increases greater than 3/10 then they should have a short rest. If reducing the juvenile’s training days has helped reduce their knee pain, then the concept of managing their training load with shorter training sessions or less frequent training for example every 2nd day can be introduced. When knee pain improves, the frequency of training can be gradually increased to greater than every 2nd day.
What Treatment & Exercises are Beneficial?
In Juvenile Knee pain, the gluteal muscles are commonly found to be weak; hence strengthening exercises should initially be focused on strengthening the glutes. Once positive results have been achieved with these 3 exercises, then more specific knee strengthening can then begin. Taping of the patella (knee cap) can help reduce knee pain, by removing the patella impingement from the sensitive fat pad and also taping can be used to help limit knee extension and thus reduce patella tendon load when walking. Juveniles should avoid sitting with knees bent and feet tucked underneath chair in order to reduce compression and irritation at the patella femoral joint. Finally, it important to assess other contributing factors such as a poor knee angle or a dropped pelvis caused by carrying a school bag on a single shoulder.
Tomás Ryan is a Registered Physical Therapist with The Irish Association of Physical Therapy (MIAPT) and is based in Thurles. Contact Number: 0504 26672
Share on Facebook
Share on Twitter
Injury Solutions Clinic
Physiotherapy & Injury Rehabilitation Clinic in Tipperary