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

Hoops: Saints fall despite double-double from Green

Hoops: Saints fall despite double-double from GreenThe Christian Academy of Myrtle Beach boys basketball team suffered [more]

All-County XC: CF's Mohr, NMB's Spickler lead pack

All-County XC: CF's Mohr, NMB's Spickler lead packRunning is more than a hobby for Michael Mohr; it’s [more]

Change is name of game for North-South All-Stars

Change is name of game for North-South All-Stars The wholesale changes to the 2018 South Carolina football season [more]

Hoops: Tigers, Sharks post big wins over county rivals

Hoops: Tigers, Sharks post big wins over county rivalsThe Conway High boys remained undefeated on the season with [more]

Chants on break for finals week after loss to Terriers

Chants on break for finals week after loss to TerriersSophomore Tre Brown had a career and team-high 24 points, [more]

CAC swimmers post hot times at Snowflake Invite

CAC swimmers post hot times at Snowflake InviteThe Coastal Aquatic Club (CAC) spent the weekend in Rock [more]

Knox's triple-double lifts Seahawks past Panthers

Knox's triple-double lifts Seahawks past Panthers Myrtle Beach High sophomore Emorie Knox hit a major milestone [more]

CAC's Steele captures gold at Winter Junior Nationals

CAC's Steele captures gold at Winter Junior NationalsCarolina Forest senior and Coastal Aquatic Club standout Taylor Steele [more]

SEAHAWKS STORM PAST GREER FOR STATE TITLE

SEAHAWKS STORM PAST GREER FOR STATE TITLE Over the summer, the Myrtle Beach players were gathered inside [more]

Green Sea Floyds captures first state championship

Green Sea Floyds captures first state championshipFacing fourth down and a sneaker, Green Sea Floyds coach [more]

Hoops: Sharks beat buzzer, Warriors on late foul shots

Hoops: Sharks beat buzzer, Warriors on late foul shotsThe St. James High boys basketball team won a thriller [more]

Schools send football team to state with Seahawk Walk

Schools send football team to state with Seahawk WalkThe Myrtle Beach High football team received a hero's send-off [more]

Hoops: Myrtle Beach boys double up rival Socastee

Hoops: Myrtle Beach boys double up rival SocasteeThe Myrtle Beach High boys basketball team doubled up rival [more]

Seahawks' strange season takes a final twist to state

Seahawks' strange season takes a final twist to stateMickey Wilson has led his team to state championship games [more]

Hoops: NMB boys, CF girls fall short in comeback bids

Hoops: NMB boys, CF girls fall short in comeback bidsWhat appeared to be a pair of lopsided affairs turned [more]

MB's shot at state crown moved to Friday afternoon

MB's shot at state crown moved to Friday afternoonGame time has been moved up a day for the [more]

Socastee product Renfrow titled nation's top walk-on

Socastee product Renfrow titled nation's top walk-onThe Burlsworth Foundation announced Monday that wide receiver Hunter Renfrow [more]

Sun Belt puts 5 in bowls after inaugural title game

Sun Belt puts 5 in bowls after inaugural title gameAfter a thrilling 30-19 win by Appalachian State over Louisiana [more]

Gamecocks get close bowl trip to Charlotte vs. Cavs

Gamecocks get close bowl trip to Charlotte vs. CavsSouth Carolina football fans won't have to travel far to [more]

No. 2 Tigers in high Cotton for bowl game against Irish

No. 2 Tigers in high Cotton for bowl game against IrishThe College Football Playoff and the Goodyear Cotton Bowl announced [more]

Hoops: Conway wins; NMB gives female coach first win

Hoops: Conway wins; NMB gives female coach first winThe Conway High boys basketball team came down from its [more]

Seahawks flip the script on No. 1 Hartsville in rematch

Seahawks flip the script on No. 1 Hartsville in rematch Myrtle Beach exorcised its biggest demon from the 2018 regular [more]

Green Sea Floyds transitions from struggles to state final

Green Sea Floyds transitions from struggles to state finalAs the clock ticked toward zero, Josh Slobodiak searched for [more]

Chants go cold during key stretch, fall to Gamecocks

Chants go cold during key stretch, fall to GamecocksZac Cuthbertson recorded his fourth double-double of the season, but [more]

Gunter tops seven Chants earning Sun Belt awards

Gunter tops seven Chants earning Sun Belt awardsCoastal Carolina football had three players earn all-conference accolades and [more]

Hoops: Saints fall despite double-double from Green

Hoops: Saints fall despite double-double from GreenThe Christian Academy of Myrtle Beach boys basketball team suffered [more]

All-County XC: CF's Mohr, NMB's Spickler lead pack

All-County XC: CF's Mohr, NMB's Spickler lead packRunning is more than a hobby for Michael Mohr; it’s [more]

Leave a Reply

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

© 2018 Grand Strand Sports Report · RSS
Myrtle Beach Web Design
Kayaking in Myrtle Beach