Traumatic Knee Injuries
By Tomás Ryan BSc.AHS, Ph.Th. MIAPT, Registered Physical Therapist based in Clonmel & Thurles
Traumatic Knee Injuries that occur in sport most commonly occur during a non-contact landing, or twisting and turning motion. The pain is often severe with the Athlete having different grades of discomfort. The most important step is that the injury is correctly diagnosed, as only then will the appropriate treatment and rehabilitation program commence. Correct Diagnosis will determine the need for an MRI scan or surgery.
Important Injury History Details to Help Knee Injury Diagnosis
Was the injury caused by contact or non-contact twisting & turning or Landing Action
Did you play on after injury? If so, how long did you play on for?
Did you hear a pop or a crack noise from the knee
Did the swelling appear immediately or did it come on later or a number of days?
Have you felt any subsequent popping noise or ‘Giving Way’ feeling in the knee afterwards?
Patient needs to define ‘Giving Way’ sensation, such as is there a feeling of ‘Giving Way’ when changing direction, which would indicate an Anterior Cruciate Ligament Injury. Or alternatively is there ‘Giving Way’ in a straight line when walking which would indicate common quadriceps insufficiency, swelling and knee weakness after a knee injury. The above points will help indicate the severity of the injury and if the Patient needs to travel for an x-ray.
Types of trauma Knee Injuries
Medial Meniscus – very common, pain & tenderness along inside joint line
Medial Collateral Ligament – trauma injury of varying grades of severity, characterised by inside joint line pain and instability
Articular Cartilage – pain along the joint line, swelling, lack of movement, diagnosed best by a process of eliminating the other injuries.
Anterior Cruciate Ligament & Patella Dislocation – pain, heavy swelling and instability
Lateral Collateral Ligament and Lateral Meniscus – located on outside area of knee joint – rarely injured.
If the knee has swollen a lot after an acute traumatic non-contact or contact injury, then there is possibly bleeding into the joint, which is known as Hemarthrosis. If Hemarthrosis is present, then only 3 injuries to the knee are suspected; a) Anterior Cruciate Ligament Tear because of the rich blood supply into the ligament, b) a Patella (Knee Cap) c) Dislocation or a possible fracture. If the swelling is milder and comes on overtime then if indicates a different type of knee injury such as meniscus, cartilage tear or collateral ligament rupture.
Tomás Ryan is a Registered Physical Therapist with The Irish Association of Physical Therapy (MIAPT) and is based in Clonmel & Thurles. Email: tomaspryan@gmail.com, Contact Number: 0504 26672
