Athletic knee pain: causes and solutions from the Doctor

One of the more common areas of injury we treat in our outpatient physical therapy setting is the knee.   In this article we will discuss two types of knee pain commonly seen in athletic populations.

The first is patellofemoral dysfunction (PFD). This type of knee pain arises from a dysfunctional movement (maltracking) of the patella (kneecap) within the femoral groove it moves in.  In other words the knee cap is moving incorrectly causing repetitive micro trauma.  The pain in most cases is described as a dull ache in the front of the knee, behind or around the area of your patella.  It is commonly seen more in females than in males due mainly to anatomical predisposition.  Pain is usually reported with activity, stair negotiation, and rising from a prolonged seated position.  It is also commonly seen with repetitive landing forces and improper equipment set-up in runners and cyclists respectively. Overall, during these activities you are eccentrically loading the joint and there is a dramatic increase in joint pressure, ranging from 3-20x your bodyweight.   These pressures combined with a maltracking patella leads to a myriad of problems and subsequent pain.

PFD can be due to anatomical predisposition, muscular imbalances, decreased flexibility, limited joint mobility, training errors, or a selected combination.  An important concept to remember is that the lower extremity (i.e. your leg) is a linkage system that includes a series of joints, beginning at the foot and extending into the trunk, which in combination make possible the transmission of forces during running, jumping, kicking, throwing, cycling, and other forms of activity.  Dysfunction in any area of this linkage system may result in dysfunction and subsequent pain in another area. This means that your knee pain may be a result of a problem originating in your hip or your foot/ankle.  More importantly, there is no “one size fits all” approach to treating this condition and a thorough physical therapy evaluation will detect if there are specific components contributing to your problem.   An individualized and evidence based treatment approach should be initiated.

Another common knee condition that is commonly treated in the outpatient physical therapy setting is patellar tendinopathy (sometimes referred to as jumpers’ knee), which is a generic term used to describe conditions that affect the patellar tendon. Patellar tendinopathy occurs more frequently in skeletally mature adolescents or adults, ranging from ages 16-40 years, though not solely limited to this population.  Recent studies show equal occurrences in both males and females. Usually the condition is further described or diagnosed as a tendonitis or tendinosis, which is determined based on the stage of the injury and symptoms present.   Acute tendinitis involves an active inflammatory process, often occurring following an injury or training errors, which if treated, properly heals in 3-6 wks.  In contrast, chronic patellar tendinosis manifests itself after 6 wks-3 months and beyond as degenerative changes occur in the tendon.   At this stage there is a disorganized arrangement of tendon fibers, though there are no inflammatory cells present.  Pain is reported in the anterior aspect of the knee, below the patella (knee cap), and usually occurs with activity/exercise, ceasing with rest.  If left untreated and causative factors are not addressed, there exists the possibility of progressive weakening and subsequent tendon rupture.  A correct diagnosis is essential, in that there are differences in the treatment approach for both tendonitis and tendinosis, and a poor outcome, may be the result of incorrect treatment design, not a failure to respond to conservative treatment.  As above, these conditions can be caused by in part or whole by anatomical predisposition, muscular imbalances, decreased flexibility, and training errors and we must consider that the causative factor for your knee pain may, in fact, be somewhere else in the linkage system.

Some of the more effective treatment approaches include corrective exercise to address the suspected muscle imbalances, patellofemoral taping to unload irritated tissues and/or reposition structures, manual therapy to release any restricted tissues or joints, and recommendation of orthotics/bracing to reposition or offload certain areas.  Visit http://prsrehabservices.com/athletic-knee-pain for the full article, including depictions of some corrective exercises.

Dr. Richard DeFalco is a physical therapist with Professional Rehabilitation Services in Myrtle Beach. He is a Board Certified Orthopedic Specialist as well as a Certified Strength and Conditioning Specialist.  He treats patients of all ages and activity levels that suffer with neuromusculoskeletal disorders.  He can be contacted at 843-839-1300 for further information or to schedule a Free 15 Minute Consultation.

Comments

comments

Chants handle Vandals, score first Sun Belt win

Chants handle Vandals, score first Sun Belt winIdaho scored on the opening possession of the game but [more]

CCU men fall to Vermont; Lady Chants blast UNCW

CCU men fall to Vermont; Lady Chants blast UNCWZac Cuthbertson scored a game-high 23 points and had another [more]

Saints open season with wins, reach tourney final

Saints open season with wins, reach tourney finalThe Christian Academy of Myrtle Beach boys basketball team opened [more]

Lady Chants spike Wolves, reach Sun Belt title game

Lady Chants spike Wolves, reach Sun Belt title gameThe Coastal Carolina volleyball team is making its second straight [more]

Chiefs stumble at Stags, suffer first loss of season

Chiefs stumble at Stags, suffer first loss of season North Myrtle Beach's record-setting season came to an end Friday [more]

Chants land in Bahamas with hot hand for hoops

Chants land in Bahamas with hot hand for hoopsFour players reached double digits for Coastal Carolina in the [more]

Gamecocks bounce back, blow out UTEP in Conway

Gamecocks bounce back, blow out UTEP in ConwaySouth Carolina's debut in the Puerto Rico Classic at the [more]

Beach Ball Classic lineup has big names, top teams

Beach Ball Classic lineup has big names, top teamsThe 2017 Beach Ball Classic announced its schedule for the [more]

Coastal shuts out Mercer, advances to face Clemson

Coastal shuts out Mercer, advances to face ClemsonFrantzdy Pierrot teamed up with Martin Melchor to give the [more]

Chants go west in quest for first Sun Belt victory

Chants go west in quest for first Sun Belt victoryThe Coastal Carolina football team (1-9, 0-6 Sun Belt) will [more]

Redbirds top Gamecocks in opener of PR Tip-Off

Redbirds top Gamecocks in opener of PR Tip-OffThe South Carolina men's basketball team has home court of [more]

CCU men, women suffer narrow six-point losses

CCU men, women suffer narrow six-point lossesJaylen Shaw scored 17 points, but it was not enough [more]

CCU nets honors, enters SBC tourney as top seed

CCU nets honors, enters SBC tourney as top seedThe Sun Belt Conference announced its final weekly volleyball awards [more]

Chants win Sun Belt title, face Mercer in NCAA tilt

Chants win Sun Belt title, face Mercer in NCAA tiltCoastal Carolina men's soccer team gathered in the athletics field [more]

Golf: SJ's White inks deal; CF's Spencer closes strong

Golf: SJ's White inks deal; CF's Spencer closes strongSt. James High golfer Jordan White made her first hole-in-one [more]

Gamecocks invade Strand to compete in PR Tip-Off

Gamecocks invade Strand to compete in PR Tip-OffFresh off its first Final Four appearance, South Carolina travels [more]

Riptides Racing swimmers dive in for rare double dip

Riptides Racing swimmers dive in for rare double dipRiptides Racing team had a busy weekend with two squads [more]

Youth Soccer: BUFC, Coast claim four championships

Youth Soccer: BUFC, Coast claim four championshipsSixteen Coast  FA teams entered the Adidas Clash in Greensboro, [more]

CCU volleyball captures Sun Belt title, No. 1 seed

CCU volleyball captures Sun Belt title, No. 1 seedThe Coastal Carolina volleyball team clinched the number one overall [more]

CCU suffers ninth straight defeat to big-play Trojans

CCU suffers ninth straight defeat to big-play TrojansMarcus Jones returned the opening kickoff 91 yards for a [more]

Late goal lifts Chanticleers into Sun Belt tourney final

Late goal lifts Chanticleers into Sun Belt tourney finalFrandzty Pierrott scored the winning goal in the 82nd minute [more]

NMB holds off Crestwood, goes to Lower State semis

NMB holds off Crestwood, goes to Lower State semisThe North Myrtle Beach High had to battle to keep [more]

Seahawks stunned on final play by Lower Richland

Seahawks stunned on final play by Lower RichlandShocking! That's the only word to describe Myrtle Beach's heartbreaking [more]

Class 5A: Tigers, Panthers defeated in second round

Class 5A: Tigers, Panthers defeated in second roundThis looked like it could be the year for Conway [more]

CCU men, women open seasons with big victories

CCU men, women open seasons with big victoriesCoastal Carolina University started the 2017-18 season in strong fashion [more]

Chants handle Vandals, score first Sun Belt win

Chants handle Vandals, score first Sun Belt winIdaho scored on the opening possession of the game but [more]

CCU men fall to Vermont; Lady Chants blast UNCW

CCU men fall to Vermont; Lady Chants blast UNCWZac Cuthbertson scored a game-high 23 points and had another [more]

Leave a Reply

Your email address will not be published. Required fields are marked *

© 2017 Grand Strand Sports Report · RSS
Myrtle Beach Web Design
Kayaking in Myrtle Beach